500 RE and S-RE 500 Survey Final RE and S-RE 12.27.11

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Overview

Welcome and Thank You Text
Model Qsts EE
Model Qsts EN
Model Qsts SP
Model Qsts SP (12-09-10)
Current Custom Qsts EE
Current Custom Qsts EN
Current Custom Qsts SP
Custom Qsts EE (12-27-11)
Custom Qsts EN (12-27-11)
Custom Qsts SP (12-27-11)
Custom Qsts EE (10-6-10)
Custom Qsts EN (10-6-10)
Custom Qsts SP (12-09-10)
Custom Qsts SP (10-6-10)
Custom Qsts EE (9-28-10)
Custom Qsts EN (9-28-10)
Custom Qsts SP (9-28-10)
Custom Qsts EE (9-20-10)
Custom Qsts EN (9-20-10)
Custom Qsts SP (9-20-10)
Custom Qsts EE 9-7-10
Custom Qsts EN 9-7-10
Custom Qsts SP 9-7-10

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
SSA Retirement Estimator v3
MID:	AshNI5IMsplFJJMYA9c9JA==
Date:	Fill In Date
Welcome and Thank You Text
	Directions:
	This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome text shown in the box below.
					Examples
					Welcome Text Example
	Welcome Text
	Thank you for using the Retirement Estimator on the Social Security Administration web site. Please take a minute or two and tell us what we’re doing well and where we need to do better. The feedback you provide will help us improve our site and serve you better in the future. We keep all of your answers strictly confidential. Your participation in this survey will not affect your eligibility for benefits or any business you have with Social Security.
					Thank You Text Example
	Thank You Text
	Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our web site, http://www.socialsecurity.gov/pgm/reach.htm

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Sheet 2: Model Qsts EE

Model Instance Name:
SSA Retirement Estimator v3
MID:	AshNI5IMsplFJJMYA9c9JA==
Date:	8/16/2010
\
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Site Performance (If applicable) (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Apply online for Benefits (1=Very Unlikely, 10=Very Likely)
1	Please rate how quickly pages load on this online Retirement Estimator.	10	What is your overall satisfaction with the online Retirement Estimator?	13	How likely are you to apply for Social Security Benefits online?
2	Please rate the consistency of speed from page-to-page on this online Retirement Estimator.	11	How well does the online Retirement Estimator meet your expectations?		Apply in field office for Benefits (1=Very Unlikely, 10=Very Likely)
3	Please rate the ability to load pages without getting errors on this online Retirement Estimator.	12	How does the online Retirement Estimator compare to your idea of an ideal online process?	14	How likely are you to apply for Social Security Benefits in the field office?
	Look and Feel (1=Poor, 10=Excellent, Don't Know)				Recommend (1=Very Unlikely, 10=Very Likely)
4	Please rate the visual appeal of this online Retirement Estimator.			15	How likely are you to recommend this online Retirement Estimator to someone else?
5	Please rate the layout of the online Retirement Estimator.				Return (if applicable) (1=Very Unlikely, 10=Very Likely)
6	Please rate the readability of the online Retirement Estimator.			16	How likely are you to return to the Retirement Estimator?
	On-Line Application Process (1=Poor, 10=Excellent, Don't Know)				Use Other SSA Applications (1=Very Unlikely, 10=Very Likely)
7	Please rate the clarity of the instructions to complete this online Retirement Estimator.			17	How likely are you to use other online applications on the Social Security web site?
8	Please rate the simplicity of completing this online Retirement Estimator.
9	Please rate the number of steps for entering the information into the online Retirement Estimator.

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Sheet 3: Model Qsts EN

Model Instance Name:
SSA Retirement Estimator v3
MID:	JU89h10NUtR9V44MIk9ldA==
Date:	8/16/2010
\
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Site Performance (If applicable) (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Apply online for Benefits (1=Very Unlikely, 10=Very Likely)
1	Please rate how quickly pages load on this online Retirement Estimator.	10	What is your overall satisfaction with the online Retirement Estimator?	13	How likely are you to apply for Social Security Benefits online?
2	Please rate the consistency of speed from page-to-page on this online Retirement Estimator.	11	How well does the online Retirement Estimator meet your expectations?		Apply in field office for Benefits (1=Very Unlikely, 10=Very Likely)
3	Please rate the ability to load pages without getting errors on this online Retirement Estimator.	12	How does the online Retirement Estimator compare to your idea of an ideal online process?	14	How likely are you to apply for Social Security Benefits in the field office?
	Look and Feel (1=Poor, 10=Excellent, Don't Know)				Recommend (1=Very Unlikely, 10=Very Likely)
4	Please rate the visual appeal of this online Retirement Estimator.			15	How likely are you to recommend this online Retirement Estimator to someone else?
5	Please rate the layout of the online Retirement Estimator.				Return (if applicable) (1=Very Unlikely, 10=Very Likely)
6	Please rate the readability of the online Retirement Estimator.			16	How likely are you to return to the Retirement Estimator?
	On-Line Application Process (1=Poor, 10=Excellent, Don't Know)				Use Other SSA Applications (1=Very Unlikely, 10=Very Likely)
7	Please rate the clarity of the instructions to complete this online Retirement Estimator.			17	How likely are you to use other online applications on the Social Security web site?
8	Please rate the simplicity of completing this online Retirement Estimator.
9	Please rate the number of steps for entering the information into the online Retirement Estimator.

