557 PBGC.gov v3 Questionnaire 8-15-12

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Overview

Model Qs
Custom Qs
Custom Qs (8-15-12)
Custom Qs (4-13-12)
Qs (4-5-12)
Custom Qs (2-21-12)
Custom Qs (2-17-12)
Custom Qs 1-23-12

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Sheet 1: Model Qs

Model Instance Name:
PBGC.gov v3
MID:	AVlQFl1U8FsFotVgEd1oww==
Date:	9/22/2011
PBGC.gov v3 MODEL QUESTION LIST
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Return (1=Very Unlikely, 10=Very Likely)
1	Please rate the completeness of information on this site.	24	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)	27	How likely are you to return to this site?
2	Please rate the quality of information on this site.	25	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)		Prefer Web Channel (1=Very Unlikely, 10=Very Likely)
3	Please rate the freshness of content on this site.	26	How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close)	28	How likely are you to use this site rather than calling or writing?
	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 site.			29	How likely are you to recommend this site to someone else?
5	Please rate the balance of graphics and text on this site.				Trust (1=Not at all Trustworthy, 10=Very Trustworthy)
6	Please rate the readability of the pages on this site (for example, text size or color).			30	Please rate your level of trust in this agency.
	Navigation (1=Poor, 10=Excellent, Don't Know)
7	Please rate how well the site is organized.
8	Please rate the options available for navigating this site.
9	Please rate how well the site layout helps you find what you are looking for.
10	Please rate the number of clicks to get where you want on this site.
	Online Transparency (1=Poor, 10=Excellent, Don't Know)
11	Please rate how thoroughly this website discloses information about what this agency is doing.
12	Please rate how quickly agency information is made available on this website.
13	Please rate how well information about this agency's actions can be accessed by the public on this website.
	Search (1=Poor, 10=Excellent, Don't Know)
14	Please rate the relevance of search results on this site.
15	Please rate the organization of search results on this site.
16	Please rate how well the headings and descriptions in the search results help you decide what to select.
17	Please rate how well the search feature helps you to narrow the results to find what you want.
	Plain Language (1=Poor, 10=Excellent, Don't Know)
18	Please rate the clarity of the wording on this site.
19	Please rate how well you understand the wording on this site.
20	Please rate the site on its use of short, clear sentences.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
21	Please rate how quickly pages load on this site.
22	Please rate the consistency of speed from page to page on this site.
23	Please rate the ability to load pages without getting error messages on this site.

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Sheet 2: Custom Qs

Model Instance Name:				red & strike-through: DELETE
PBGC.gov v3				underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==				pink: ADDITION
Date:	9/22/2011			blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text		Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
SAC4232		Is this your first visit to PBGC.gov?	SAC4232A001	Yes		Radio button, one-up vertical	Single	Y		Visit
			SAC4232A002	No
			SAC4232A003	Not sure
SAC4233		Which best describes you?		United Airlines worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			SAC4233A001	Worker or retiree
			SAC4233A002	Widow(er) or spouse or beneficiary
			SAC4233A003	Researcher or student
			SAC4233A004	Practitioner or pension professional
			SAC4233A005	Media or press representative
			SAC4233A006	Trade association or business organization
			SAC4233A007	Other (please specify)	A
SAC4234	A	Other - best describes you:				Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	SAC4235A001	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			SAC4235A002	To search for unclaimed pensions on PBGC’s missing participant list
			SAC4235A003	To log in to MyPBA (worker or retiree info)
			SAC4235A004	To obtain tax information or Form 1099					Randomize
			SAC4235A005	To follow up on an annual funding notice I received
			SAC4235A006	To find premium-related information
			SAC4235A007	To log in to My PAA (premium-related matters)
			SAC4235A008	To research plan termination
			SAC4235A009	To find information and news about PBGC
			SAC4235A010	To find information on defined benefit pensions
			SAC4235A011	Other (please specify)	A	Pin Answer Choice
SAC4236	A	Other - purpose in visiting PBGC's website today:				Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	SAC4237A001	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			SAC4237A002	No	A
			SAC4237A003	In part	A
			SAC4237A004	Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	SAC4238A001	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			SAC4238A002	Could not log in to MyPBA or My PAA
			SAC4238A003	Had technical difficulties
			SAC4238A004	Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.				Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	SAC4240A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			SAC4240A002	No
SAC4241	A	Did you find what you were looking for?	SAC4241A001	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			SAC4241A002	No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	SAC4242A001	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			SAC4242A002	Search results were not helpful
			SAC4242A003	Returned too many results
			SAC4242A004	Returned not enough or zero results
			SAC4242A005	Returned results that were too similar/redundant
			SAC4242A006	Results were not relevant to my search terms or needs
			SAC4242A007	I was not sure what words to use in my search
			SAC4242A008	Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.				Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	SAC4244A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			SAC4244A002	No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	SAC4245A001	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			SAC4245A002	2	B
			SAC4245A003	3	B
			SAC4245A004	4	B
			SAC4245A005	5	B
			SAC4245A006	6	B
			SAC4245A007	7	B
			SAC4245A008	8	B
			SAC4245A009	9	B
			SAC4245A010	10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	SAC4246A001	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			SAC4246A002	I found myself or my pension plan
			SAC4246A003	I didn’t find myself or my pension plan
			SAC4246A004	Search results were helpful
			SAC4246A005	Search results were not helpful
			SAC4246A006	Returned too many results
			SAC4246A007	Returned not enough or zero results
			SAC4246A008	Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.				Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	SAC4248A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			SAC4248A002	No
SAC4249	A	Description of difficulties:				Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	SAC4250A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			SAC4250A002	No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	SAC4251A001	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			SAC4251A002	The information on the website was not clear or helpful
			SAC4251A003	I did not find the information I was looking for
			SAC4251A004	I was already planning to call
			SAC4251A005	Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.				Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	SAC4253A001	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			SAC4253A002	Please consider	A
SAC4254	A	Description of other information or online services:				Text area, no char limit		N	Skip logic group	OE_Other info or services

