457 CQs 457 CQs 5-17-11

American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Surveys

2011 457 CQs for OMB started 5-17-2011.xlsx

Previously Cleared ICs from prior Generic ICR

OMB: 1090-0008

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Measures Name/Client name (CQs and Answer choices)









Social Security Admin: SSA FAQ Sat Survey, MID RhtAg4UV8ddoAhlZwpFIEw==









SAC2270
Are you currently receiving Social Security Benefits? SAC2270A001 Yes
Dropdown (Select-one) Single Y
Receiving SS Benefits



SAC2270A002 No







SAC2270A003 Not Sure





SAC2271
Which of the following topics were you were looking for within the FAQs? (check all that apply) SAC2271A001 Social Security Benefit Statement (Form SSA-1099)
Checkbox One Up Vertical Multi Y Skip Logic Topic



SAC2271A002 Annual Social Security Statement








SAC2271A003 Social Security Card or Number A







SAC2271A004 Retirement Benefits B







SAC2271A005 Social Security Disability Benefits C







SAC2271A006 Supplemental Security Income (SSI) Payments D







SAC2271A007 Survivor Benefits E







SAC2271A008 Medicare Benefits F







SAC2271A009 Address change








SAC2271A010 Direct deposit of monthly check








SAC2271A011 Paying taxes on Social Security benefits








SAC2271A012 Other, please specify Z




SAC2272 A What Social Security card or number information were you seeking today? SAC2272A001 Replacing a lost or stolen Social Security card
Radio Button One Up Vertical Single Y Skip Logic SSCard/#



SAC2272A002 Changing a name on a Social Security card








SAC2272A003 Requesting a Social Security card for a minor child








SAC2272A004 Learning what documents are needed








SAC2272A005 Other, please specify AA




SAC2273 AA Please tell us what other Social Security card or number information you wanted.


Text Area – no character limit
N Skip Logic OE_SSCard/#
SAC2274 B What best describes the subject of your Retirement Benefits question? SAC2274A001 Applying for Retirement benefits – how and when
Radio Button One Up Vertical Single Y Skip Logic Retirement



SAC2274A002 Estimating Retirement benefits








SAC2274A003 Working while receiving Retirement benefits








SAC2274A004 Learning what documents are needed to file for Retirement benefits








SAC2274A005 Learning about benefits for a spouse and/or child(ren)








SAC2274A006 Other, please specify BB




SAC2275 BB Please tell us about your Retirement Benefits question.


Text Area – no character limit
N Skip Logic OE_Retirement
SAC2276 C What best describes the subject of your Social Security Disability benefits question? SAC2276A001 Applying for Disability benefits – how and when
Radio Button One Up Vertical Single Y Skip Logic Disability



SAC2276A002 Learning about benefits for spouse and/or child(ren)








SAC2276A003 Appealing an adverse Disability decision – how and when








SAC2276A004 Working while disabled








SAC2276A005 Other, please specify CC




SAC2277 CC Please tell us about your Social Security Disability question.


Text Area – no character limit
N Skip Logic OE_Disability
SAC2278 D What Supplemental Security Income (SSI) information were you seeking? SAC2278A001 Applying for SSI payments – how and when
Radio Button One Up Vertical Single Y Skip Logic SSI



SAC2278A002 Learning the difference between SSI and Social Security benefit payments








SAC2278A003 Learning what affects SSI payments (e.g., work, property, savings, inheritance, etc.)








SAC2278A004 Learning if a spouse and/or child(ren) can receive payments from my SSI record








SAC2278A005 Other, please specify DD




SAC2279 DD Please tell us about your Supplemental Security Income (SSI) question.


Text Area – no character limit
N Skip Logic OE_SSI
SAC2280 E What Survivor Benefits information were you seeking? SAC2280A001 Applying for Survivor Benefits - how and when
Radio Button One Up Vertical Single Y Skip Logic Survivor Benefits



SAC2280A002 Receiving Survivor Benefits AND my own retirement benefit







SAC2280A003 Receiving Survivor Benefits on a divorced spouse’s record








SAC2280A004 Obtaining necessary documents needed to file for survivor benefits








SAC2280A005 Learning how remarriage affects my survivor benefits








SAC2280A006 Other, please specify EE




SAC2281 EE Please tell us about your Survivor Benefits question.