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Sheet 4: Model Qsts SP

Model Instance Name:
SSA Retirement Estimator v3
MID:	VAdlI9VQFstVQBhNYFkAxw==
Date:	12/6/2010
\
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Site Performance (If applicable) (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Apply online for Benefits (1=Very Unlikely, 10=Very Likely)
1	Favor de calificar la rapidez con la que descargan las páginas en este Calculador de beneficios por jubilación.	10	¿Cuál es su impresión general de este Calculador de beneficios por jubilación?	13	¿Cuáles son las posibilidades de que solicite los beneficios de Seguro Social usando la Internet?
2	Favor de calificar la consistencia de la rapidez para moverse de una página a la otra en este Calculador de beneficios por jubilación.	11	¿Con qué exactitud cumple con sus expectativas este Calculador?		Apply in field office for Benefits (1=Very Unlikely, 10=Very Likely)
3	Favor de calificar la capacidad para descargar las páginas sin errores en este Calculador de beneficios por jubilación.	12	¿Cómo compararía el Calculador de beneficios por jubilación con su idea de un procedimiento ideal por Internet?	14	¿Cuáles son las posibilidades de que solicite los beneficios de Seguro Social visitando la oficina local del Seguro Social?
	Look and Feel (1=Poor, 10=Excellent, Don't Know)				Recommend (1=Very Unlikely, 10=Very Likely)
4	Favor de calificar el atractivo visual de este Calculador de beneficios por jubilación.			15	¿Cuáles son las posibilidades que recomiende este Calculador de beneficios por jubilación a otra persona?
5	Favor de calificar el diseño de este Calculador de beneficios por jubilación.				Return (if applicable) (1=Very Unlikely, 10=Very Likely)
6	Favor de calificar la legibilidad de Calculador de beneficios por jubilación.			16	¿Cuáles son las posibilidades de que regrese a este Calculador de beneficios por jubilación?
	On-Line Application Process (1=Poor, 10=Excellent, Don't Know)				Use Other SSA Applications (1=Very Unlikely, 10=Very Likely)
7	Favor de calificar la claridad de las instrucciones para contestar las preguntas de Calculador de beneficios por jubilación.			17	¿Cuáles son las posibilidades de que use otras solicitudes en este sitio de Internet del Seguro Social?
8	Favor de calificar la sencillez de las preguntas de este Calculador de beneficios por jubilación.
9	Favor de calificar la cantidad de pasos a seguir para ingresar la información requerida en este Calculador de beneficios por jubilación.

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Sheet 5: Model Qsts SP (12-09-10)

