Thank you for taking the time to come and fill out this quick and simple customer survey.

Survey
	Please enter the survey code provided on your letter.
	Please answer Yes or No to the following:
	Do you own any cars, trucks motorcycles or motor homes not shown on your coverage summary?	Yes No
	Have you sold or purchased a vehicle this past year and failed to notify us?	Yes No
	Do you often drive vehicles owned by others, including an employer's vehicle?	Yes No
	Do you ever use your vehicle for business reasons?	Yes No
	Do any of your vehicles have custom equipment?	Yes No
	Do you ever rent cars?	Yes No
	Do you have any questions about your insurance coverage?	Yes No

	Please answer the following based on your customer service experience:	Very Satisfied	Somewhat Satisfied	Fairly Satisfied	Very Dissatisfied	Completely Dissatisfied

	Overall, how satisfied are you with the insurance service you receive from us?	5 4 3 2 1
	Does the Charter staff give you the information that you need?	5 4 3 2 1
	Is the Charter staff friendly and professional?	5 4 3 2 1
	Are we prompt in meeting your needs?	5 4 3 2 1
	Did you recently speak with someone directly from Charter?	Yes No
	Were you satisfied with the timeliness and accuracy of the representative helping you?	5 4 3 2 1

	What can CHARTER INSURANCE SERVICES do to serve you better?
	Is there anything you would like to say to The President of Charter Insurance?

	Would you like us to contact you with more information about any of our Banking, Mortgage, Insurance or Financing products or services? (Please check all products or services you want further information on.)
	Personal Insurance (Life or Health) Credit or ATM cards Commercial Insurance CD's, Money Market Checking Accounts Individual Retirement Account (IRA) Savings Account Consumer Loans (Home Equity, etc.) Commercial Checking Account Construction Loan Home Mortgage Commercial Loan Lot Loans Commercial Real Estate and Mortgage Loan Stock, Bond, Mutual Funds
	Thank you for choosing Charter Insurance Services as your insurance provider!

About You
	Optional Information Please complete if you wish to receive more information or would like a response.
	First Name:
	Last Name:
	Phone Number:
	Email:
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	How do you prefer that we contact you? Please Select Email Phone Mail
	Disclaimer-Any coverage change requested on this survey/check-up is not bound or covered until the request is verbally requested and confirmed by the insured and the agency.