Form FSR 231 FSR 231 SSA Retirement Estimator

Model Instance Name:

red & strike-through: DELETE

SSA Retirement Estimator

underlined & italicized: RE-ORDER

MID:

pink: ADDITION

Date:

7/16/2008

blue + -->: REWORDING

violet (bold): SKIP-LOGIC

SSA Retirement Estimator CUSTOM QUESTION LIST

QID

Skip Logic Label

Question Text

Answer Choices (limited to 50 characters)

Type (select from list)

Single or Multi

Required Y/N

How did you first learn about the Retirement Estimator?

Search engine

Radio Button One Up Vertical

Single

Y

Types

Linked from another website

Open-ended

From an SSA representative

Text Field – limited to 100 characters

SSA publication

Text Area – no character limit

From my Annual Social Security Statement

Dropdown (Select-one)

Newspaper, magazine or other media

Radio Button One Up Vertical

My employer or Human Resources department

Radio Button Two Up Vertical

My financial advisor

Radio Button Three Up Vertical

Word of mouth

Radio Button Scale Has Don’t Know

Other [ specify ]

Radio Button Scale No Don’t Know

From where are you accessing the Retirement Estimator?

Home

Radio Button One Up Vertical

Single

Y

Checkbox One Up Vertical

Work

Checkbox Two Up Vertical

Financial Planner's office

Checkbox Three Up Vertical

Friend or relative's home

Select-multiple Show Two

Other [specify]

Select-multiple Show Three

Which of the following best describes you?

Individual/self

Radio Button One Up Vertical

Single

Y

Select-multiple Show Four

Employer (e.g., Human Resources Department)

Financial Advisor

Service Agency or Organization (e.g., AARP, Council on Aging, government agency, non-profit organization, etc.)

Other [ specify

When do you expect to file for retirement benefits?

Within 12 months

Radio Button One Up Vertical

Single

Y

1 to 3 years

More than 3 but less than 6 years

More than 6 years

Not applicable

How do you plan to file for retirement benefits?

I prefer to file my retirement application online

Radio Button One Up Vertical

Single

Y

By telephone interview

Face-to-face in my local SSA field office

Online with telephone or in-person assistance, if needed

Not applicable

Did you accomplish your primary purpose in using the Retirement Estimator?

Yes

Radio Button One Up Vertical

Single

Y

No

Still Trying

If you did not accomplish your primary purpose in using the Retirement Estimator, please tell us why you were not able to do so.

Text Area – no character limit

N

What is your overall rating of SSA’s Retirement Estimator?

scale 1-10

Radio Button Scale No Don’t Know

Y

If there were one thing you could change about the SSA’s Retirement Estimator, what would it be?

Text Area – no character limit

N