Model Instance Name:
SSA Retirement Estimator v3
MID:	VAdlI9VQFstVQBhNYFkAxw==
Date:	12/6/2010
\
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Site Performance (If applicable) (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Apply online for Benefits (1=Very Unlikely, 10=Very Likely)
1	Favor de calificar la rapidez con la que descargan las páginas en este Calculador de beneficios por jubilación.	10	¿Cuál es su impresión general de este Calculador de beneficios por jubilación?	13	¿Cuáles son las posibilidades de que solicite los beneficios de Seguro Social usando la Internet?
2	Favor de calificar la consistencia de la rapidez para moverse de una página a la otra en este Calculador de beneficios por jubilación.	11	¿Con qué exactitud el Calculador de beneficios por jubilación esatisfizo sus expectaciones? --> ¿Con qué exactitud cumple con sus expectativas este Calculador?		Apply in field office for Benefits (1=Very Unlikely, 10=Very Likely)
3	Favor de calificar la capacidad para descargar las páginas sin errores en este Calculador de beneficios por jubilación.	12	¿Cómo compararía el Calculador de beneficios por jubilación con su idea de un procedimiento perfecto? --> ¿Cómo compararía el Calculador de beneficios por jubilación con su idea de un procedimiento ideal por Internet?	14	¿Cuáles son las posibilidades de que solicite los beneficios de Seguro Social visitando la oficina local del Seguro Social?
	Look and Feel (1=Poor, 10=Excellent, Don't Know)				Recommend (1=Very Unlikely, 10=Very Likely)
4	Favor de calificar el atractivo visual de este Calculador de beneficios por jubilación.			15	¿Cuáles son las posibilidades que recomiende este Calculador de beneficios por jubilación a otra persona?
5	Favor de calificar el diseño de este Calculador de beneficios por jubilación.				Return (if applicable) (1=Very Unlikely, 10=Very Likely)
6	Favor de calificar la legibilidad de Calculador de beneficios por jubilación.			16	¿Cuáles son las posibilidades de que regrese a este Calculador de beneficios por jubilación?
	On-Line Application Process (1=Poor, 10=Excellent, Don't Know)				Use Other SSA Applications (1=Very Unlikely, 10=Very Likely)
7	Favor de calificar la claridad de las instrucciones para contestar las preguntas de Calculador de beneficios por jubilación.			17	¿Cuáles son las posibilidades de que use otras solicitudes en este sitio de Internet del Seguro Social?
8	Favor de calificar la sencillez de las preguntas de este Calculador de beneficios por jubilación.
9	Favor de calificar la cantidad de pasos a seguir para ingresar la información requerida en este Calculador de beneficios por jubilación.

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Sheet 6: Current Custom Qsts EE

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: AshNI5IMsplFJJMYA9c9JA==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
EDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
EDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
EDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
EDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
EDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
EDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No	A
ACQLiv0010089	A	Please tell us why the Retirement Estimator did not help you decide at what age to claim benefits.			Text area, no char limit		N	Skip Logic Group	OE_Didn't help decide age to claim
EDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Unsure
			Other, please specify	E
EDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
EDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
EDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
EDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
EDO05326	F	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 char limit	Single	N		OE_Did not accomplish
ACQLiv0010093		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			Links often did not take me where I expected
			I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
ACQLiv0010094	A	Other navigation difficulty			Text field, <100 char		N	OPS Group	Other Difficulty
EDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
EDO05328		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
EDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
EDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
EDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
EDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
EDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
EDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
EDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
EDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
EDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital
ACQLiv0010070		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.			Text area, no char limit		N		Improvement

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Sheet 7: Current Custom Qsts EN

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: JU89h10NUtR9V44MIk9ldA==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
ENEDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
ENEDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
ENEDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
ENEDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
ENEDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No	A
ENACQLiv0010089	A	Please tell us why the Retirement Estimator did not help you decide at what age to claim benefits.			Text area, no char limit		N	Skip Logic Group	OE_Didn't help decide age to claim
ENEDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Unsure
			Other, please specify	E
ENEDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
ENEDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
ENEDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
ENEDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
ENEDO05326	F	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 char limit	Single	N		OE_Did not accomplish
ENACQLiv0010093		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			Links often did not take me where I expected
			I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
ENACQLiv0010094	A	Other navigation difficulty			Text field, <100 char		N	OPS Group	Other Difficulty
ENEDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
ENEDO05328		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
ENEDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
ENEDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
ENEDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
ENEDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
ENEDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
ENEDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
ENEDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
ENEDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital
ENACQLiv0010070		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.			Text area, no char limit		N		Improvement

---

Sheet 8: Current Custom Qsts SP

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Lo completé para otra persona
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y	Skip Logic Group	Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No	A
SPACQLiv0010089	A	Por favor díganos por qué el Calculador de beneficios por jubilación no le ayudó a decidir a qué edad reclamar los beneficios.			Text area, no char limit		N	Skip Logic Group	OE_Didn't help decide age to claim
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			No estoy seguro(a)
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
SPACQLiv0010093		¿Cómo describiría su experiencia navegando el sitio de Internet del Seguro Social hoy antes de llegar al Calculador de beneficios por jubilación? (Por favor seleccione todo lo que aplique.)	No tuve dificultad navegando hacia el Calculador de beneficios por jubilación.		Checkbox, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			Tuve dificultad encontrando los enlaces hacia el Calculador de beneficios por jubilación.
			Los enlaces a veces no me llevaban a donde esperaba llegar.
			Experimenté dificultades técnicas (mensajes de error, enlaces rotos, etc.).
			Tuve una dificultad navegando el sistema que no está listada arriba:	A
SPACQLiv0010094	A	Other navigation difficulty			Text field, <100 char		N	OPS Group	Other Difficulty
SPEDO05327		¿Alguna vez ha usado el Planificador de jubilación del Seguro Social?	Sí		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál sera su próximo paso para obtener respuestas sobre la estimación de sus beneficios por jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sitio de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO06581		¿Cuál es su idioma preferido para llevar a cabo sus transacciones con la Administración del Seguro Social?	Inglés		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Español
			Otro (especifique)	A
SPEDO06582	A	Otro idioma preferido			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education
SPEDO06583		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
SPEDO06584	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital
SPACQLiv0010070		Por favor díganos si hay alguna mejora/cambio que le gustaría que se hiciera al Calculador de beneficios por jubilación.			Text area, no char limit		N		Improvement

