682 2013 682 Retirement Estimator v4 with Spanish Translatio

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Overview

Welcome and Thank You Text
v4 Model Qsts (EE)
v4 Current Custom Qsts EE

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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: v4 Model Qsts (EE)

Model Instance Name:
SSA Retirement Estimator v4
MID:		dwYM9t9olVlhBdRVhFxhIw4C
Partitioned (Y/N)?		N			Element rotation scheme has been added
FPI Included(Y/N)?
Date:		7/19/2013
SSA Retirement Estimator v4
Model questions utilize the ACSI methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS	FPI
	MQ Label			MQ Label			MQ Label		Y?
		Look and Feel (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Apply in office for Benefits (1=Very Unlikely, 10=Very Likely)
	Look and Feel - Appeal	Please rate the visual appeal of this online Retirement Estimator.		Satisfaction - Overall	What is your overall satisfaction with the online Retirement Estimator? (1=Very Dissatisfied, 10=Very Satisfied)		Apply in Office	How likely are you to apply for Social Security Benefits in the field office?
	Look and Feel - Balance	Please rate the balance of graphics and text in this online Retirement Estimator.		Satisfaction - Expectations	How well does the online Retirement Estimator meet your expectations? (1=Falls Short, 10=Exceeds)			Apply online for Benefits (1=Very Unlikely, 10=Very Likely)
	Look and Feel - Readability	Please rate the readability of the pages in this online Retirement Estimator.		Satisfaction - Ideal	How does the online Retirement Estimator compare to your idea of an ideal online process? (1=Not Very Close, 10=Very Close)		Apply Online	How likely are you to apply for Social Security Benefits online?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Recommend (1=Very Unlikely, 10=Very Likely)
	Site Performance - Loading	Please rate how quickly pages load in this online Retirement Estimator.					Recommend	How likely are you to recommend this online Retirement Estimator to someone else?
	Site Performance - Consistency	Please rate the consistency of speed from page to page in this online Retirement Estimator.						Return (if applicable) (1=Very Unlikely, 10=Very Likely)
	Site Performance - Errors	Please rate the ability to load pages without getting error messages in this online Retirement Estimator.					Return	How likely are you to return to the Retirement Estimator?
		Plain Language (1=Poor, 10=Excellent, Don't Know)						Use Other SSA Applications (1=Very Unlikely, 10=Very Likely)
	Plain Language - Clear	Please rate the clarity of the wording in the online Retirement Estimator.					Use Other Online Services	How likely are you to use other Social Security online services?
	Plain Language - Understandable	Please rate how well you understand the wording in the online Retirement Estimator.
	Plain Language - Concise	Please rate the online Retirement Estimator on its use of short, clear sentences.

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Sheet 3: v4 Current Custom Qsts EE

