Form 1082 2014 837 SSA MySSA

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Overview

Guidelines
Welcome and Thank You Text
v2 Model Qsts
V2 Current CQs
V2 Current CQs (3-11-14)
V2 CQs (12-13-13)
V2 Current CQs (12-12-13)
CQs (1-7-13)
CQs
Current CQs (10-2-12)
CQs (4-2-12)
CQs (3-13-12)

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Sheet 1: Guidelines

SSA My Social Security v2

Partitioned Yes

Questionnaire Management Guidelines

Goals:

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One consolidated document to track all model and CQ changes throughout the life of the project

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Questionnaire always matches the live survey

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Easy and error-free way to submit CQ changes

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All changes tracked and reflected in one document (DOT will help)

Questionnaire Resources:

1

Questionnaire Design and Approval Process

2

Question Grouping Rules

3

OPS vs. Skip Logic Decision for "Other, Please Specify"

4

Model and Custom Question Checks_ SRA

5

Model and Custom Question Checks_ Team LeadManager

6

Model and Custom Question Checks_ DOT

7

Foreign Language Survey Instructions

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Sheet 2: Welcome and Thank You Text

Model Instance Name:

SSA My Social Security v2

MID:

Z5w0N58sJ5AkRkYUg4pVFg==

Partitioned Yes

2/8/2012

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 visiting our site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.

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 website.

us

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Sheet 3: v2 Model Qsts

Model Instance Name:
SSA My Social Security v2
MID:	R9JQtMNl09w1VJAZFxsVYQ4C
Partitioned Yes
FPI Included(Y/N)?
Date:		6/12/2013
SSA My Social Security v2
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			Recommend (1=Very Unlikely, 10=Very Likely)
	Look and Feel - Appeal	Please rate the visual appeal of this site.		Satisfaction - Overall	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)		Recommend	How likely are you to recommend this site to someone else?
	Look and Feel - Balance	Please rate the balance of graphics and text on this site.		Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)			Return (1=Very Unlikely, 10=Very Likely)
	Look and Feel - Readability	Please rate the readability of the pages on this site.		Satisfaction - Ideal	How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close)		Return	How likely are you to return to this site?
		Navigation (1=Poor, 10=Excellent, Don't Know)						Use Web Channel Over Others (1=Very Unlikely, 10=Very Likely)
	Navigation - Organized	Please rate how well the site is organized.					Use Web Channel Over Others	How likely are you to use this site rather than seek information from other channels (i.e. local field office, call center)?
	Navigation - Options	Please rate the options available for navigating this site.
	Navigation - Layout	Please rate how well the site layout helps you find what you are looking for.
		Site Performance (1=Poor, 10=Excellent, Don't Know)
	Site Performance - Loading	Please rate how quickly pages load on this site.
	Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.
	Site Performance - Errors	Please rate the ability to load pages without getting error messages on this site.
		My Social Security Information (1=Poor, 10=Excellent, Don't Know)
	My Social Security Information - Thoroughness	Please rate the thoroughness of information you viewed on this site today.
	My Social Security Information - Quality	Please rate the quaility of information you viewed today.
	My Social Security Information - Provided Answers	Please rate how well the information viewed today provided answers to your questions.
		Plain Language (1=Poor, 10=Excellent, Don't Know)
	Plain Language - Clear	Please rate the clarity of the wording on this site.
	Plain Language - Understandable	Please rate how well you understand the wording on this site.
	Plain Language - Concise	Please rate this site on its use of short, clear sentences.