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Sheet 3: Custom Qs (8-15-12)

Model Instance Name:				red & strike-through: DELETE
PBGC.gov v3				underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==				pink: ADDITION
Date:	9/22/2011			blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text		Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
SAC4232		Is this your first visit to PBGC.gov?	SAC4232A001	Yes		Radio button, one-up vertical	Single	Y		Visit
			SAC4232A002	No
			SAC4232A003	Not sure
SAC4233		Which best describes you?		United Airlines worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			SAC4233A001	Worker or retiree
			SAC4233A002	Widow(er) or spouse or beneficiary
			SAC4233A003	Researcher or student
			SAC4233A004	Practitioner or pension professional
			SAC4233A005	Media or press representative
			SAC4233A006	Trade association or business organization
			SAC4233A007	Other (please specify)	A
SAC4234	A	Other - best describes you:				Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	SAC4235A001	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			SAC4235A002	To search for unclaimed pensions on PBGC’s missing participant list
			SAC4235A003	To log in to MyPBA (worker or retiree info)
			SAC4235A004	To obtain tax information or Form 1099					Randomize
			SAC4235A005	To follow up on an annual funding notice I received
			SAC4235A006	To find premium-related information
			SAC4235A007	To log in to My PAA (premium-related matters)
			SAC4235A008	To research plan termination
			SAC4235A009	To find information and news about PBGC
			SAC4235A010	To find information on defined benefit pensions
			SAC4235A011	Other (please specify)	A	Pin Answer Choice
SAC4236	A	Other - purpose in visiting PBGC's website today:				Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	SAC4237A001	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			SAC4237A002	No	A
			SAC4237A003	In part	A
			SAC4237A004	Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	SAC4238A001	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			SAC4238A002	Could not log in to MyPBA or My PAA
			SAC4238A003	Had technical difficulties
			SAC4238A004	Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.				Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	SAC4240A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			SAC4240A002	No
SAC4241	A	Did you find what you were looking for?	SAC4241A001	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			SAC4241A002	No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	SAC4242A001	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			SAC4242A002	Search results were not helpful
			SAC4242A003	Returned too many results
			SAC4242A004	Returned not enough or zero results
			SAC4242A005	Returned results that were too similar/redundant
			SAC4242A006	Results were not relevant to my search terms or needs
			SAC4242A007	I was not sure what words to use in my search
			SAC4242A008	Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.				Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	SAC4244A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			SAC4244A002	No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	SAC4245A001	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			SAC4245A002	2	B
			SAC4245A003	3	B
			SAC4245A004	4	B
			SAC4245A005	5	B
			SAC4245A006	6	B
			SAC4245A007	7	B
			SAC4245A008	8	B
			SAC4245A009	9	B
			SAC4245A010	10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	SAC4246A001	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			SAC4246A002	I found myself or my pension plan
			SAC4246A003	I didn’t find myself or my pension plan
			SAC4246A004	Search results were helpful
			SAC4246A005	Search results were not helpful
			SAC4246A006	Returned too many results
			SAC4246A007	Returned not enough or zero results
			SAC4246A008	Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.				Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	SAC4248A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			SAC4248A002	No
SAC4249	A	Description of difficulties:				Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	SAC4250A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			SAC4250A002	No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	SAC4251A001	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			SAC4251A002	The information on the website was not clear or helpful
			SAC4251A003	I did not find the information I was looking for
			SAC4251A004	I was already planning to call
			SAC4251A005	Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.				Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	SAC4253A001	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			SAC4253A002	Please consider	A
SAC4254	A	Description of other information or online services:				Text area, no char limit		N	Skip logic group	OE_Other info or services

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Sheet 4: Custom Qs (4-13-12)