---

Sheet 9: Custom Qsts EE (12-27-11)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: AshNI5IMsplFJJMYA9c9JA==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
EDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
EDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
EDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
EDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
EDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
EDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No	A
	A	Please tell us why the Retirement Estimator did not help you decide at what age to claim benefits.			Text area, no char limit		N	Skip Logic Group	OE_Didn't help decide age to claim
EDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Unsure
			Other, please specify	E
EDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
EDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
EDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
EDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
EDO05326	F	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 char limit	Single	N		OE_Did not accomplish
		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	I had no difficulty navigating/browsing to the Retirement Estimator		Radio button, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			Links often did not take me where I expected
			I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
	A	Other navigation difficulty			Text field, <100 char		N	OPS Group	Other Difficulty
EDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
EDO05328		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
EDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
EDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
EDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
EDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
EDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
EDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
EDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
EDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
EDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital
		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.			Text area, no char limit		N		Improvement

---

Sheet 10: Custom Qsts EN (12-27-11)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: JU89h10NUtR9V44MIk9ldA==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
ENEDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
ENEDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
ENEDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
ENEDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
ENEDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No	A
	A	Please tell us why the Retirement Estimator did not help you decide at what age to claim benefits.			Text area, no char limit		N	Skip Logic Group	OE_Didn't help decide age to claim
ENEDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Unsure
			Other, please specify	E
ENEDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
ENEDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
ENEDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
ENEDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
ENEDO05326	F	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 char limit	Single	N		OE_Did not accomplish
		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	I had no difficulty navigating/browsing to the Retirement Estimator		Radio button, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			Links often did not take me where I expected
			I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
	A	Other navigation difficulty			Text field, <100 char		N	OPS Group	Other Difficulty
ENEDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
ENEDO05328		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
ENEDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
ENEDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
ENEDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
ENEDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
ENEDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
ENEDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
ENEDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
ENEDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital
		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.			Text area, no char limit		N		Improvement

---

Sheet 11: Custom Qsts SP (12-27-11)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Lo completé para otra persona
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y	Skip Logic Group	Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No	A
	A	Por favor díganos por qué el Calculador de beneficios por jubilación no le ayudó a decidir a qué edad reclamar los beneficios.			Text area, no char limit		N	Skip Logic Group	OE_Didn't help decide age to claim
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			No estoy seguro(a)
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
		¿Cómo describiría su experiencia navegando el sitio de Internet del Seguro Social hoy antes de llegar al Calculador de beneficios por jubilación? (Por favor seleccione todo lo que aplique.)	No tuve dificultad navegando hacia el Calculador de beneficios por jubilación.		Radio button, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			Tuve dificultad encontrando los enlaces hacia el Calculador de beneficios por jubilación.
			Los enlaces a veces no me llevaban a donde esperaba llegar.
			Experimenté dificultades técnicas (mensajes de error, enlaces rotos, etc.).
			Tuve una dificultad navegando el sistema que no está listada arriba:	A
	A	Other navigation difficulty			Text field, <100 char		N	OPS Group	Other Difficulty
SPEDO05327		¿Alguna vez ha usado el Planificador de jubilación del Seguro Social?	Sí		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál sera su próximo paso para obtener respuestas sobre la estimación de sus beneficios por jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sitio de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO06581		¿Cuál es su idioma preferido para llevar a cabo sus transacciones con la Administración del Seguro Social?	Inglés		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Español
			Otro (especifique)	A
SPEDO06582	A	Otro idioma preferido			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education
SPEDO06583		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
SPEDO06584	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital
		Por favor díganos si hay alguna mejora/cambio que le gustaría que se hiciera al Calculador de beneficios por jubilación.			Text area, no char limit		N		Improvement