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Sheet 4: V2 Current CQs

Model Instance Name:			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
MID:	R9JQtMNl09w1VJAZFxsVYQ4C		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
CAS0045388		How did you learn about my Social Security?	Learned about my Social Security on the SSA website		check box, one up	Multi	Y	Skip	Learn about
			SSA field office representative encouraged me to sign up
			SSA 800 Number representative encouraged me to sign up
			Other, please explain	A
CAS0045390	A	How did you learn about my Social Security			Text area, no char limit		N		OPS_Learn about
CAS0045392		Including today, how often have you accessed your my Social Security account?	This is my first time		radial button, one up vertical	Single	Y		Access Freq
			Once a month
			Once every three months
			Once every six months
			Once a year
CAS0045394		How often do you plan to access your my Social Security account in the future?	At least once a month		radial button, one up vertical	Single	Y		Future Use
			Once a month
			Once every three months
			Once every six months
			Once a year
BJL1506		Are you currently receiving cash benefits?	Yes, I am receiving Supplemental Security Income (SSI)		Radio button, one-up vertical	Single	Y		Cash Benefits
			Yes, I am receiving Social Security Benefits (Retirement, Disability, Spouses or Survivors)
			Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors)
			Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI
			I am entitled to Medicare Only coverage - no cash benefits
			I am not entitled to monthly benefits or Medicare
			I don't know or prefer not to answer
CAS0045395		What is your primary reason for visiting my Social Security today? (Check all that apply)	To print or view my online Social Security Statement	A	check box one up vertical	Multi	Yes	Skip Logic Group	Primary Reason
			To make sure my earnings record is correct
			To view my Benefits and Payment Details
			To check the status of my recently filed online application for benefits
			To get a Benefit Verification Letter	B
			Add Extra Security to my online account
			To use SSA's online benefit calculators
			To apply online for Social Security or Medicare Only benefits
			To change my address with SSA
			To enroll in or update my direct deposit
			To learn about the benefits to which I might be entitled
			Just curious - wanted to see what information was contained in my Social Security account
			Other reason for visiting today:	Z
CAS0045407	A	How often do you review your online Social Security Statement?	This is my first time	AA	check box one up vertical	Single	Y	Skip Logic Group	Freq View Statement
			Less frequently than once a year
			At least once a year
			Every 6 months
			Every 3 months
			Once a month
			More frequently than once a month
			Other
CAS0045408	AA	Do you plan to view your Social Security Statement online again?	Yes		radio button one up vertical			skip logic group	Plan to View State again
			No
CAS0045409	B	For which Agency or program do you need a Benefit Verification Letter? (Check all that apply)	USDA - SNAP		check box vertical one up	Multiple	Y	skip logic group	Agency Need
			IRS
			HUD - Federal Housing Admin. (FHA)
			Department of Veterans Affairs (VA)
			Requesting a Retirement Visa from another country
			Medicare
			Medicaid
			State or Local Department of Social Services
			Other agency or program	BB
CAS0045396	BB	Which "other" agency or program requested your Benefit Verification information?			Text area, no Char limit		N		OPS_Other Agency
CAS0045397	Z	Please tell us what your primary reason was for visiting today:			Text area, no Char limit		N		OPS_Primary Reason
CAS0045398		Did you register for my Social Security online or in person?	Registered online on my first attempt	A	Radio button, one-up vertical	Single	Y	Skip Logic Group	How Registered
			Registered online after prior unsuccessful attempts	A,B
			Registered with in-person assistance from my local SSA office	A,C
			Not sure or don't remember
CAS0045399	A	Please select the approximate length of time it took for you complete your registration	Less than 15 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Time
			More than 15 but less than 30 minutes
			30 minutes or more
CAS0045400	B	How many prior unsuccessful online registration attempts did you make?	One		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Attempts
			Two
			Three or more
CAS0045410	C	Why did you decide to register in-person?	I was unsuccessful registering online and was required to do so in-person	CC	Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg In person
			I preferred registering for my Social Security in-person at my SSA office	CC
			Don't remember or prefer not to say	CC
CAS0045401	CC	Please describe your in-person registration experience.			Text area, no char limit		N		OE_In-person Experience
CAS0045411		Did you register for Extra Security?	Yes		Radio button, one-up vertical	Single	Y		Xtra Security Reg
			No
			I tried but was unsuccessful
			I don't know
CAS0045413		Did you understand all of my Social Security's instructions for registering a username and password?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Instructions Understand
			Partially	A
			No	A
CAS0045414	A	Please explain what you did not understand about my Social Security's registration instructions			Text area, no char limit		N	Skip Logic Group	OE_Instructions
CAS0045415		Did you see any information describing my Social Security's security policies or features?	Yes		Radio button, one-up vertical	Single	Y		Security Policies
			No
CAS0045424		Do you have any concerns about the security of the personal information contained in your my Social Security account?	No		Radio Button, One-up	Single	Y	Skip Logic Group	Security Concerns
			Yes	A
CAS0045425	A	Please describe your security concerns.			Text area, no char limit		N		OE_Security Concern
CAS0045422		Did the information obtained during your my Social Security account visit enable you to accomplish what you wanted to do?	Yes		Radio button, one up	single	Yes	Skip Logic Group	Ability to Accomplish
			No	A,B
CAS0045426	A	What specifically were you trying to accomplish?			Text area, no char limit		N	Skip Logic	OE_Trying to accomplish
CAS0045427	B	Since you were not able to accomplish what you wanted to do, what do you plan to do next? (Please select all that apply)	Return and try again		Check box vertical	Multi	Y	Skip Logic	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	BB
CAS0045428	BB	Please tell us what "other" action you plan to take next.			Text area, no char limit		N		OPS_Do Next
CAS0045373		Was the information in your my Social Security account clear to you?	Yes		radial button, one up vertical	Single	Y	skip logic	AccountClarity
			No	A
CAS0045374	A	Please tell us what information or instructions were not clear			Text area, no Char limit		N		OE_Account Clarity
CAS0045375		Please select the category that includes your age.	Under 25		Drop down, select one	Single	N		New Age
			26 to 45
			46 to 55
			56 to 60
			61 to 64
			65 to 66
			67 or older
			Prefer not to answer
CAS0045416		Do you have any suggestions for improving the my Social Security registration process?			Text area, no char limit		N		OE_Improve Reg
CAS0045417		Do you have any suggestions for improving my Social Security's content and features?			Text area, no char limit		N		OE_Improve Contents