Text Area – no character limit
N Skip Logic OE_Survivor
SAC2282 F What best describes the subject of your Medicare question? SAC2282A001 How to apply for Medicare benefits – how and when?
Radio Button One Up Vertical Single Y Skip Logic Medicare



SAC2282A002 What documents are needed to file for Medicare







SAC2282A003 Who is eligible for Medicare








SAC2282A004 What is covered under the Medicare program








SAC2282A005 What are the Medicare premiums








SAC2282A006 What is the Medicare Prescription Drug Plan








SAC2282A007 Other, please specify FF




SAC2283 FF Please tell us about your Medicare question.


Text Area – no character limit
N Skip Logic OE_Medicare
SAC2284 Z Please tell us what other information you were seeking.


Text Area – no character limit
N Skip Logic OE_Topic
4969
Did we answer your question(s)?
Yes, my question (s) was answered completely A Dropdown (Select-one) Single Y Skip Logic Answer Questions




Yes, my question (s) was answered partially A, B







No, my question (s) was not answered at all B




SAC2285 A Did the answer(s) you received using our FAQs help you accomplish your task with Social Security? SAC2285A001 Yes
Dropdown (Select-one) Single Y Skip Logic Help Accomplish



SAC2285A002 No







SAC2285A003 Partially





7786 B If we didn't answer your question(s), please tell us what information you were looking for? --> What was your question? Please explain:


Text Area – no character limit
N Skip Logic Information Sought --> OE_No Answer
SAC2286
Please tell us if you had any of the following concerns or problems while using the FAQs? (check all that apply) SAC2286A001 Experienced no problems
Checkbox One Up Vertical Multi N Skip Logic Problems



SAC2286A002 Could not figure out the best way to find the answers I needed







SAC2286A003 Too many answers to choose from








SAC2286A004 Answer link(s) did not take me where I expected








SAC2286A005 Found the answer link(s) difficult to understand








SAC2286A006 Answers were too long








SAC2286A007 Had difficulty understanding the information in the answer








SAC2286A008 Experienced technical difficulties (e.g. broken links, error messages)








SAC2286A009 Took me too long to search through the FAQs








SAC2286A010 Other, please specify A




SAC2287 A Please tell us about your concerns or problems using the FAQs.


Text Area – no character limit
N Skip Logic OE_Problems
SAC2288
Which FAQ feature(s) did you use today? (check all that apply) SAC2288A001 Most Popular Answer links
Checkbox One Up Vertical Multi Y Skip Logic FAQ Feature



SAC2288A002 Most Popular Topic links







SAC2288A003 Browse All Topic links








SAC2288A004 FAQ Search Box A







SAC2288A005 Not sure








SAC2288A006 None of the above





SAC2289 A Which of the following, if any, did you experience while using the FAQ Search tool today? (check all that apply) SAC2289A001 Experienced no problems
Checkbox One Up Vertical Multi Y Skip Logic Search



SAC2289A002 Results were not relevant to my search terms or needs







SAC2289A003 I was not sure what words to use in my search








SAC2289A004 Search required too many refinements to get to what I wanted








SAC2289A005 Returned too many results








SAC2289A006 Returned not enough results








SAC2289A007 Returned no results








SAC2289A008 Returned results were too similar or redundant








SAC2289A009 Other, please specify B




SAC2290 B Please tell us about your FAQ search experience.


Text Area – no character limit
N Skip Logic OE_Search
SAC2291
What will your next step(s) be relative to the information you were seeking? (choose the one that most applies) SAC2291A001 I got the information I was seeking and have no plans to follow up with SSA
Radio Button One Up Vertical Single Y
Next Steps



SAC2291A002 I will conduct my SSA business online (if available)







SAC2291A003 I will visit my local SSA office








SAC2291A004 I will call my local SSA office








SAC2291A005 I will call the SSA Toll Free 800 Number








SAC2291A006 I will email SSA








SAC2291A007 I did not get the information I was seeking but have no plans to follow up with SSA








SAC2291A008 Not sure what my next steps will be





SAC2292
How frequently do you visit SSA’s FAQ section? SAC2292A001 First time
Radio Button One Up Vertical Single Y
Visit Frequency



SAC2292A002 At least once a week







SAC2292A003 At least once a month








SAC2292A004 At least once every six months








SAC2292A005 At least once a year








SAC2292A006 Not sure





811
What is your age group?
Under 18
Dropdown (Select-one) Single Y
Age




18-24


N





25-44









45-54









55-64









65+





SAC2293
Do you have any suggestions for improving the FAQ section?