Model Instance Name:				red & strike-through: DELETE
PBGC.gov v3				underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==				pink: ADDITION
Date:	9/22/2011			blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text		Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
SAC4232		Is this your first visit to PBGC.gov?	SAC4232A001	Yes		Radio button, one-up vertical	Single	Y		Visit
			SAC4232A002	No
			SAC4232A003	Not sure
SAC4233		Which best describes you?	SAC4233A001	Worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			SAC4233A002	Widow(er) or spouse or beneficiary
			SAC4233A003	Researcher or student
			SAC4233A004	Practitioner or pension professional
			SAC4233A005	Media or press representative
			SAC4233A006	Trade association or business organization
			SAC4233A007	Other (please specify)	A
SAC4234	A	Other - best describes you:				Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	SAC4235A001	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			SAC4235A002	To search for unclaimed pensions on PBGC’s missing participant list
			SAC4235A003	To log in to MyPBA (worker or retiree info)
			SAC4235A004	To obtain tax information or Form 1099					Randomize
			SAC4235A005	To follow up on an annual funding notice I received
			SAC4235A006	To find premium-related information
			SAC4235A007	To log in to My PAA (premium-related matters)
			SAC4235A008	To research plan termination
			SAC4235A009	To find information and news about PBGC
			SAC4235A010	To find information on defined benefit pensions
			SAC4235A011	Other (please specify)	A	Pin Answer Choice
SAC4236	A	Other - purpose in visiting PBGC's website today:				Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	SAC4237A001	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			SAC4237A002	No	A
			SAC4237A003	In part	A
			SAC4237A004	Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	SAC4238A001	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			SAC4238A002	Could not log in to MyPBA or My PAA
			SAC4238A003	Had technical difficulties
			SAC4238A004	Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.				Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	SAC4240A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			SAC4240A002	No
SAC4241	A	Did you find what you were looking for?	SAC4241A001	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			SAC4241A002	No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	SAC4242A001	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			SAC4242A002	Search results were not helpful
			SAC4242A003	Returned too many results
			SAC4242A004	Returned not enough or zero results
			SAC4242A005	Returned results that were too similar/redundant
			SAC4242A006	Results were not relevant to my search terms or needs
			SAC4242A007	I was not sure what words to use in my search
			SAC4242A008	Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.				Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	SAC4244A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			SAC4244A002	No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	SAC4245A001	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			SAC4245A002	2	B
			SAC4245A003	3	B
			SAC4245A004	4	B
			SAC4245A005	5	B
			SAC4245A006	6	B
			SAC4245A007	7	B
			SAC4245A008	8	B
			SAC4245A009	9	B
			SAC4245A010	10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	SAC4246A001	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			SAC4246A002	I found myself or my pension plan
			SAC4246A003	I didn’t find myself or my pension plan
			SAC4246A004	Search results were helpful
			SAC4246A005	Search results were not helpful
			SAC4246A006	Returned too many results
			SAC4246A007	Returned not enough or zero results
			SAC4246A008	Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.				Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	SAC4248A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			SAC4248A002	No
SAC4249	A	Description of difficulties:				Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	SAC4250A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			SAC4250A002	No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	SAC4251A001	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			SAC4251A002	The information on the website was not clear or helpful
			SAC4251A003	I did not find the information I was looking for
			SAC4251A004	I was already planning to call
			SAC4251A005	Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.				Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	SAC4253A001	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			SAC4253A002	Please consider	A
SAC4254	A	Description of other information or online services:				Text area, no char limit		N	Skip logic group	OE_Other info or services

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Sheet 5: Qs (4-5-12)