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Sheet 5: V2 Current CQs (3-11-14)

Model Instance Name:			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
MID:	R9JQtMNl09w1VJAZFxsVYQ4C		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
CAS0045388		How did you learn about my Social Security?	Learned about my Social Security on the SSA website		check box, one up	Multi	Y	Skip	Learn about
			SSA field office representative encouraged me to sign up
			SSA 800 Number representative encouraged me to sign up
			Other, please explain	A
CAS0045390	A	How did you learn about my Social Security			Text area, no char limit		N		OPS_Learn about
CAS0045392		Including today, how often have you accessed your my Social Security account?	This is my first time		radial button, one up vertical	Single	Y		Access Freq
			Once a month
			Once every three months
			Once every six months
			Once a year
			2-4 times
			5-8 times
			9 or more times
CAS0045394		How often do you plan to access your my Social Security account in the future?	At least once a month		radial button, one up vertical	Single	Y		Future Use
			Once a month
			Once every three months
			Once every six months
			Once a year
			9 or more times
BJL1506		Are you currently receiving cash benefits?	Yes, I am receiving Supplemental Security Income (SSI)		Radio button, one-up vertical	Single	Y		Cash Benefits
			Yes, I am receiving Social Security Benefits (Retirement, Disability, Spouses or Survivors)
			Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors)
			Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI
			I am entitled to Medicare Only coverage - no cash benefits
			I am not entitled to monthly benefits or Medicare
			I don't know or prefer not to answer
CAS0045395		What is your primary reason for visiting my Social Security today? (Check all that apply)	To print or view my online Social Security Statement	A	check box one up vertical	Multi	Yes	Skip Logic Group	Primary Reason
			To make sure my earnings record is correct
			To view my Benefits and Payment Details
			To check the status of my recently filed online application for benefits
			To get a Benefit Verification Letter	B
			Add Extra Security to my online account
			To use SSA's online benefit calculators
			To apply online for Social Security or Medicare Only benefits
			To change my address with SSA
			To enroll in or update my direct deposit
			To learn about the benefits to which I might be entitled
			Just curious - wanted to see what information was contained in my Social Security account
			Other reason for visiting today:	Z
CAS0045407	A	How often do you review your online Social Security Statement?	This is my first time	AA	check box one up vertical	Single	Y	Skip Logic Group	Freq View Statement
			Less frequently than once a year
			At least once a year
			Every 6 months
			Every 3 months
			Once a month
			More frequently than once a month
			Other
CAS0045408	AA	Do you plan to view your Social Security Statement online again?	Yes		radio button one up vertical			skip logic group	Plan to View State again
			No
CAS0045409	B	For which Agency or program do you need a Benefit Verification Letter? (Check all that apply)	USDA - SNAP		check box vertical one up	Multiple	Y	skip logic group	Agency Need
			IRS
			HUD - Federal Housing Admin. (FHA)
			Department of Veterans Affairs (VA)
			Requesting a Retirement Visa from another country
			Medicare
			Medicaid
			State or Local Department of Social Services
			Other agency or program	BB
CAS0045396	BB	Which "other" agency or program requested your Benefit Verification information?			Text area, no Char limit		N		OPS_Other Agency
CAS0045397	Z	Please tell us what your primary reason was for visiting today:			Text area, no Char limit		N		OPS_Primary Reason