Text Area – no character limit
N
Improve











USDA Forest Service Content + Search









C5316
In what capacity are you visiting the Forest Service website?
Government (federal, state, local or Forest Service)
Radio button, one-up vertical Single Y OPS Group




Private sector (business owner/employee)









Professor or student









U.S. Citizen/public









Non U.S. citizen









Primary or Secondary Education Student









University Student









Primary or Secondary Education Teacher









University Professor









General public









Other (Please specify) A





A Other:


Text field, <100 char
N OPS Group
C5309
What is your primary purpose in visiting this site today?
Contact information (phone numbers)
Radio button, one-up vertical Single Y Skip Logic Group




Current forest conditions (e.g. fire activity, road closures, weather)









Employment or volunteering opportunities









Employment









Volunteering Opportunities









Natural resource management (policy, plans, programs and projects)









Official communications (e.g. news releases or testimony)









Personal-use Permit information









Commercial-use Permit information









Scientific information D








General information









Travel or vacation planning









To plan a visit to a national forest or grassland B, C








Other (Please Specify) A





A Other purpose:


Text field, <100 char
N Skip Logic Group

B What activity will you primarily perform during your visit to a national forest or grassland?
Alpine Skiing
Radio button, one-up vertical Single Y Skip Logic Group Activity




Bicycling









Boating









Camping









Cabin Rentals









Canoeing









Climbing









Fishing









Hiking









Horse Riding









Hunting









Kayaking









Mountain biking









Nature Viewing









Nordic Skiing









OHV Riding









Outdoor Learning









Picknicking









Rafting









Rock hounding









Scenic Driving









Snowmobiling









Other (Please specify) E





E Other activity:


Text field, <100 char
N Skip Logic Group OE_Activity

C What visitor information are you mostly looking for? Information about:
Current forest conditions (e.g. fire activity, road closures, weather)
Radio button, one-up vertical Single Y Skip Logic Group Visitor Info




Online maps









Off Highway Vehicle (OHV) use









Roads and access









Other (Please specify) F





F Other visitor information:


Text field, <100 char
N Skip Logic Group OE_Visitor Info

D What scientific information are you mostly looking for? Information about:
GIS tools
Radio button, one-up vertical Single Y Skip Logic Group Scientific Info




Ecology management tools









Computer-based tools









Databases









Fire









Find an expert









Journal articles









Maps









Photos or graphics









Publications









Technical manuals









Other (Please specify) G





G Other scientific information:


Text field, <100 char
N Skip Logic Group OE_Scientific Info
C5314
If you're seeking an online map, what best describes the kind of online maps you prefer?
Detailed and printable travel map of a National Forest or Grassland
Radio button, one-up vertical Single Y OPS Group




Simple online map that give basic location information for recreation









Full-featured online map that would allow you to zoom, pan, etc.









I'm not looking for an online map









Other (Please specify) A





A Other:


Text field, <100 char
N OPS Group
CDEZ10013
What was your primary method of looking for information on our site today?
Browsed, that is, followed links in the page
Drop down, select one Single Y Skip Logic Group




Typed text in search box in upper left corner A








Used advanced search feature on site A








Used a third-party search engine (e.g., Google)









Searched by State via the drop-down box









Searched by Forest Name via the drop-down box









Don't know






A Please tell us about your experience with the site's search feature today. (Please select all that apply.)
Search results were helpful
Checkbox, one-up vertical Multi Y Skip Logic Group Search




Results were not relevant/not what I wanted









Too many results/I needed to refine my search









Not enough results









Returned NO results









Received error message(s)









Search speed was too slow









I experienced a different search issue (please explain): B





B Other search issue:


Text area, no char limit
N Skip Logic Group OE_Search


Did you find what you were looking for on the site today?
Yes
Radio button, one-up vertical Single Y Skip Logic Group Find




Partially









No, I wanted to find: A








I was just browsing






A Please tell us specifically what you were looking for on the site.


Text area, no char limit
N Skip Logic Group OE_Find
C3182
How frequently do you visit the Forest Service website?
First time
Drop down, select one Single Y





More than once a day









Daily









About once a week









About once a month









Every 6 months or less





C3183
How frequently do you go to a National Forest or Grassland?
Several times a week
Drop down, select one Single Y





Once a week









Once a month









Once every six months









About once a year or less often









Never







What is your gender?
Female
Drop down, select one Single N
Gender




Male









Prefer not to respond







What is your age range?
Under 12
Drop down, select one Single N
Age




13 - 17









18 - 25









26 - 45









46 - 64









65 or older









Prefer not to respond





C6649
Are there any additional comments you would like to provide us?


Text area, no char limit
N

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