ice.disa.mil
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https://ice.disa.mil/index.cfm?fa=card&s=683&sp=128709&dep=%2aDoD
Submission: On January 17 via manual from US — Scanned from DE
Submission: On January 17 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST index.cfm
<form action="index.cfm" method="post" id="comment_card" onsubmit="return allowSubmit(this.form);" autocomplete="off">
<input type="hidden" name="fa" value="add_card">
<input type="hidden" name="card_id" value="83757">
<input type="hidden" name="csrf_token" value="072EA4ECCDC6A78F473714F371B71630D21981B9">
<input type="hidden" name="service_provider_id" value="128709">
<input type="hidden" name="site_id" value="683">
<input type="hidden" name="timeleness_question_id" value="q_110024" id="timeleness_question_id">
<input type="hidden" name="unit_question_id" value="unit_110024" id="unit_question_id">
<section title="Questions" style="background: white; font-size:.9em; margin-bottom: 0px; margin-left: 0px; padding:0 10px 0 10px; line-height:1; font-family: verdana;">
<table cellspacing="0" cellpadding="0" style=" width:100%; margin: 0px 0 0 0; padding:0px; ">
<tbody>
<tr>
<td>
<table width="100%" style="border-top:none; border-left:none; border-right: none;">
<tbody>
<tr height="25">
<td width="40%" align="baseline"> </td>
<td align="center" valign="middle" width="10%">Yes </td>
<td align="center" valign="middle" width="10%">No </td>
<td align="center" valign="middle" width="10%">N/A</td>
<td align="center" valign="middle" width="30%"> </td>
</tr>
</tbody>
</table>
<fieldset title="Were you satisfied with your overall experience?" style=" border: none;">
<table style="width:100%; cellpadding:5px 0 5px 0px; border:none;" border="0" cellspacing="0">
<tbody>
<tr height="25px" bgcolor="EAEAEA">
<td style="font-size : auto;padding:7px;font-style : bold; line-height: 1.3;font-weight : lighter; width: inherit; height:25; ">
<div id="o_43" style="font-weight:500; border:none;">Were you satisfied with your overall experience?</div>
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_43-Yes" style=" display: none;">Yes</label> <input type="radio" id="q_43-Yes" name="q_43" title="Yes" value="1">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_43-No" style=" display: none;">No</label> <input type="radio" id="q_43-No" name="q_43" title="No" value="0">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_43-N/A" style=" display: none;">N/A</label> <input type="radio" id="q_43-N/A" name="q_43" title="N/A" value="" checked="">
</td>
<td align="center" valign="middle" width="30%"> </td>
</tr>
</tbody>
</table>
</fieldset>
</td>
</tr>
</tbody>
</table>
<br><br>
<table cellspacing="0" cellpadding="0" style=" width:100%; margin: 0px 0 0 0; padding:0px; ">
<tbody>
<tr>
<td>
<fieldset title="Please select from the drop down box the site these comments refer to" style=" border: none;">
<table style="width:100%; cellpadding:5px 0 5px 0px; border:none;" border="0" cellspacing="0">
<tbody>
<tr height="25px" bgcolor="EAEAEA">
<td style="font-size : auto;padding:7px;font-style : bold; line-height: 1.3;font-weight : lighter; width: inherit; height:25; ">
<div id="o_172773" style="font-weight:500; border:none;">Please select from the drop down box the site these comments refer to</div>
</td>
<td align="left" width="60%" style=" padding-left: 5px;">
<select id="q_172773" style=" font-size: larger;" name="q_172773">
<optgroup label="Please select from the drop down box the site these comments refer to">
<option value="1"> Aberdeen </option>
<option value="2"> Anchorage </option>
<option value="3"> Anniston </option>
<option value="4"> Aviano </option>
<option value="5"> Bagram </option>
<option value="6"> Barstow </option>
<option value="7"> Benning </option>
<option value="8"> Bliss </option>
<option value="9"> Bragg </option>
<option value="10"> Campbell </option>
<option value="11"> Cape Canaveral </option>
<option value="12"> Cherry Point </option>
<option value="13"> Colorado Springs </option>
<option value="14"> Columbus </option>
<option value="15"> Corpus Christi </option>
<option value="16"> Crane </option>
<option value="17"> Djibouti </option>
<option value="18"> Drum </option>
<option value="19"> Duluth </option>
<option value="20"> Dyess </option>
<option value="21"> Eglin </option>
<option value="22"> Ellsworth </option>
<option value="23"> Fairbanks </option>
<option value="24"> Fairchild </option>
<option value="25"> Germersheim </option>
<option value="26"> Gimcheon (Korea) </option>
<option value="27"> Gordon </option>
<option value="28"> Grafenwoehr </option>
<option value="29"> Great Falls </option>
<option value="30"> Great Lakes </option>
<option value="31"> Groton </option>
<option value="32"> Guam </option>
<option value="33"> Hill </option>
<option value="34"> Holloman </option>
<option value="35"> Hood </option>
<option value="36"> Huntsville </option>