CAS0045398		Did you register for my Social Security online or in person?	Registered online on my first attempt	A	Radio button, one-up vertical	Single	Y	Skip Logic Group	How Registered
			Registered online after prior unsuccessful attempts	A,B
			Registered with in-person assistance from my local SSA office	A,C
			Not sure or don't remember
CAS0045399	A	Please select the approximate length of time it took for you complete your registration	Less than 15 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Time
			More than 15 but less than 30 minutes
			30 minutes or more
CAS0045400	B	How many prior unsuccessful online registration attempts did you make?	One		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Attempts
			Two
			Three or more
CAS0045410	C	Why did you decide to register in-person?	I was unsuccessful registering online and was required to do so in-person	CC	Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg In person
			I preferred registering for my Social Security in-person at my SSA office	CC
			Don't remember or prefer not to say	CC
CAS0045401	CC	Please describe your in-person registration experience.			Text area, no char limit		N		OE_In-person Experience
CAS0045411		Did you register for Extra Security?	Yes		Radio button, one-up vertical	Single	Y		Xtra Security Reg
			No
			I tried but was unsuccessful
			I don't know
CAS0045413		Did you understand all of my Social Security's instructions for registering a username and password?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Instructions Understand
			Partially	A
			No	A
CAS0045414	A	Please explain what you did not understand about my Social Security's registration instructions			Text area, no char limit		N	Skip Logic Group	OE_Instructions
CAS0045415		Did you see any information describing my Social Security's security policies or features?	Yes		Radio button, one-up vertical	Single	Y		Security Policies
			No
CAS0045424		Do you have any concerns about the security of the personal information contained in your my Social Security account?	No		Radio Button, One-up	Single	Y	Skip Logic Group	Security Concerns
			Yes	A
CAS0045425	A	Please describe your security concerns.			Text area, no char limit		N		OE_Security Concern
CAS0045422		Did the information obtained during your my Social Security account visit enable you to accomplish what you wanted to do?	Yes		Radio button, one up	single	Yes	Skip Logic Group	Ability to Accomplish
			No	A,B
CAS0045426	A	What specifically were you trying to accomplish?			Text area, no char limit		N	Skip Logic	OE_Trying to accomplish
CAS0045427	B	Since you were not able to accomplish what you wanted to do, what do you plan to do next? (Please select all that apply)	Return and try again		Check box vertical	Multi	Y	Skip Logic	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	BB
CAS0045428	BB	Please tell us what "other" action you plan to take next.			Text area, no char limit		N		OPS_Do Next
CAS0045373		Was the information in your my Social Security account clear to you?	Yes		radial button, one up vertical	Single	Y	skip logic	AccountClarity
			No	A
CAS0045374	A	Please tell us what information or instructions were not clear			Text area, no Char limit		N		OE_Account Clarity
CAS0045375		Please select the category that includes your age.	Under 25		Drop down, select one	Single	N		New Age
			26 to 45
			46 to 55
			56 to 60
			61 to 64
			65 to 66
			67 or older
			Prefer not to answer
CAS0045416		Do you have any suggestions for improving the my Social Security registration process?			Text area, no char limit		N		OE_Improve Reg
CAS0045417		Do you have any suggestions for improving my Social Security's content and features?			Text area, no char limit		N		OE_Improve Contents