---

Sheet 12: Custom Qsts EE (10-6-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: AshNI5IMsplFJJMYA9c9JA==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
EDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
EDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
EDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
EDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
EDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
EDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
EDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Unsure
			Other, please specify	E
EDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
EDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
EDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
EDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
EDO05326	F	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 char limit	Single	N		OE_Did not accomplish
EDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
EDO05328		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
EDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
EDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
EDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
EDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
EDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
EDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
EDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
EDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
EDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 13: Custom Qsts EN (10-6-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: JU89h10NUtR9V44MIk9ldA==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
ENEDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
ENEDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
ENEDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
ENEDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
ENEDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
ENEDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Unsure
			Other, please specify	E
ENEDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
ENEDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
ENEDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
ENEDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
ENEDO05326	F	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 char limit	Single	N		OE_Did not accomplish
ENEDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
ENEDO05328		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
ENEDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
ENEDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
ENEDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
ENEDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
ENEDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
ENEDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
ENEDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
ENEDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 14: Custom Qsts SP (12-09-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Lo completé para otra persona
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			No estoy seguro(a)
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Si --> Sí		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
SPEDO05327		¿Alguna vez ha usado el Planificador de jubilación del Seguro Social?	Si --> Sí		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál será su próximo que en cuanto a obtener respuestas sobre la estimación de sus beneficios por jubilación? -->¿Cuál sera su próximo paso para obtener respuestas sobre la estimación de sus beneficios por jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sition de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO06581		¿Cuál es su idioma preferido para llevar a cabo sus transacciones con la Administración del Seguro Social?	Inglés		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Español
			Otro (especifique)	A
SPEDO06582	A	Otro idioma preferido			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education
SPEDO06583		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
SPEDO06584	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 15: Custom Qsts SP (10-6-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Lo completé para otra persona
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			No estoy seguro(a)
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Si		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
SPEDO05327		¿Alguna ha usado el Planificador de jubilación del Seguro Social?	Si		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál será su próximo que en cuanto a obtener respuestas sobre la estimación de sus beneficios por jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sition de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO06581		¿Cuál es su idioma preferido para llevar a cabo sus transacciones con la Administración del Seguro Social?	Inglés		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Español
			Otro (especifique)	A
SPEDO06582	A	Otro idioma preferido			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education
SPEDO06583		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
SPEDO06584	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 16: Custom Qsts EE (9-28-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: AshNI5IMsplFJJMYA9c9JA==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
EDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
EDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
EDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
EDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
EDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
EDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
EDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Other, please specify	E
EDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
EDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
EDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
EDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
EDO05326	F	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 char limit	Single	N		OE_Did not accomplish
EDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
EDO05328		What do you plan to do next in regards to getting answers about your estimated retirement? --> What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
EDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
EDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
EDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
EDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
EDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
EDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
EDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
EDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
EDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 17: Custom Qsts EN (9-28-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: JU89h10NUtR9V44MIk9ldA==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
ENEDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
ENEDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
ENEDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
ENEDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			I completed it for someone else
			Other
ENEDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
ENEDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Other, please specify	E
ENEDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
ENEDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
ENEDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
ENEDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
ENEDO05326	F	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 char limit	Single	N		OE_Did not accomplish
ENEDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
ENEDO05328		What do you plan to do next in regards to getting answers about your estimated retirement? --> What do you plan to do next in regard to getting answers about your estimated retirement benefits?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
ENEDO06581		What is your preferred language for conducting business with the Social Security Administration?	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Spanish
			Other, please specify	A
ENEDO06582	A	Other preferred language			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
ENEDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
ENEDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
ENEDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
ENEDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education
ENEDO06583		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
ENEDO06584	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 18: Custom Qsts SP (9-28-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Lo completé para otra persona
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Si		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
SPEDO05327		¿Alguna ha usado el Planificador de jubilación del Seguro Social?	Si		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál es el próximo paso que planifica tomar con referencia a sus preguntas sobre la estimación de sus beneficios por jubilación que acaba de recibir? --> ¿Cuál será su próximo que en cuanto a obtener respuestas sobre la estimación de sus beneficios por jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sition de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO06581		¿Cuál es su idioma preferido para llevar a cabo sus transacciones con la Administración del Seguro Social?	Inglés		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			Español
			Otro (especifique)	A
SPEDO06582	A	Otro idioma preferido			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education
SPEDO06583		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
SPEDO06584	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital

---

Sheet 19: Custom Qsts EE (9-20-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: AshNI5IMsplFJJMYA9c9JA==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
EDO05312		What is your preferred speaking language?	English		Radio button, one-up vertical	Single	Y	Skip Logic Group	Pref. Language	To access the need for non-English versions of the RE and the accessibility of the S-RE to Spanish speakers with different levels of ability to speak English.
			Spanish	A
			Other, please specify	B
EDO05313	B	What other language do you speak?			Text field, <100 char		N	Skip Logic Group	Other Lang.
EDO05314	A	What other SSA internet service would you like to see in Spanish? (check all that apply)	File a Claim		Checkbox, one-up vertical	Multi	N	Skip Logic Group	SSA Services	This question addresses the overall level of interest in doing business with SSA online and in Spanish in particular.
			File an Appeal
			Apply for Medicare Subsidy
			Business Services Online
EDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
EDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
EDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
EDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
EDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			Other
EDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
EDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Other, please specify	E
EDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
EDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
EDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
EDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
EDO05326	F	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 char limit	Single	N		OE_Did not accomplish
EDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
EDO05328		What do you plan to do next in regards to getting answers about your estimated retirement?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
EDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
EDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
EDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
EDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
EDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education