Social Security Administration				red & strike-through: DELETE
SSA Retirement Estimator v4				underlined & italicized: RE-ORDER
MID: dwYM9t9olVlhBdRVhFxhIw4C				pink: ADDITION
Date:	10/6/2010			blue + -->: REWORDING
SSA Retirement Estimator v4 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer IDs (DOT ONLY)	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)
BJL2254		How did you first learn about the Retirement Estimator?	BJL2254A01	Search engine		Radio button, one-up vertical	Single	Y	OPS Group	Learned about RE	This is not a new question
			BJL2254A02	Linked from another website
			BJL2254A03	From an SSA representative
			BJL2254A04	SSA publication
			BJL2254A05	From my Annual Social Security Statement
			BJL2254A06	Newspaper, magazine or other media
			BJL2254A07	My employer or Human Resources department
			BJL2254A08	My financial advisor
			BJL2254A09	Word of mouth
			BJL2254A10	Other, please specify	C
BJL2255	C	Other learned about				Text field, <100 char		N	OPS Group	Other learned about
BJL2256		Have you ever sought advice on retirement/financial planning or saving strategies?	BJL2256A01	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.
			BJL2256A02	No
BJL2257	D	From what source have you sought advice on retirement/financial planning or saving strategies.	BJL2257A01	Family/Friend		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Advice Source
			BJL2257A02	Financial professional
			BJL2257A03	Internet
			BJL2257A04	Other
BJL2258		Which statement best describes how you completed the Retirement Estimator?	BJL2258A01	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.
			BJL2258A02	I completed it for myself with assistance from a friend or family member
			BJL2258A03	I completed it for myself with assistance from a professional
			BJL2258A04	I completed it for someone else
			BJL2258A05	Other
BJL2259		Did the Retirement Estimator help you decide at what age to claim benefits?	BJL2259A01	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.
			BJL2259A02	No	A
BJL2260	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
BJL2261		At what age do you plan to file for benefits?	BJL2261A01	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. .
			BJL2261A02	63
			BJL2261A03	64
			BJL2261A04	65
			BJL2261A05	66
			BJL2261A06	67
			BJL2261A07	68
			BJL2261A08	69
			BJL2261A09	70
			BJL2261A10	71 or older
			BJL2261A11	Unsure
			BJL2261A12	Other, please specify	E
BJL2262	E	Please specify the age at which you intend to file for benefits.				Text field, <100 char		N	Skip Logic Group	Other Age
BJL2263		When do you expect to file for retirement benefits?	BJL2263A01	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			BJL2263A02	1 to 3 years
			BJL2263A03	More than 3 but less than 6 years
			BJL2263A04	More than 6 years
			BJL2263A05	Don't Know
BJL2264		How do you plan to file for retirement benefits?	BJL2264A01	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			BJL2264A02	By telephone interview
			BJL2264A03	Face-to-face in my local SSA field office
			BJL2264A04	Online with telephone or in-person assistance, if needed
			BJL2264A05	Don't Know
BJL2265		Did you accomplish your primary purpose in using the Retirement Estimator?	BJL2265A01	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal	This is not a new question
			BJL2265A02	No	F
			BJL2265A03	Still Trying	F
BJL2266	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	Skip Logic Group	OE_Did not accomplish
BJL2267		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	BJL2267A01	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	OPS Group	Navigation Experience
			BJL2267A02	I had difficulty finding the links to the Retirement Estimator
			BJL2267A03	Links often did not take me where I expected
			BJL2267A04	I experienced technical difficulties (error messages, broken links, etc.)
			BJL2267A05	I had a navigation difficulty not listed above:	A
BJL2268	A	Other navigation difficulty				Text field, <100 char		N	OPS Group	Other Difficulty
BJL2269		Have you ever used the SSA Retirement Planner?	BJL2269A01	Yes		Radio button, one-up vertical	Single	Y		RE Planner	This is not a new question
			BJL2269A02	No
			BJL2269A03	Don't know what that is
BJL2270		What do you plan to do next in regard to getting answers about your estimated retirement benefits?	BJL2270A01	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.