<option value="37"> Incirlik </option>
<option value="38"> Iwakuni </option>
<option value="39"> Jackson </option>
<option value="40"> Jacksonville </option>
<option value="41"> Kaiserslautern </option>
<option value="42"> Kandahar </option>
<option value="43"> Keesler </option>
<option value="44"> Kirtland </option>
<option value="45"> Knox </option>
<option value="46"> Kuwait (Arifjan) </option>
<option value="47"> LeJeune </option>
<option value="48"> Letterkenny </option>
<option value="49"> Lewis </option>
<option value="50"> Little Rock </option>
<option value="51"> Livorno </option>
<option value="52"> Meade </option>
<option value="53"> Minot </option>
<option value="54"> Misawa </option>
<option value="55"> Molesworth </option>
<option value="56"> Naples </option>
<option value="57"> Nellis </option>
<option value="58"> Norfolk </option>
<option value="59"> Offutt </option>
<option value="60"> Okinawa </option>
<option value="61"> Pearl Harbor (Hawaii) </option>
<option value="62"> Pendleton </option>
<option value="63"> Polk </option>
<option value="64"> Port Hueneme </option>
<option value="65"> Portsmouth-Pease </option>
<option value="66"> Puerto Rico </option>
<option value="67"> Red River </option>
<option value="68"> Richmond </option>
<option value="69"> Riley </option>
<option value="70"> Rock Island </option>
<option value="71"> Rota </option>
<option value="72"> Sagami </option>
<option value="73"> San Antonio </option>
<option value="74"> San Diego </option>
<option value="75"> Scott </option>
<option value="76"> Sierra </option>
<option value="77"> Sigonella </option>
<option value="78"> Sill </option>
<option value="79"> Sparta </option>
<option value="80"> St Juliens </option>
<option value="81"> Stewart </option>
<option value="82"> Susquehanna </option>
<option value="83"> Tobyhanna </option>
<option value="84"> San Joaquin </option>
<option value="85"> Travis </option>
<option value="86"> Tucson </option>
<option value="87"> Vandenburg </option>
<option value="88"> Vicenza </option>
<option value="89"> Warner Robins </option>
<option value="90"> Wright Patterson </option>
<option value="91"> Yuma </option>
<option value="92"> HQ Battle Creek </option>
<option value="93"> LESO </option>
<option value="94"> Other (please specify in comments) </option>
<option value="95"> If site is not listed please specify in comments </option>
<option value="" selected=""> N/A </option>
</optgroup>
</select>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset title="Which DLA Disposition Services personnel are you rating today" style=" border: none;">
<table style="width:100%; cellpadding:5px 0 5px 0px; border:none;" border="0" cellspacing="0">
<tbody>
<tr height="25px" bgcolor="dododo">
<td style="font-size : auto;padding:7px;font-style : bold; line-height: 1.3;font-weight : lighter; width: inherit; height:25; ">
<div id="o_124028" style="font-weight:500; border:none;">Which DLA Disposition Services personnel are you rating today</div>
</td>
<td align="left" width="60%" style=" padding-left: 5px;">
<select id="q_124028" style=" font-size: larger;" name="q_124028">
<optgroup label="Which DLA Disposition Services personnel are you rating today">
<option value="1"> HQ Battle Creek, MI </option>
<option value="2"> Field Location </option>
<option value="3"> Both </option>
<option value="" selected=""> N/A </option>
</optgroup>
</select>
</td>
</tr>
</tbody>
</table>
</fieldset>
<table width="100%" style="border-top:none; border-left:none; border-right: none;">
<tbody>
<tr height="40">
<td width="40%" align="baseline"> </td>
<td align="center" valign="bottom" width="10%">Business Card QR Code</td>
<td align="center" valign="bottom" width="10%">Website Link</td>
<td align="center" valign="bottom" width="10%">Email Link</td>
<td align="center" valign="bottom" width="10%">Direct URL</td>
<td align="center" valign="bottom" width="10%">Other</td>
<td align="center" valign="bottom" width="10%">N/A</td>
</tr>
</tbody>
</table>
<fieldset title="How did you access this survey?" style=" border: none;">
<table style="width:100%; cellpadding:5px 0 5px 0px; border:none;" border="0" cellspacing="0">
<tbody>
<tr height="25px" bgcolor="EAEAEA">
<td style="font-size : auto;padding:7px;font-style : bold; line-height: 1.3;font-weight : lighter; width: inherit; height:25; ">
<div id="o_199504" style="font-weight:500; border:none;">How did you access this survey?</div>
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_199504-Business Card QR Code" style=" display: none;">Business Card QR Code</label> <input type="radio" id="q_199504-Business Card QR Code" name="q_199504" title="Business Card QR Code"
