Satisfaction Survey

Please complete the following questions so that we can better serve you and the City of Independence

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Note: all inputs are required

† Contact via:

Phone

Email

Either

† Full Name

† Email

Address

City State Zip

† Phone

† Reason for Visit:

Pay Taxes

Passport Application

Permit - Building & Zoning

Shelter or Senior Center Rental

Police Related Issue

Other

If Other, please specify

Regarding your visit

† Was the City employee knowledgeable?

Yes

No

† Was the City employee Felpful and Courteous?

Yes

No

† If your visit was not directly related to City of Independence business, did they offer guidance on who to contact?

Yes

No

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