			BJL2270A02	Call Social Security's 800 number
			BJL2270A03	Call my local Social Security office
			BJL2270A04	Visit my local Social Security office
			BJL2270A05	Try finding the answers on the Social Security website
			BJL2270A06	Try the Retirement Estimator again
			BJL2270A07	Don't Know
BJL2271		What is your preferred language for conducting business with the Social Security Administration?	BJL2271A01	English		Radio button, one-up vertical	Single	Y	OPS Group	Preferred language	This is not a new question
			BJL2271A02	Spanish
			BJL2271A03	Other, please specify	A
BJL2272	A	Other preferred language				Text field, <100 char		N	OPS Group	Other learned about
BJL2273		What is your age?	BJL2273A01	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.
			BJL2273A02	18-20
			BJL2273A03	21-30
			BJL2273A04	31-40
			BJL2273A05	41-50
			BJL2273A06	51-55
			BJL2273A07	56
			BJL2273A08	57
			BJL2273A09	58
			BJL2273A10	59
			BJL2273A11	60
			BJL2273A12	61
			BJL2273A13	62
			BJL2273A14	63
			BJL2273A15	64
			BJL2273A16	65
			BJL2273A17	66
			BJL2273A18	67 or older
			BJL2273A19	Prefer not to answer
BJL2274		Where do you live?	BJL2274A01	Alabama		Drop down, select one	Single	N	Skip Logic Group	Location
			BJL2274A02	Alaska							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.
			BJL2274A03	Arizona
			BJL2274A04	Arkansas
			BJL2274A05	California
			BJL2274A06	Colorado
			BJL2274A07	Connecticut
			BJL2274A08	Delaware
			BJL2274A09	District of Columbia
			BJL2274A10	Florida
			BJL2274A11	Georgia
			BJL2274A12	Hawaii
			BJL2274A13	Idaho
			BJL2274A14	Illinois
			BJL2274A15	Indiana
			BJL2274A16	Iowa
			BJL2274A17	Kansas
			BJL2274A18	Kentucky
			BJL2274A19	Louisiana
			BJL2274A20	Maine
			BJL2274A21	Maryland
			BJL2274A22	Massachusetts
			BJL2274A23	Michigan
			BJL2274A24	Minnesota
			BJL2274A25	Mississippi
			BJL2274A26	Missouri
			BJL2274A27	Montana
			BJL2274A28	Nebraska
			BJL2274A29	Nevada
			BJL2274A30	New Hampshire
			BJL2274A31	New Jersey
			BJL2274A32	New Mexico
			BJL2274A33	New York
			BJL2274A34	North Carolina
			BJL2274A35	North Dakota
			BJL2274A36	Ohio
			BJL2274A37	Oklahoma
			BJL2274A38	Oregon
			BJL2274A39	Pennsylvania
			BJL2274A40	Rhode Island
			BJL2274A41	South Carolina
			BJL2274A42	South Dakota
			BJL2274A43	Tennessee
			BJL2274A44	Texas
			BJL2274A45	Utah
			BJL2274A46	Vermont
			BJL2274A47	Virginia
			BJL2274A48	Washington
			BJL2274A49	West Virginia
			BJL2274A50	Wisconsin
			BJL2274A51	Wyoming
			BJL2274A52	American Samoa
			BJL2274A53	Guam
			BJL2274A54	Northern Mariana Islands
			BJL2274A55	Puerto Rico
			BJL2274A56	US Virgin Islands
			BJL2274A57	Bajo Nuevo Bank
			BJL2274A58	Baker Island
			BJL2274A59	Howland Island
			BJL2274A60	Jarvis Island
			BJL2274A61	Johnston Atoll
			BJL2274A62	Kingman Reef
			BJL2274A63	Midway Atoll
			BJL2274A64	Navassa Island
			BJL2274A65	Palmyra Atoll
			BJL2274A66	Serranilla Bank
			BJL2274A67	Wake Island
			BJL2274A68	Other - Please specify	G
BJL2275	G	Please specify where you live.				Text field, <100 char		N	Skip Logic Group	Other Location
BJL2276		What is the highest level of education you have completed?	BJL2276A01	No high school		Drop down, select one	Single	N	Skip Logic Group	Education
			BJL2276A02	Some high school							To examine which groups are more/less likely to use the RE, as well as a proxy for their income levels.
			BJL2276A03	High school diploma or equivalent
			BJL2276A04	Some college, but no degree
			BJL2276A05	Associate's degree
			BJL2276A06	Bachelor's degree
			BJL2276A07	Master's degree
			BJL2276A08	Professional degree (MD, JD, etc)
			BJL2276A09	Doctorate degree (PhD)
			BJL2276A10	Prefer not to answer
			BJL2276A11	Other, please specify	X
BJL2277	X	Please specify the highest level of education you have completed.				Text field, <100 char		N	Skip Logic Group	Other Education
BJL2278		What is your current marital status?	BJL2278A01	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			BJL2278A02	Separated
			BJL2278A03	Divorced
			BJL2278A04	Widowed
			BJL2278A05	Never married
			BJL2278A06	Prefer not to answer
			BJL2278A07	Other, please specify	x
BJL2279	X	Other marital status				Text field, <100 char		N	OPS Group	Other Marital
BJL2280		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.				Text area, no char limit		N		Improvement