---

Sheet 20: Custom Qsts EN (9-20-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: JU89h10NUtR9V44MIk9ldA==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
ENEDO05312		What is your preferred speaking language?	English		Radio button, one-up vertical	Single	Y	Skip Logic Group	Pref. Language	To access the need for non-English versions of the RE and the accessibility of the S-RE to Spanish speakers with different levels of ability to speak English.
			Spanish	A
			Other, please specify	B
ENEDO05313	B	What other language do you speak?			Text field, <100 char		N	Skip Logic Group	Other Lang.
ENEDO05314	A	What other SSA internet service would you like to see in Spanish? (check all that apply)	File a Claim		Checkbox, one-up vertical	Multi	N	Skip Logic Group	SSA Services	This question addresses the overall level of interest in doing business with SSA online and in Spanish in particular.
			File an Appeal
			Apply for Medicare Subsidy
			Business Services Online
ENEDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
ENEDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
ENEDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
ENEDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			Other
ENEDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
ENEDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Other, please specify	E
ENEDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
ENEDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
ENEDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
ENEDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
ENEDO05326	F	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 char limit	Single	N		OE_Did not accomplish
ENEDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
ENEDO05328		What do you plan to do next in regards to getting answers about your estimated retirement?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
ENEDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
ENEDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
ENEDO05331	G	Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
ENEDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
ENEDO05333	X	Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education

---

Sheet 21: Custom Qsts SP (9-20-10)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05312		¿Cuál es su preferencia de idioma al hablar?	Inglés		Radio button, one-up vertical	Single	Y	Skip Logic Group	Pref. Language	To access the need for non-English versions of the RE and the accessibility of the S-RE to Spanish speakers with different levels of ability to speak English.
			Español	A
			Otro (especifique)	B
SPEDO05313	B	¿Qué otros idiomas habla?			Text field, <100 char		N	Skip Logic Group	Other Lang.
SPEDO05314	A	¿Qué otros servicios que presta el Seguro Social por Internet le gustaría ver? (marque todos los que apliquen)	Llenar una reclamación		Checkbox, one-up vertical	Multi	N	Skip Logic Group	SSA Services	This question addresses the overall level of interest in doing business with SSA online and in Spanish in particular.
			Llenar una apelación
			Solicite para un subsidio de Medicare
			Servicios por Internet para empresas
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Si		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
SPEDO05327		¿Alguna ha usado el Planificador de jubilación del Seguro Social?	Si		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál es el próximo paso que planifica tomar con referencia a sus preguntas sobre la estimación de sus beneficios por jubilación que acaba de recibir?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sition de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education

---

Sheet 22: Custom Qsts EE 9-7-10

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: AshNI5IMsplFJJMYA9c9JA==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
EDO05312		What is your preferred speaking language?	English		Radio button, one-up vertical	Single	Y	Skip Logic Group	Pref. Language	To access the need for non-English versions of the RE and the accessibility of the S-RE to Spanish speakers with different levels of ability to speak English.
			Spanish	A
			Other, please specify	B
EDO05313	B	What other language do you speak?			Text field, <100 char		N	Skip Logic Group	Other Lang.
EDO05314	A	What other SSA internet service would you like to see in Spanish? (check all that apply)	File a Claim		Checkbox, one-up vertical	Multi	N	Skip Logic Group	SSA Services	This question addresses the overall level of interest in doing business with SSA online and in Spanish in particular.
			File an Appeal
			Apply for Medicare Subsidy
			Business Services Online
EDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
EDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
EDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
EDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
EDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			Other
EDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
EDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Other, please specify	E
EDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
EDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
EDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
EDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
EDO05326	F	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 char limit	Single	N		OE_Did not accomplish
EDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
EDO05328		What do you plan to do next in regards to getting answers about your estimated retirement?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
EDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
EDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
EDO05331	G	Other location --> Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
EDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
EDO05333	X	Other education level --> Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education