Model Instance Name:				red & strike-through: DELETE
PBGC.gov v3				underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==				pink: ADDITION
Date:	9/22/2011			blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text		Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
CQMMW001		Thinking about the agency as a whole, please rate your perception of the thoroughness of the information that the PBGC provides.	CQMMW001A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW001A02	2
			CQMMW001A03	3
			CQMMW001A04	4
			CQMMW001A05	5
			CQMMW001A06	6
			CQMMW001A07	7
			CQMMW001A08	8
			CQMMW001A09	9
			CQMMW001A10	10=Excellent
			CQMMW001A11	Don't Know
CQMMW002		Please rate how understandable you find the information that the PBGC provides.	CQMMW002A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW002A02	2
			CQMMW002A03	3
			CQMMW002A04	4
			CQMMW002A05	5
			CQMMW002A06	6
			CQMMW002A07	7
			CQMMW002A08	8
			CQMMW002A09	9
			CQMMW002A10	10=Excellent
			CQMMW002A11	Don't Know
CQMMW003		Please rate how well the agency's information provides answers to your questions.	CQMMW003A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW003A02	2
			CQMMW003A03	3
			CQMMW003A04	4
			CQMMW003A05	5
			CQMMW003A06	6
			CQMMW003A07	7
			CQMMW003A08	8
			CQMMW003A09	9
			CQMMW003A10	10=Excellent
			CQMMW003A11	Don't Know
CQMMW004		Thinking about the agency's services as a whole, please rate the extent to which the PBGC provides needed services.	CQMMW004A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW004A02	2
			CQMMW004A03	3
			CQMMW004A04	4
			CQMMW004A05	5
			CQMMW004A06	6
			CQMMW004A07	7
			CQMMW004A08	8
			CQMMW004A09	9
			CQMMW004A10	10=Excellent
			CQMMW004A11	Don't Know
ACQWro0010915		Please rate your perception of the range of services offered by the PBGC.	ACQWro0010915A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010915A02	2
			ACQWro0010915A03	3
			ACQWro0010915A04	4
			ACQWro0010915A05	5
			ACQWro0010915A06	6
			ACQWro0010915A07	7
			ACQWro0010915A08	8
			ACQWro0010915A09	9
			ACQWro0010915A10	10=Excellent
			ACQWro0010915A11	Don't Know
ACQWro0010916		Please rate your perception of how well the PBGC delivers its services.	ACQWro0010916A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010916A02	2
			ACQWro0010916A03	3
			ACQWro0010916A04	4
			ACQWro0010916A05	5
			ACQWro0010916A06	6
			ACQWro0010916A07	7
			ACQWro0010916A08	8
			ACQWro0010916A09	9
			ACQWro0010916A10	10=Excellent
			ACQWro0010916A11	Don't Know
CQMMW007		Please rate your impression of the PBGC's level of responsiveness to those served by the agency.	CQMMW007A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW007A02	2
			CQMMW007A03	3
			CQMMW007A04	4
			CQMMW007A05	5
			CQMMW007A06	6
			CQMMW007A07	7
			CQMMW007A08	8
			CQMMW007A09	9
			CQMMW007A10	10=Excellent
			CQMMW007A11	Don't Know
ACQWro0010917		Please rate your perception of the options available for the delivery of PBGC services.	ACQWro0010917A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010917A02	2
			ACQWro0010917A03	3
			ACQWro0010917A04	4
			ACQWro0010917A05	5
			ACQWro0010917A06	6
			ACQWro0010917A07	7
			ACQWro0010917A08	8
			ACQWro0010917A09	9
			ACQWro0010917A10	10=Excellent
			ACQWro0010917A11	Don't Know
ACQWro0010918		Please rate your overall impression of the PBGC's work as it carries out its mission to protect pensions.	ACQWro0010918A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010918A02	2
			ACQWro0010918A03	3
			ACQWro0010918A04	4
			ACQWro0010918A05	5
			ACQWro0010918A06	6
			ACQWro0010918A07	7
			ACQWro0010918A08	8
			ACQWro0010918A09	9
			ACQWro0010918A10	10=Excellent
			ACQWro0010918A11	Don't Know
ACQWro0010919		Please rate how well the PBGC shows that it takes responsibility for preserving pension plans.	ACQWro0010919A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010919A02	2
			ACQWro0010919A03	3
			ACQWro0010919A04	4
			ACQWro0010919A05	5
			ACQWro0010919A06	6
			ACQWro0010919A07	7
			ACQWro0010919A08	8
			ACQWro0010919A09	9
			ACQWro0010919A10	10=Excellent
			ACQWro0010919A11	Don't Know
ACQWro0010934		Please rate how well the PBGC perserves pension plans.	ACQWro0010934A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010934A02	2
			ACQWro0010934A03	3
			ACQWro0010934A04	4
			ACQWro0010934A05	5
			ACQWro0010934A06	6
			ACQWro0010934A07	7
			ACQWro0010934A08	8
			ACQWro0010934A09	9
			ACQWro0010934A10	10=Excellent
			ACQWro0010934A11	Don't Know
ACQWro0010935		Please rate how effectively you feel the PBGC protects pensioners.	ACQWro0010935A01	1=Poor		Radio button, scale, has don't know	S	Y
			ACQWro0010935A02	2
			ACQWro0010935A03	3
			ACQWro0010935A04	4
			ACQWro0010935A05	5
			ACQWro0010935A06	6
			ACQWro0010935A07	7
