E-Gov Post-Entitlement Survey

Generic Clearance of Customer Satisfaction Surveys

E-gov PE Survey Form - Representative Payees

E-Gov Post-Entitlement Survey

OMB: 0960-0526

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E-gov Postentitlement Survey - Representative Payees


Prior to beginning the survey, the interviewer will reiterate the purpose of the survey already described in the prenotice letter that will be sent to all participants. They will explain that the sampled person should answer all questions in his/her capacity as a representative payee.


Right now Social Security permits representative payees to use certain types of automated telephone and Internet services when they do business on behalf of the people they receive benefits for. Social Security would like to find out how interested representative payees would be in having more automated telephone and Internet services available to them.


Interviewers will ask participants if they would like to hear the Paperwork Reduction Act statement again. If so, they will read the following:


Paperwork Reduction Act Statement

This information collection meets the requirements of 44 U.S.C. § 3507, as amended by Section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we have a valid Office of Management and Budget control number: The OMB control number for this survey is 0960-0526. We estimate that it will take about 15 minutes to complete this survey. This includes the time it will take to listen to the questions and give your responses. You may send comments on our time estimate above to: Social Security Administration, 1338 Annex Building, Baltimore, MD 21235-0001. Send only comments relating to our time estimate to this address.


  1. If you were able to, how likely would you be to use automated telephone services to handle Social Security business for the beneficiary you represent? Would you be:


(Read rating scale. Select only one response.)

a. Very likely (Skip to Q3.)

b. Somewhat likely (Skip to Q3.)

c. Not very likely, or

d. Not at all likely

e. Don’t know/don’t remember (Skip to Q8.)


  1. Why do you feel that way? (All responders to Q2 skip to Q8.)


(Do not read responses. Select all that apply.)

a. Might have questions I want to talk to someone about

b. Automated telephone services are too hard to use, confusing, hard to follow, etc.

c. Takes too long to get through it; tedious

d. Options don’t fit my situation; don’t have what I need

e. Not confident that the action will be processed

f. Don’t like dealing with automated services; just prefer dealing with a person

g. Personal circumstance like limited education, hearing/speech problem, limited English skills, or other communication issue

h. Other (Explain.)

i. Don’t know/don’t remember


  1. I’m going to read a short list of some different kinds of business you might have in the future as a representative payee for Social Security benefits. As I read each one, please tell me how likely you would be to use an automated telephone service to complete this type of business? First, if you needed to report a change of address or telephone number, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use an automated telephone service

e. Don’t know/don’t remember


  1. If you needed to report direct deposit information, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use an automated telephone service

e. Don’t know/don’t remember


  1. If you needed to report that you didn’t receive the beneficiary’s monthly benefit, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use an automated telephone service

e. Don’t know/don’t remember


  1. If you needed to give personal information to get a replacement Social Security card, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use an automated telephone service

e. Don’t know/don’t remember


  1. If you needed to complete the annual accounting showing how you used the benefits you received as a representative payee, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use an automated telephone service

e. Don’t know/don’t remember


  1. Next, Social Security would like to know how much experience you have doing business electronically. Do you currently use the Internet?


(Do not read responses. Select only one response.)

a. Yes

b. No (Skip to Q29.)

c. Don’t know/don’t remember (Skip to Q29.)


  1. How would you rate your level of experience using the Internet? Are you:


(Read rating scale. Select only one response.)

a. Very experienced

b. Somewhat experienced

c. Somewhat inexperienced, or

d. Not at all experienced

e. Don’t know/don’t remember


  1. Where do you access the Internet?


(Read responses. Select only one response.)

a. Only at home

b. Only at work

c. Both at home and at work, or

d. Only somewhere else (Explain.)

e. Don’t know/don’t remember


  1. Have you ever visited Social Security’s Internet website?


(Do not read responses. Select only one response.)

a. Yes

b. No

c. Don’t know/don’t remember


  1. In general, how likely would you be to do business as a representative payee on Social Security’s Internet website? Would you be:


(Read rating scale. Select only one response.)

a. Very likely (Skip to Q14.)

b. Somewhat likely (Skip to Q14.)

c. Not very likely, or

d. Not at all likely

e. Don’t know/don’t remember (Skip to Q29.)


