DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Document Code 

FM-SP-DILG-07-09
CSS Data Sheet  
Rev. No.  Eff. Date  Page 
00  02.01.23   of 1 1
Office: DILG COTABATO PROVINCE
Procedure Title/Service Provided: PROCESSING AND PAYMENT OF CLAIMS
Covered Period: February 1-28 2023

CITIZEN'S CHARTER
DEMOGRAPHIC QUESTIONS (CC) QUESTIONS SERVICE QUALITY DIMENSION (SQD) QUESTIONS CLIENT INFORMATION
DATE
DOCUMENT DATE CSS
NO. RELEASED/S FORM Overall Access & FREE RESPONSE
ERVICE RECEIVED Client Type Age Gender CC1 CC2 CC3 Responsiveness Reliability Communication Costs Integrity Assurance Outcome
Satisfaction Facilities Name Email Address Contact Number
RENDERED (SQD0) (SQD1) (SQD2) (SQD3) (SQD4) (SQD5) (SQD6) (SQD7) (SQD8)

1
2
3
4
5
6
7
8
9
nth

Prepared By  Noted By 

   

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