value="1">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_199504-Website Link" style=" display: none;">Website Link</label> <input type="radio" id="q_199504-Website Link" name="q_199504" title="Website Link" value="2">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_199504-Email Link" style=" display: none;">Email Link</label> <input type="radio" id="q_199504-Email Link" name="q_199504" title="Email Link" value="3">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_199504-Direct URL" style=" display: none;">Direct URL</label> <input type="radio" id="q_199504-Direct URL" name="q_199504" title="Direct URL" value="4">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_199504-Other" style=" display: none;">Other</label> <input type="radio" id="q_199504-Other" name="q_199504" title="Other" value="5">
</td>
<td align="center" valign="middle" style="padding-top: 5px;" width="10%">
<label for="q_199504-N/A" style=" display: none;">N/A</label> <input type="radio" id="q_199504-N/A" name="q_199504" title="N/A" value="" checked="">
</td>
</tr>
</tbody>
</table>
</fieldset>
</td>
</tr>
</tbody>
</table>
<br><br>
</section>
<input type="hidden" name="question_list" value="q_43,q_172773,q_124028,q_199504">
<input type="hidden" id="text_to_validate" name="text_to_validate" value="comments">
<section style=" background-color:#FFFFFF; padding: 10px; border-bottom:solid silver thin; margin-bottom: 0px; margin-left: 0px; title=" provide="" comments,="" contact="" information,="" submit="" card="" button"="">
<section style=" background-color:#F3F3F3; font-size:1em; margin-left: 0px; line-height:1.2; letter-spacing:1.2; font-family: verdana;">
<div style="margin:0 20px 20px 20px; ">
<span style="font-size:1em; line-height:2; font-family: sans-serif;"><label for="comments"> Comments & Recommendations for Improvement:</label></span>
<textarea class="std_textarea" name="comments" pattern="^[a-zA-Z0-9\-\s\,\(\)\/\&\'\_]*$" style="font-family: sans-serif; width: 99%;" wrap="virtual" id="comments" maxlength="4000" onkeyup="countChar(this.form)"
onchange="clear_msg(this.form)" onblur="validateText(this.form)"
placeholder="CAUTION: Do NOT enter sensitive or personally identifying information in this text field. By providing comment information in the text comment box, you are acknowledging that the information provided may be reviewed throughout the organization to which the comment was submitted and possibly at higher organization levels within the ICE system."></textarea>
<span style="font-size:1em; float:right; margin-right:10px;"><span id="chr_cnt">0</span>/4000</span><br>
</div>
<br>
<div style="margin: 0 0 0 6%;">
<input type="Checkbox" class="lg_checkbox" name="responseRequested" value="1" id="responseRequested" onclick="allowSubmit(this.form)"> <label for="responseRequested">Request a Response</label>
<br><br>
<div style="valign: bottom; padding-left:15px;font-size:small;"> *If you would like a response, please check the Request a Response checkbox above and enter your contact information below. </div>
</div>
<br><br>
<div align="center" style="margin: 0 0 0 5%; padding-right: 1px;">
<table style=" line-height: 2; padding-left: 0; width:90%; " cellspacing="5px">
<tbody>
<tr>
<td>
<label for="customer">Name: </label><span id="name_opt" style="font-size:.8em; "> (optional)</span><br>
<input type="text" name="customer" pattern="^[a-zA-Z0-9\.\ ]*$" title="Letters only" size="30" maxlength="75" id="customer" class="lg_input" style=" height: 26px;"><span id="name_msg" style="font-size:16pt; color:red;"> </span><br>
</td>
<td>
<label for="phone">Phone:</label><span id="phone_opt" style="font-size:.8em; "> (optional)</span><br>
<input type="tel" name="phone" size="30" maxlength="50" id="phone" title="555-5555 or (555)5555555 or 5555555555" class="lg_input" style=" height: 26px;" pattern="^[0-9\-\(\)]{7,16}$" placeholder=""
onfocus="clear_msg(this.form)"><span id="phone_msg" style="font-size:16pt; color:red;"> </span><br>
</td>
</tr>
<tr>
<td>
<label for="email">Email: </label><span id="email_opt" style="font-size:.8em;"> (optional)</span><br>
<input type="email" name="email" size="30" maxlength="100" id="email" title="your.name@test.mil" class="lg_input" style=" height: 26px;" onfocus="clear_msg(this.form)" placeholder=""><span id="email_msg"
style="font-size:16pt; color:red;"> </span><br>
</td>
<td>
<label for="reference">Reference Number:</label><span id="ref_opt" style="font-size:.8em;"> (optional)</span><br>
<input type="text" name="reference" size="30" maxlength="75" id="reference" title="Ticket or Request number" class="lg_input" style=" height: 26px; " pattern="^[0-9a-zA-Z\-\s]*$"><span id="ref_msg" style="font-size:16pt; color:red;">
</span><br>
</td>
</tr>
</tbody>
</table>
</div>
<br><br>
<p style="font-size:.75em; max-height:999px; font-family:sans-serif; padding: 15px;">
<b>Agency Disclosure Notice:</b>The public reporting burden for this collection of information, OMB 0704-0420, is estimated to average 3 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services,
at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if
it does not display a currently valid OMB control number.