			ACQWro0010935A08	8
			ACQWro0010935A09	9
			ACQWro0010935A10	10=Excellent
			ACQWro0010935A11	Don't Know
ACQLiv0010405		What could PBGC do differently as an agency to better meet your needs?				Text area, no char limit	Single	N		Meet Needs
SAC4232		Is this your first visit to PBGC.gov?	SAC4232A001	Yes		Radio button, one-up vertical	Single	Y		Visit
			SAC4232A002	No
			SAC4232A003	Not sure
SAC4233		Which best describes you?	SAC4233A001	Worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			SAC4233A002	Widow(er) or spouse or beneficiary
			SAC4233A003	Researcher or student
			SAC4233A004	Practitioner or pension professional
			SAC4233A005	Media or press representative
			SAC4233A006	Trade association or business organization
			SAC4233A007	Other (please specify)	A
SAC4234	A	Other - best describes you:				Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	SAC4235A001	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			SAC4235A002	To search for unclaimed pensions on PBGC’s missing participant list
			SAC4235A003	To log in to MyPBA (worker or retiree info)
			SAC4235A004	To obtain tax information or Form 1099
			SAC4235A005	To follow up on an annual funding notice I received
			SAC4235A006	To find premium-related information
			SAC4235A007	To log in to My PAA (premium-related matters)
			SAC4235A008	To research plan termination
			SAC4235A009	To find information and news about PBGC
			SAC4235A010	To find information on defined benefit pensions
			SAC4235A011	Other (please specify)	A
SAC4236	A	Other - purpose in visiting PBGC's website today:				Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	SAC4237A001	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			SAC4237A002	No	A
			SAC4237A003	In part	A
			SAC4237A004	Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	SAC4238A001	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			SAC4238A002	Could not log in to MyPBA or My PAA
			SAC4238A003	Had technical difficulties
			SAC4238A004	Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.				Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	SAC4240A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			SAC4240A002	No
SAC4241	A	Did you find what you were looking for?	SAC4241A001	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			SAC4241A002	No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	SAC4242A001	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			SAC4242A002	Search results were not helpful
			SAC4242A003	Returned too many results
			SAC4242A004	Returned not enough or zero results
			SAC4242A005	Returned results that were too similar/redundant
			SAC4242A006	Results were not relevant to my search terms or needs
			SAC4242A007	I was not sure what words to use in my search
			SAC4242A008	Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.				Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	SAC4244A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			SAC4244A002	No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	SAC4245A001	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			SAC4245A002	2	B
			SAC4245A003	3	B
			SAC4245A004	4	B
			SAC4245A005	5	B
			SAC4245A006	6	B
			SAC4245A007	7	B
			SAC4245A008	8	B
			SAC4245A009	9	B
			SAC4245A010	10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	SAC4246A001	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			SAC4246A002	I found myself or my pension plan
			SAC4246A003	I didn’t find myself or my pension plan
			SAC4246A004	Search results were helpful
			SAC4246A005	Search results were not helpful
			SAC4246A006	Returned too many results
			SAC4246A007	Returned not enough or zero results
			SAC4246A008	Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.				Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	SAC4248A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			SAC4248A002	No
SAC4249	A	Description of difficulties:				Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	SAC4250A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			SAC4250A002	No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	SAC4251A001	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			SAC4251A002	The information on the website was not clear or helpful
			SAC4251A003	I did not find the information I was looking for
			SAC4251A004	I was already planning to call
			SAC4251A005	Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.				Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	SAC4253A001	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			SAC4253A002	Please consider	A
SAC4254	A	Description of other information or online services:				Text area, no char limit		N	Skip logic group	OE_Other info or services

