486 PBGC 486 PBGC v3

Model Instance Name:			red & strike-through: DELETE
PBGC.gov v3			underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==			pink: ADDITION
Date:	9/22/2011		blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
SAC4232		Is this your first visit to PBGC.gov?	Yes		Radio button, one-up vertical	Single	Y		Visit
			No
			Not sure
SAC4233		Which best describes you?	Worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			Widow(er) or spouse or beneficiary
			Researcher or student
			Practitioner or pension professional
			Media or press representative
			Trade association or business organization
			Other (please specify)	A
SAC4234	A	Other - best describes you:			Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			To search for unclaimed pensions on PBGC’s missing participant list
			To log in to MyPBA (worker or retiree info)
			To obtain tax information or Form 1099
			To follow up on an annual funding notice I received
			To find premium-related information
			To log in to My PAA (premium-related matters)
			To research plan termination
			To find information and news about PBGC
			To find information on defined benefit pensions
			Other (please specify)	A
SAC4236	A	Other - purpose in visiting PBGC's website today:			Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			No	A
			In part	A
			Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			Could not log in to MyPBA or My PAA
			Had technical difficulties
			Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.			Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			No
SAC4241	A	Did you find what you were looking for?	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			Search results were not helpful
			Returned too many results
			Returned not enough or zero results
			Returned results that were too similar/redundant
			Results were not relevant to my search terms or needs
			I was not sure what words to use in my search
			Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.			Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			2	B
			3	B
			4	B
			5	B
			6	B
			7	B
			8	B
			9	B
			10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			I found myself or my pension plan
			I didn’t find myself or my pension plan
			Search results were helpful
			Search results were not helpful
			Returned too many results
			Returned not enough or zero results
			Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.			Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			No
SAC4249	A	Description of difficulties:			Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			The information on the website was not clear or helpful
			I did not find the information I was looking for
			I was already planning to call
			Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.			Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			Please consider	A
SAC4254	A	Description of other information or online services:			Text area, no char limit		N	Skip logic group	OE_Other info or services