  1. Why do you feel that way? (All responders to Q13 skip to Q29.)


(Do not read responses. Select all that apply.)

a. Might have questions I want to talk to someone about

b. Internet services are too hard to use, confusing, hard to follow, etc.

c. Not confident that the action will be processed

d. My own lack of experience with computers/Internet

e. Problems with my computer or Internet connection

f. Concerned about the security of my information online

g. Don’t do business on the Internet; just prefer dealing with a person

h. Personal circumstance like limited education, hearing/speech problem, limited English skills, or other communication issue

i. Other (Explain.)

j. Don’t know/don’t remember


  1. Social Security is interested in finding out what types of services people might be comfortable using on the Internet. I’m going to read a short list of some different kinds of business you might have in the future as a representative payee for Social Security benefits. As I read each one, please tell me how likely you would be to use this type of Internet service if it were available on Social Security’s website? First, if you needed to report a change of address or telephone number for the beneficiary, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use the Internet

e. Don’t know/don’t remember


  1. If you needed to report direct deposit information, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use the Internet

e. Don’t know/don’t remember


  1. If you needed to give personal information to get a replacement Social Security card, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use the Internet

e. Don’t know/don’t remember


  1. If you needed to complete the annual accounting showing how you used the benefits you received as a representative payee, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely to use the Internet

e. Don’t know/don’t remember


  1. If you needed to request a statement showing the amount of the beneficiary’s monthly Social Security benefit, would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or (Skip to Q20.)

d. Not at all likely to use the Internet (Skip to Q20.)

e. Don’t know/don’t remember (Skip to Q20.)


  1. Right now if you use Social Security’s website to request a statement showing the amount of the beneficiary’s monthly benefit, the information is not displayed on your computer screen and the statement is mailed to you. Some people think it would be more convenient to be able to get the statement right away. Knowing that Social Security would only display the information after they verified your identity, how comfortable would you be having the information shown on your computer screen and printing your own statement? Would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. There are several services Social Security is considering adding to help people use its Website to do business. If you needed help while using Social Security’s website, please tell me how likely you would be to use each of the following methods. First, how likely would you be to use Instant Messaging to get help with Social Security’s website? Would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely

e. Don’t know/don’t remember


  1. How likely would you be to use a special email address to get help with Social Security’s website? Would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely

e. Don’t know/don’t remember


  1. How likely would you be to use a special toll-free number to get help with Social Security’s website? Would you be:


(Read rating scale. Select only one response.)

a. Very likely

b. Somewhat likely

c. Not very likely, or

d. Not at all likely

e. Don’t know/don’t remember


  1. When people do business electronically, Social Security verifies their identity to protect the privacy of their records. Social Security would like to know how comfortable people are entering different kinds of personal information to verify their identity. If asked to enter information already in your Social Security record, such as your date and place of birth, would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. If asked to enter your driver’s license number, would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. If asked to enter your credit card number, would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. When you do business electronically, the personal information you enter has to be checked to verify your identity. If Social Security matched your personal information against their own records, would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. If Social Security matched your personal information against records from other government agencies like Motor Vehicles, would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. If Social Security matched your personal information against records from private companies like banks, would you feel:


(Read rating scale. Select only one response.)

a. Very comfortable

b. Somewhat comfortable

c. Somewhat uncomfortable, or

d. Very uncomfortable

e. Don’t know/don’t remember


  1. For their final question today, Social Security would like to know a little more about you. What is the highest grade you completed in school?


(Do not read responses. Select only one response. If responder is reluctant to give information, offer to read ranges.)

a. Less than high school graduate

b. High school graduate

c. Some college

d. Trade/technical/vocational training

e. College graduate

f. Graduate degree or postgraduate training

g. Don’t know/don’t remember


(End survey by thanking the person for participating.)


File Typeapplication/msword
File TitleRepresentative Payee Survey
Authordpse
Last Modified ByFaye
File Modified2006-09-15
File Created2006-06-26

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