REPUBLIC OF THE PHILIPPINES DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT (DILG) CUSTOMER SATISFACTION SURVEY FORM PENNA ee DD Barangay Officials Death Benefit Assistance | [I Payment of Clatms (BoDBA) Certificate of No Pending Case Certification of Compliance to Full Disclosure Pol- | (1 Vehicular Support Handling of Complaints Details of the Complaints: icy (FDP) 1 Authority to LGUs to Purchase Vehicles Department Authority to Travel Abroad certification of ncumbency of Local Officials Certification of Service Rendered by Local/Baran- say Officials for application for CSC Bligbiity C Certifiation and Certificate of Accreditation to Civil Society Organizations Posting of Information on the DILG Website CG Status Report on Accomplishment of Major Deliv- cerables of Priority Programs and Projects Ci thers (Please specify) SURVEY MODE: in Person (i Electronics Dear Client (Minamahal naming Kiiyente), We at DILG-BLGS endeavors to consistently provide effective and efficient services to meet our client's needs. In this regard, may we request you to help us improve our serviees by allowing us to hear your voice, (Kami sa DILG-BLGS ay lubos na nagsistkap upang patulay na magbigay ng epektibo at mataas na kalidad na serbisyo teang motugunan eng mga pangangailangan ng aming mga klyente. So bagay na ito, aming hiniiling na kami ay jong matulungan sa paculay na pagpapabuti ng aming mga serbisyo sa pamamagitan ng pag-papaalam sa amin ng inyong mga saloobin,) “Kindly ill-up this survey form and reflect your impressions about our services and let us know your experience while transacting official business with us. Shade the rating that corresponds to your satisfaction level and/or write your cobservations/comments. (Kung maarilamang pong pakipunan tong Sarbey atilahad ang inyong masasabi sa aming narbigay na serbisyo.kiman ‘ang bilog na katumbas ng numero na tutugma sa inyong antas ng kasivahan.) RATING SCALE 5 Very High 4 High 3 Moderate 2Low 1 Very Low (Napakataas) (Matas) (Katamtaman) (Mababa) (Napakababa) |A. SERVICE PARAMETER s 4 3 2 1 1. Service Quality (Kalidad ng Serbisyo) coeceeer 2, Service Timeliness (Pagkamaagap sa Serbisyo) c ceer 3, Staff Responsiveness (Pagtugon) el te fo [e. [B, OVERALL IMPRESSION (PANGKALAHATANG IMPRESYON) 5 Very High 4 High 3 Moderate row @ eyes (Napakataas) (Matas) (Katarmtaman) (Mababa) (Napakababa) c c c c c c. SUGGESTION FOR IMPROVEMENT (MGA MUNGKAHI AT OBSERBASYON PARA SA PAGPAPABUTI NG SER BISvO) Address: Date Accomplished: Name of Client: emda emi tt aed th eo oes hy ed errr (jor DUS mage pasion ag grey Anne pan aon ug sy in ay aan pane deny in okay angsmsgmezenr hare oo)