---

Sheet 6: Custom Qs (2-21-12)

Model Instance Name:				red & strike-through: DELETE
PBGC.gov v3				underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==				pink: ADDITION
Date:	9/22/2011			blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text		Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
CQMMW001		Thinking about the agency as a whole, please rate your perception of the thoroughness of the information that the PBGC provides.	CQMMW001A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW001A02	2
			CQMMW001A03	3
			CQMMW001A04	4
			CQMMW001A05	5
			CQMMW001A06	6
			CQMMW001A07	7
			CQMMW001A08	8
			CQMMW001A09	9
			CQMMW001A10	10=Excellent
			CQMMW001A11	Don't Know
CQMMW002		Please rate how understandable you find the information that the PBGC provides.	CQMMW002A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW002A02	2
			CQMMW002A03	3
			CQMMW002A04	4
			CQMMW002A05	5
			CQMMW002A06	6
			CQMMW002A07	7
			CQMMW002A08	8
			CQMMW002A09	9
			CQMMW002A10	10=Excellent
			CQMMW002A11	Don't Know
CQMMW003		Please rate how well the agency's information provides answers to your questions.	CQMMW003A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW003A02	2
			CQMMW003A03	3
			CQMMW003A04	4
			CQMMW003A05	5
			CQMMW003A06	6
			CQMMW003A07	7
			CQMMW003A08	8
			CQMMW003A09	9
			CQMMW003A10	10=Excellent
			CQMMW003A11	Don't Know
CQMMW004		Thinking about the agency's services as a whole, please rate the extent to which the PBGC provides needed services.	CQMMW004A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW004A02	2
			CQMMW004A03	3
			CQMMW004A04	4
			CQMMW004A05	5
			CQMMW004A06	6
			CQMMW004A07	7
			CQMMW004A08	8
			CQMMW004A09	9
			CQMMW004A10	10=Excellent
			CQMMW004A11	Don't Know
CQMMW005		Please rate the range of services offered by the PBGC.	CQMMW005A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW005A02	2
			CQMMW005A03	3
			CQMMW005A04	4
			CQMMW005A05	5
			CQMMW005A06	6
			CQMMW005A07	7
			CQMMW005A08	8
			CQMMW005A09	9
			CQMMW005A10	10=Excellent
			CQMMW005A11	Don't Know
New		Please rate your perception of the range of services offered by the PBGC.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
CQMMW006		Please rate how well the PBGC delivers its services.	CQMMW006A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW006A02	2
			CQMMW006A03	3
			CQMMW006A04	4
			CQMMW006A05	5
			CQMMW006A06	6
			CQMMW006A07	7
			CQMMW006A08	8
			CQMMW006A09	9
			CQMMW006A10	10=Excellent
			CQMMW006A11	Don't Know
New		Please rate your perception of how well the PBGC delivers its services.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
CQMMW007		Please rate your impression of the PBGC's level of responsiveness to those served by the agency.	CQMMW007A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW007A02	2
			CQMMW007A03	3
			CQMMW007A04	4
			CQMMW007A05	5
			CQMMW007A06	6
			CQMMW007A07	7
			CQMMW007A08	8
			CQMMW007A09	9
			CQMMW007A10	10=Excellent
			CQMMW007A11	Don't Know
CQMMW008		Please rate the options available for the delivery of PBGC services.	CQMMW008A01	1=Poor		Radio button, scale, has don't know	S	Y
			CQMMW008A02	2
			CQMMW008A03	3
			CQMMW008A04	4
			CQMMW008A05	5
			CQMMW008A06	6
			CQMMW008A07	7
			CQMMW008A08	8
			CQMMW008A09	9
			CQMMW008A10	10=Excellent
			CQMMW008A11	Don't Know
CQMMW009		Please rate your overall impression of the PBGC's work as it carries out its mission to protect pensions.	CQMMW009A01	1=Poor		Radion button, scale, no don't know	S	Y
			CQMMW009A02	2
			CQMMW009A03	3
			CQMMW009A04	4
			CQMMW009A05	5
			CQMMW009A06	6
			CQMMW009A07	7
			CQMMW009A08	8
			CQMMW009A09	9
			CQMMW009A10	10=Excellent
CQMMW010		Please rate how well the PBGC shows that it takes responsibility for preserving pension plans.	CQMMW010A01	1=Poor		Radion button, scale, no don't know	S	Y
			CQMMW010A02	2
			CQMMW010A03	3
			CQMMW010A04	4
			CQMMW010A05	5
			CQMMW010A06	6
			CQMMW010A07	7
			CQMMW010A08	8
			CQMMW010A09	9
			CQMMW010A10	10=Excellent
CQMMW011		Please rate how effectively you feel the PBGC perserves pension plans.	CQMMW011A01	1=Poor		Radion button, scale, no don't know	S	Y
			CQMMW011A02	2
			CQMMW011A03	3
			CQMMW011A04	4
			CQMMW011A05	5
			CQMMW011A06	6
			CQMMW011A07	7
			CQMMW011A08	8
			CQMMW011A09	9
			CQMMW011A10	10=Excellent
CQMMW012		Please rate how effectively you feel the PBGC protects pensioners.	CQMMW012A01	1=Poor		Radion button, scale, no don't know	S	Y
			CQMMW012A02	2
			CQMMW012A03	3
			CQMMW012A04	4
			CQMMW012A05	5
			CQMMW012A06	6
			CQMMW012A07	7
			CQMMW012A08	8
			CQMMW012A09	9
			CQMMW012A10	10=Excellent
New		Please rate your perception of the options available for the delivery of PBGC services.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
New		Please rate your overall impression of the PBGC's work as it carries out its mission to protect pensions.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
New		Please rate how well the PBGC shows that it takes responsibility for preserving pension plans.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
