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[1]
["Were you interviewed in person or over the phone?",{"$nulls":5},"□ IN PERSON",null,"□  BY PHONE"]
[{"$nulls":6},"(Go to Question 2a)",null,"(Go to Question 2b)"]
[]
["2a"]
["For interviews conducted in person:"]
[null,"Was the Investigator dressed professionally and well groomed?",{"$nulls":4},"□ YES",null,"□  NO"]
[]
[null,"Did the Investigator show you credentials and introduce himself/herself"]
[null,"as a Special Agent or Investigator with the U.S. Office of Personnel Management?",{"$nulls":4},"□ YES",null,"□  NO"]
[]
[null,"Were you interviewed in private?",{"$nulls":4},"□ YES",null,"□  NO"]
[null,"If \"NO\", please explain:_________________________________________________"]
[]
[]
[]
["2b"]
["For interviews conducted by phone:"]
[null,"Did the Investigator introduce himself/herself as a Special Agent or Investigator"]
[" ","with the U.S. Office of Personnel Management?",{"$nulls":4},"□ YES",null,"□  NO"]
[]
[null,"Please check the reason for the telephone interview:"]
[]
["□  MY REQUEST            □  INVESTIGATOR'S REQUEST             □  NO REASON GIVEN"]
[]
[]
[3]
["Was the Investigator polite and professional?",{"$nulls":5},"□ YES",null,"□ NO"]
[]
[]
[4]
["Did the Investigator explain that the interview was for employment or security clearance purposes?",{"$nulls":5},"□ YES",null,"□ NO"]
[]
[]
[5]
["Were questions presented in a clear manner so that they could be understood easily?",{"$nulls":5},"□ YES",null,"□ NO"]
[]
[]
[6]
["The information you provided about the person being investigated (check one)…",{"$nulls":5},"□ ...was favorable.",null,"□...included issues"]
[{"$nulls":8},"      or concerns."]
["If you told the Investigator about concerns regarding the person being investigated, briefly identify those concerns below:"]
["(For example--criminal conduct, illegal drug use, alcohol abuse, violent behavior, foreign travel)"]
[]
["     CONCERNS:"]
[]
[]
[7]
["Please provide any additional comments or concerns you have about the interview, the investigation, or the investigator. "]
{"$rows_empty":9}
["Is it necessary for a representative from OPM to contact you?",{"$nulls":5},"□ YES",null,"□ NO"]
[]
[]
[8]
["Signature:________________________________________________  Date:_____________________________"]
[]
["               Please provide your contact information: "]
["Daytime telephone number:   (           )  ________ - ____________"]
["Email address:__________________________________________"]

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["Signature:__________________________________________  Date:_____________________________"]
[]
["               Please provide you daytime telephone number:  (      )  ________  -  ____________"]

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