---

Sheet 23: Custom Qsts EN 9-7-10

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: JU89h10NUtR9V44MIk9ldA==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
ENEDO05312		What is your preferred speaking language?	English		Radio button, one-up vertical	Single	Y	Skip Logic Group	Pref. Language	To access the need for non-English versions of the RE and the accessibility of the S-RE to Spanish speakers with different levels of ability to speak English.
			Spanish	A
			Other, please specify	B
ENEDO05313	B	What other language do you speak?			Text field, <100 char		N	Skip Logic Group	Other Lang.
ENEDO05314	A	What other SSA internet service would you like to see in Spanish? (check all that apply)	File a Claim		Checkbox, one-up vertical	Multi	N	Skip Logic Group	SSA Services	This question addresses the overall level of interest in doing business with SSA online and in Spanish in particular.
			File an Appeal
			Apply for Medicare Subsidy
			Business Services Online
ENEDO05315		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Linked from another website
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
ENEDO05316	C	Other learned about			Text field, <100 char		N	OPS Group	Other learned about
ENEDO05317		Have you ever sought advice on retirement/financial planning or saving strategies?	Yes	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
ENEDO05318	D	From what source have you sought advice on retirement/financial planning or saving strategies.	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Financial professional
			Internet
			Other
ENEDO05319		Which statement best describes how you completed the Retirement Estimator?	I completed it for myself without assistance from anyone else		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			I completed it for myself with assistance from a friend or family member
			I completed it for myself with assistance from a professional
			Other
ENEDO05320		Did the Retirement Estimator help you decide at what age to claim benefits?	Yes		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
ENEDO05321		At what age do you plan to file for benefits?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			71 or older
			Other, please specify	E
ENEDO05322	E	Please specify the age at which you intend to file for benefits.			Text field, <100 char		N	Skip Logic Group	Other Age
ENEDO05323		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years
			Don't Know
ENEDO05324		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
ENEDO05325		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Still Trying	F
ENEDO05326	F	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 char limit	Single	N		OE_Did not accomplish
ENEDO05327		Have you ever used the SSA Retirement Planner?	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			Don't know what that is
ENEDO05328		What do you plan to do next in regards to getting answers about your estimated retirement?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
ENEDO05329		What is your age?	Under 18		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			67 or older
			Prefer not to answer
ENEDO05330		Where do you live?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			American Samoa
			Guam
			Northern Mariana Islands
			Puerto Rico
			US Virgin Islands
			Bajo Nuevo Bank
			Baker Island
			Howland Island
			Jarvis Island
			Johnston Atoll
			Kingman Reef
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Serranilla Bank
			Wake Island
			Other - Please specify	G
ENEDO05331	G	Other location --> Please specify where you live.			Text field, <100 char		N	Skip Logic Group	Other Location
ENEDO05332		What is the highest level of education you have completed?	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			Some high school					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			High school diploma or equivalent
			Some college, but no degree
			Associate's degree
			Bachelor's degree
			Master's degree
			Professional degree (MD, JD, etc)
			Doctorate degree (PhD)
			Prefer not to answer
			Other, please specify	X
ENEDO05333	X	Other education level --> Please specify the highest level of education you have completed.			Text field, <100 char		N	Skip Logic Group	Other Education