New		Please rate how well the PBGC perserves pension plans.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
New		Please rate how effectively you feel the PBGC protects pensioners.		1=Poor		Radio button, scale, has don't know	S	Y
				2
				3
				4
				5
				6
				7
				8
				9
				10=Excellent
				Don't Know
ACQLiv0010405		What could PBGC do differently as an agency to better meet your needs?				Text area, no char limit	Single	N		Meet Needs
SAC4232		Is this your first visit to PBGC.gov?	SAC4232A001	Yes		Radio button, one-up vertical	Single	Y		Visit
			SAC4232A002	No
			SAC4232A003	Not sure
SAC4233		Which best describes you?	SAC4233A001	Worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			SAC4233A002	Widow(er) or spouse or beneficiary
			SAC4233A003	Researcher or student
			SAC4233A004	Practitioner or pension professional
			SAC4233A005	Media or press representative
			SAC4233A006	Trade association or business organization
			SAC4233A007	Other (please specify)	A
SAC4234	A	Other - best describes you:				Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	SAC4235A001	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			SAC4235A002	To search for unclaimed pensions on PBGC’s missing participant list
			SAC4235A003	To log in to MyPBA (worker or retiree info)
			SAC4235A004	To obtain tax information or Form 1099
			SAC4235A005	To follow up on an annual funding notice I received
			SAC4235A006	To find premium-related information
			SAC4235A007	To log in to My PAA (premium-related matters)
			SAC4235A008	To research plan termination
			SAC4235A009	To find information and news about PBGC
			SAC4235A010	To find information on defined benefit pensions
			SAC4235A011	Other (please specify)	A
SAC4236	A	Other - purpose in visiting PBGC's website today:				Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	SAC4237A001	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			SAC4237A002	No	A
			SAC4237A003	In part	A
			SAC4237A004	Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	SAC4238A001	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			SAC4238A002	Could not log in to MyPBA or My PAA
			SAC4238A003	Had technical difficulties
			SAC4238A004	Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.				Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	SAC4240A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			SAC4240A002	No
SAC4241	A	Did you find what you were looking for?	SAC4241A001	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			SAC4241A002	No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	SAC4242A001	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			SAC4242A002	Search results were not helpful
			SAC4242A003	Returned too many results
			SAC4242A004	Returned not enough or zero results
			SAC4242A005	Returned results that were too similar/redundant
			SAC4242A006	Results were not relevant to my search terms or needs
			SAC4242A007	I was not sure what words to use in my search
			SAC4242A008	Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.				Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	SAC4244A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			SAC4244A002	No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	SAC4245A001	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			SAC4245A002	2	B
			SAC4245A003	3	B
			SAC4245A004	4	B
			SAC4245A005	5	B
			SAC4245A006	6	B
			SAC4245A007	7	B
			SAC4245A008	8	B
			SAC4245A009	9	B
			SAC4245A010	10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	SAC4246A001	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			SAC4246A002	I found myself or my pension plan
			SAC4246A003	I didn’t find myself or my pension plan
			SAC4246A004	Search results were helpful
			SAC4246A005	Search results were not helpful
			SAC4246A006	Returned too many results
			SAC4246A007	Returned not enough or zero results
			SAC4246A008	Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.				Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	SAC4248A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			SAC4248A002	No
SAC4249	A	Description of difficulties:				Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	SAC4250A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			SAC4250A002	No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	SAC4251A001	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			SAC4251A002	The information on the website was not clear or helpful
			SAC4251A003	I did not find the information I was looking for
			SAC4251A004	I was already planning to call
			SAC4251A005	Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.				Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	SAC4253A001	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			SAC4253A002	Please consider	A
SAC4254	A	Description of other information or online services:				Text area, no char limit		N	Skip logic group	OE_Other info or services