</p>
<br>
<div align="center">
<input type="hidden" name="dep" value="DoD">
<span style="margin-left:1%;" id="message_holder" class="warning"> </span><br><br>
<input type="image" src="/images/buttons/submit_300.png" title="Submit Card" height="70" width="300" name="fa_add_card" id="add_card" alt="Submit Comment Card">
<br><br><br><br>
</div>
<div>
<br><br>
<p align="center" style=" line-height: 1.5; font-size: 1.2em; max-height: 999px; width:90%; margin-left:5%;"> "Thank you for taking the time to complete this comment card. Your opinions are very important to us."<br><br>
</p>
<br> <br>
</div>
</section>
</section>
</form>Text Content
* HOME * About ICE * FAQ * Webmaster * Manager Login (CAC required) Home » DLA Disposition Services » Service Providers » Comment Card GENERAL CUSTOMER COMMENTS OMB 0704-0420, expires 30 Apr 2024 RCS DD-CMO(AR)2124, expires 30 APR 2026 GENERAL CUSTOMER COMMENTS COMMENT CARD COVID-19 (coronavirus) related information SHOULD NOT be submitted to services on ICE unless it is directly related to the service the customer received. General COVID-19 related feedback should be directed to resources outside of the ICE system that are dedicated to receive such info. Please use this form to pass along any comments regarding either a specific employee or field location. Simply fill in your feedback in the "COMMENTS & RECOMMENDATIONS FOR IMPROVEMENT" text box below We look forward to hearing from you. Privacy Advisory: If all fields are completed, this form contains personally identifiable information and is protected in accordance with the Privacy Act of 1974, as amended, DoD 5400.11-R and DoD Privacy Program. Yes No N/A Were you satisfied with your overall experience? Yes No N/A Please select from the drop down box the site these comments refer to Aberdeen Anchorage Anniston Aviano Bagram Barstow Benning Bliss Bragg Campbell Cape Canaveral Cherry Point Colorado Springs Columbus Corpus Christi Crane Djibouti Drum Duluth Dyess Eglin Ellsworth Fairbanks Fairchild Germersheim Gimcheon (Korea) Gordon Grafenwoehr Great Falls Great Lakes Groton Guam Hill Holloman Hood Huntsville Incirlik Iwakuni Jackson Jacksonville Kaiserslautern Kandahar Keesler Kirtland Knox Kuwait (Arifjan) LeJeune Letterkenny Lewis Little Rock Livorno Meade Minot Misawa Molesworth Naples Nellis Norfolk Offutt Okinawa Pearl Harbor (Hawaii) Pendleton Polk Port Hueneme Portsmouth-Pease Puerto Rico Red River Richmond Riley Rock Island Rota Sagami San Antonio San Diego Scott Sierra Sigonella Sill Sparta St Juliens Stewart Susquehanna Tobyhanna San Joaquin Travis Tucson Vandenburg Vicenza Warner Robins Wright Patterson Yuma HQ Battle Creek LESO Other (please specify in comments) If site is not listed please specify in comments N/A Which DLA Disposition Services personnel are you rating today HQ Battle Creek, MI Field Location Both N/A Business Card QR Code Website Link Email Link Direct URL Other N/A How did you access this survey? Business Card QR Code Website Link Email Link Direct URL Other N/A Comments & Recommendations for Improvement: 0/4000 Request a Response *If you would like a response, please check the Request a Response checkbox above and enter your contact information below. Name: (optional) Phone: (optional) Email: (optional) Reference Number: (optional) Agency Disclosure Notice:The public reporting burden for this collection of information, OMB 0704-0420, is estimated to average 3 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. "Thank you for taking the time to complete this comment card. Your opinions are very important to us." * Intended Usage Advisory * Accessibility Statement * External Link Disclaimer * Privacy and Security Notice * No FEAR Act * Freedom of Information Act * Section 508 * USA.gov * Department of Defense * The White House * GSA