---

Sheet 24: Custom Qsts SP 9-7-10

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v3			underlined & italicized: RE-ORDER
MID: VAdlI9VQFstVQBhNYFkAxw==			pink: ADDITION
Date:	3/1/2008		blue + -->: REWORDING
SSA Retirement Estimator 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	SSA Comments from Sue (8/12/10)
SPEDO05312		¿Cuál es su preferencia de idioma al hablar?	Inglés		Radio button, one-up vertical	Single	Y	Skip Logic Group	Pref. Language	To access the need for non-English versions of the RE and the accessibility of the S-RE to Spanish speakers with different levels of ability to speak English.
			Español	A
			Otro (especifique)	B
SPEDO05313	B	¿Qué otros idiomas habla?			Text field, <100 char		N	Skip Logic Group	Other Lang.
SPEDO05314	A	¿Qué otros servicios que presta el Seguro Social por Internet le gustaría ver? (marque todos los que apliquen)	Llenar una reclamación		Checkbox, one-up vertical	Multi	N	Skip Logic Group	SSA Services	This question addresses the overall level of interest in doing business with SSA online and in Spanish in particular.
			Llenar una apelación
			Solicite para un subsidio de Medicare
			Servicios por Internet para empresas
SPEDO05315		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
SPEDO05316	C	Otra manera de enterarse			Text field, <100 char		N	OPS Group	Other learned about
SPEDO05317		¿Alguna vez a solicitado asesoramiento con referencia a jubilación/planificación financiera o estrategias de ahorros?	Sí	D	Drop down, select one	Single	Y	Skip Logic Group	Sought Advice	This will provide insight about whether those who use the S-RE are planning ahead about retirement and using other sources. Also we can compare the two subgroups across other characteristics.
			No
SPEDO05318	D	¿Qué fuente de información a utilizado para solicitar asesoramiento con referencia a jubilación/planificación o estrategias de ahorros?	Pariente/Amigo		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			Experto en asuntos financieros
			Internet
			Otro
SPEDO05319		¿Qué oración tiene la mejor descripción de cómo contestó las preguntas del Calculador de beneficios por jubilación?	Las contesté sin que nadie me ayudara		Radio button, one-up vertical	Single	Y		Assistance	We want to know if users get help and how frequently this occurs, which could be more prevalent among S-RE users. The group of users who are getting help may be computer illiterate or may have language proficiency problems.
			Las contesté con la ayuda de un amigo o pariente
			Las contesté con la ayuda de un experto profesional
			Otro
SPEDO05320		¿Le ayudó el Calculador de beneficios por jubilación a decidir a qué edad solicitar los beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Help Decision	This question will provide information on whether RE is affecting users retirement plans, and the ages they plan to retire.
			No
SPEDO05321		¿A que edad planifica solicitar los beneficios por jubilación?	62		Drop down, select one	Single	Y	Skip Logic Group	Age to File	This question will provide information on distribution of the ages users plan to retire. Also it will allow to compare English versus Spanish users, or cross tab with other characteristics. .
			63					Change to Skip Logic so that it can be a drop down question.
			64
			65
			66
			67
			68
			69
			70
			después de los 71
			Otro (especifique)	E
SPEDO05322	E	Favor de indicar la edad a la que espera solicitar los beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	Other Age
SPEDO05323		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			Más de 6 años
			No sé
SPEDO05324		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
SPEDO05325		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Si		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
SPEDO05326	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
SPEDO05327		¿Alguna ha usado el Planificador de jubilación del Seguro Social?	Si		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			No
			No sé lo que es eso
SPEDO05328		¿Cuál es el próximo paso que planifica tomar con referencia a sus preguntas sobre la estimación de sus beneficios por jubilación que acaba de recibir?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sition de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
SPEDO05329		¿Qué edad tiene?	Menor de 18 años de edad		Drop down, select one	Single	N		Age	This question jointly with question #7 will allow to determine retirement horizon of people of different ages and how much weight to place on reported plans for claiming for retirement benefits across different ages.
			18-20
			21-30
			31-40
			41-50
			51-55
			56
			57
			58
			59
			60
			61
			62
			63
			64
			65
			66
			mayor de 67 años de edad
			Me reservo el derecho de contestar
SPEDO05330		¿Dónde vive?	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			Alaska					Change to Skip Logic so that it can be a drop down question.		Will allow to examine distribution of users across states, as well as to examine how they plan to file by state. This information can also be used for work load estimates and staff planning purposes.
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			Distrito de Columbia
			Florida
			Georgia
			Hawaí
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Misisipi
			Misuri
			Montana
			Nebraska
			Nevada
			Nueva Hampshire
			Nueva Jersey
			Nuevo Mexico
			Nueva York
			Carolina del Norte
			Dakota del Norte
			Ohio
			Oklahoma
			Oregon
			Pensilvania
			Rhode Island
			Carolina del Sur
			Dakota del Sur
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			Virginia Occidental
			Wisconsin
			Wyoming
			Samoa Americana
			Guam
			Islas Marianas del Norte
			Puerto Rico
			Islas Virgenes de los EE.UU.
			Bajo Nuevo Bank
			Isla Baker
			Isla Howland
			Isla Jarvis
			Johnston Atoll
			Arecife de Kingman
			Midway Atoll
			Navassa Island
			Palmyra Atoll
			Seranilla Bank
			Isla Wake
			Otro (especifique)	G
SPEDO05331	G	Otro lugar --> Por favor especifique adónde vive.			Text field, <100 char		N	Skip Logic Group	Other Location
SPEDO05332		¿Cuál es el grado de educación más alto que ha obtenido?	No se graduó de la escuela secundaria		Drop down, select one	Single	N	Skip Logic Group	Education
			Asistió por un tiempo a la escuela secundaria					Change to Skip Logic so that it can be a drop down question.		To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			Graduado de la escuela secundaría o su equivalente
			Estudió en la universidad pero no se graduó
			Grado Asociado
			Graduado de 4 años de universidad
			Graduado con una maestría
			Graduado con un título profesional (MD, JD, etc)
			Doctorado en philosofía (PhD)
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	X
SPEDO05333	X	Otro grado de educación --> Por favor especifique el nivel de educación más alto que ha completado.			Text field, <100 char		N	Skip Logic Group	Other Education