---

Sheet 7: Custom Qs (2-17-12)

Model Instance Name:			red & strike-through: DELETE
PBGC.gov v3			underlined & italicized: RE-ORDER
MID: AVlQFl1U8FsFotVgEd1oww==			pink: ADDITION
Date:	9/22/2011		blue + -->: REWORDING
PBGC.gov v3 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
ACQLiv0010397		Please rate your overall impression of PBGC's work as it carries out its mission to protect pensions.	1=Poor	A	Radio button, scale, has don't know	S	y	Skip logic group	Overall Impression
			2	A
			3	A
			4	A
			5	A
			6	A
			7
			8
			9
			10=Excellent
			Don't Know
ACQLiv0010398	A	Please specify your reason for this score.			Text area, no char limit	S	N		OE_Overall impression
ACQLiv0010399		Please rate the clarity of information you received from PBGC.	1=Poor	A	Radio button, scale, has don't know	S	y	Skip logic group	Info Received
			2	A
			3	A
			4	A
			5	A
			6	A
			7
			8
			9
			10=Excellent
			Don't Know
ACQLiv0010400	A	Please specify your reason for this score.			Text area, no char limit	S	N		OE_Info Received
ACQLiv0010401		Please rate how confident you are that future interactions with PBGC will meet your needs.	1=Not At All Confident	A	Radio button, scale, has don't know	S	y	Skip logic group	Future Interact
			2	A
			3	A
			4	A
			5	A
			6	A
			7
			8
			9
			10=Very Confident
			Don't Know
ACQLiv0010402	A	Please specify your reason for this score.			Text area, no char limit	S	N		OE_Future Interact
ACQLiv0010403		How confident are you that the PBGC will preserve defined benefit pension plans and protect workers' pensions?	1=Not At All Confident	A	Radio button, scale, has don't know	S	y	Skip logic group	Preserve Plans
			2	A
			3	A
			4	A
			5	A
			6	A
			7
			8
			9
			10=Very Confident
			Don't Know
ACQLiv0010404	A	Please specify your reason for this score.			Text area, no char limit	Single	N		OE_Preserve Plans
SAC7383		Thinking about the agency as a whole, please rate your perception of the thoroughness of the information that the PBGC provides.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7384		Please rate how understandable you find the information that the PBGC provides.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7385		Please rate how well the agency's information provides answers to your questions.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7386		Thinking about the agency's services as a whole, please rate the extent to which the PBGC provides needed services.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7387		Please rate the range of services offered by the PBGC.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7388		Please rate how well the PBGC delivers its services.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7389		Please rate your impression of the PBGC's level of responsiveness to those served by the agency.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7390		Please rate the options available for the delivery of PBGC services.	1=Poor		Radio button, scale, has don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
			Don't Know
SAC7391		Please rate your overall impression of the PBGC's work as it carries out its mission to protect pensions.	1=Poor		Radion button, scale, no don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
SAC7392		Please rate how well the PBGC shows that it takes responsibility for preserving pension plans.	1=Poor		Radion button, scale, no don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
SAC7393		Please rate how effectively you feel the PBGC perserves pension plans.	1=Poor		Radion button, scale, no don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
SAC7394		Please rate how effectively you feel the PBGC protects pensioners.	1=Poor		Radion button, scale, no don't know	S	Y
			2
			3
			4
			5
			6
			7
			8
			9
			10=Excellent
ACQLiv0010405		What could PBGC do differently as an agency to better meet your needs?			Text area, no char limit	Single	N		Meet Needs
SAC4232		Is this your first visit to PBGC.gov?	Yes		Radio button, one-up vertical	Single	Y		Visit
			No
			Not sure
SAC4233		Which best describes you?	Worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			Widow(er) or spouse or beneficiary
			Researcher or student
			Practitioner or pension professional
			Media or press representative
			Trade association or business organization
			Other (please specify)	A
SAC4234	A	Other - best describes you:			Text field, <100 char		N	Skip logic group	OE_Role
SAC4235		Why did you visit PBGC's website today?	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			To search for unclaimed pensions on PBGC’s missing participant list
			To log in to MyPBA (worker or retiree info)
			To obtain tax information or Form 1099
			To follow up on an annual funding notice I received
			To find premium-related information
			To log in to My PAA (premium-related matters)
			To research plan termination
			To find information and news about PBGC
			To find information on defined benefit pensions
			Other (please specify)	A
SAC4236	A	Other - purpose in visiting PBGC's website today:			Text area, no char limit		N	Skip logic group	OE_Purpose
SAC4237		Did you accomplish your goal?	Yes		Radio button, one-up vertical	Single	Y	Skip logic group	Accomplish
			No	A
			In part	A
			Not yet	A
SAC4238	A	Why were you unable to accomplish your goal?	Did not find specific information on me or my plan		Radio button, one-up vertical	Single	Y	Skip logic group	Unable to accomplish
			Could not log in to MyPBA or My PAA
			Had technical difficulties
			Other (please specify)	B
SAC4239	B	Please tell us specifically what you were trying to accomplish on the site.			Text area, no char limit		N	Skip logic group	OE_Accomplish
SAC4240		Did you use the “Search PBGC website” box at the top of our website?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Search box
			No
SAC4241	A	Did you find what you were looking for?	Yes	B	Radio button, one-up vertical	Single	Y	Skip logic group	Find_Search box
			No	B
SAC4242	B	Please tell us what your experience with the search was. (Select all that apply)	Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip logic group	Search box experience
			Search results were not helpful
			Returned too many results
			Returned not enough or zero results
			Returned results that were too similar/redundant
			Results were not relevant to my search terms or needs
			I was not sure what words to use in my search
			Other (please specify)	C
SAC4243	C	Please specify your experience with the “Search PBGC website” box at the top of our website.			Text area, no char limit		N	Skip logic group	OE_Search box experience
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list.	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			2	B
			3	B
			4	B
			5	B
			6	B
			7	B
			8	B
			9	B
			10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list. (Select all that apply)	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			I found myself or my pension plan
			I didn’t find myself or my pension plan
			Search results were helpful
			Search results were not helpful
			Returned too many results
			Returned not enough or zero results
			Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list.			Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4248		Did you experience any difficulties during your visit?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Difficulties
			No
SAC4249	A	Description of difficulties:			Text area, no char limit		N	Skip logic group	OE_Difficulties
SAC4250		Do you think you will call PBGC regarding the information you looked for on the website today?	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Call PBGC
			No
SAC4251	A	Please explain your reason for calling PBGC. (Select all that apply)	The website directed me to call		Checkbox, one-up vertical	Multi	Y	Skip logic group	Call reason
			The information on the website was not clear or helpful
			I did not find the information I was looking for
			I was already planning to call
			Other (please specify)	B
SAC4252	B	Please specify the other reason why you are likely to call PBGC.			Text area, no char limit		N	Skip logic group	OE_Call
SAC4253		What other information or online services would you like to see?	None		Radio button, one-up vertical	Single	Y	Skip logic group	Other info or services
			Please consider	A
SAC4254	A	Description of other information or online services:			Text area, no char limit		N	Skip logic group	OE_Other info or services

---

Sheet 8: Custom Qs 1-23-12

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