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Sheet 6: V2 CQs (12-13-13)

Model Instance Name:				red & strike-through: DELETE
SSA My Social Security v2				underlined & italicized: RE-ORDER
MID:	R9JQtMNl09w1VJAZFxsVYQ4C			pink: ADDITION
Partitioned Yes	2/8/2012			blue + -->: REWORDING
SSA My Social Security v2 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	AnswerIDs (DOT)	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
CAS0045388		How did you learn about my Social Security?	CAS0045388A001	Learned about my Social Security on the SSA website		check box, one up	Multi	Y	Skip	Learn about
			CAS0045388A002	SSA field office representative encouraged me to sign up
			CAS0045388A003	SSA 800 Number representative encouraged me to sign up
			CAS0045388A004	Other, please explain	A
CAS0045390	A	How did you learn about my Social Security				Text area, no char limit		N		OPS_Learn about
CAS0045392		Including today, how often have you accessed your my Social Security account?	CAS0045392A001	This is my first time		radial button, one up vertical	Single	Y		Access Freq
			CAS0045392A002	2-4 times
			CAS0045392A003	5-8 times
			CAS0045392A004	9 or more times
CAS0045394		How often do you plan to access your my Social Security account in the future?	CAS0045394A001	At least once a month		radial button, one up vertical	Single	Y		Future Use
			CAS0045394A002	Once every three months
			CAS0045394A003	Once every six months
			CAS0045394A004	9 or more times
BJL1506		Are you currently receiving cash benefits?	BJL1506A01	Yes, I am receiving Supplemental Security Income (SSI)		Radio button, one-up vertical	Single	Y		Cash Benefits
			BJL1506A02	Yes, I am receiving Social Security Benefits (rRetirement, Disability, Spouses or Survivors)
			BJL1506A03	Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors)
			BJL1506A04	Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI
			BJL1506A07	I am entitled to Medicare Only coverage - no cash benefits
			BJL1506A08	I am not entitled to monthly benefits or Medicare
			BJL1506A06	I don't know or prefer not to answer
CAS0045395		What is your primary reason for visiting my Social Security today? (Check all that apply)	CAS0045395A001	To print or view my online Social Security Statement	A	check box one up vertical	Multi	Yes	Skip Logic Group	Primary Reason
			CAS0045395A002	To make sure my earnings record is correct
			CAS0045395A003	To view my Benefits and Payment Details
			CAS0045395A004	To get a Benefit Verification Letter	B
			CAS0045395A005	Add Extra Security to my online account
			CAS0045395A006	To use SSA's online benefit calculators
			CAS0045395A007	To apply online for Social Security or Medicare Only benefits
			CAS0045395A008	To change my address with SSA
			CAS0045395A009	To enroll in or update my direct deposit
			CAS0045395A010	To learn about the benefits to which I might be entitled
			CAS0045395A011	Just curious - wanted to see what information was contained in my Social Security account
			CAS0045395A012	Other reason for visiting today:	Z
CAS0045407	A	How often do you review your online Social Security Statement?	CAS0045407A001	This is my first time	AA	check box one up vertical	Single	Y	Skip Logic Group	Freq View Statement
			CAS0045407A002	Less frequently than once a year
			CAS0045407A003	At least once a year
			CAS0045407A004	Every 6 months
			CAS0045407A005	Every 3 months
			CAS0045407A006	Once a month
			CAS0045407A007	More frequently than once a month
			CAS0045407A008	Other
CAS0045408	AA	Do you plan to view your Social Security Statement online again?	CAS0045408A001	Yes		radio button one up vertical			skip logic group	Plan to View State again
			CAS0045408A002	No
CAS0045409	B	For which Agency or program do you need a Benefit Verification Letter? (Check all that apply)	CAS0045409A001	USDA - SNAP		check box vertical one up	Multiple	Y	skip logic group	Agency Need
			CAS0045409A002	IRS
			CAS0045409A003	HUD - Federal Housing Admin. (FHA)
			CAS0045409A004	Department of Veterans Affairs (VA)
			CAS0045409A005	Requesting a Retirement Visa from another country
			CAS0045409A006	Medicare
			CAS0045409A007	Medicaid
			CAS0045409A008	State or Local Department of Social Services
			CAS0045409A009	Other agency or program	BB
CAS0045396	BB	Which "other" agency or program requested your Benefit Verification information?				Text area, no Char limit		N		OPS_Other Agency
CAS0045397	Z	Please tell us what your primary reason was for visiting today:				Text area, no Char limit		N		OPS_Primary Reason
CAS0045398		Did you register for my Social Security online or in person?	CAS0045398A001	Registered online on my first attempt	A	Radio button, one-up vertical	Single	Y	Skip Logic Group	How Registered
			CAS0045398A002	Registered online after prior unsuccessful attempts	A,B
			CAS0045398A003	Registered with in-person assistance from my local SSA office	A,C
			CAS0045398A004	Not sure or don't remember
CAS0045399	A	Please select the approximate length of time it took for you complete your registration	CAS0045399A001	Less than 15 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Time
			CAS0045399A002	More than 15 but less than 30 minutes
			CAS0045399A003	30 minutes or more
CAS0045400	B	How many prior unsuccessful online registration attempts did you make?	CAS0045400A001	One		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Attempts
			CAS0045400A002	Two
			CAS0045400A003	Three or more
CAS0045410	C	Why did you decide to register in-person?		I was unsuccessful registering online and was required to do so in-person	CC	Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg In person
				I preferred registering for my Social Security in-person at my SSA office	CC
				Don't remember or prefer not to say	CC
CAS0045401	CC	Please describe your in-person registration experience.				Text area, no char limit		N		OE_In-person Experience
CAS0045411		Did you register for Extra Security?	CAS0045411A001	Yes		Radio button, one-up vertical	Single	Y		Xtra Security Reg
			CAS0045411A002	No
			CAS0045411A003	I tried but was unsuccessful
			CAS0045411A004	I don't know
CAS0045413		Did you understand all of my Social Security's instructions for registering a username and password?	CAS0045413A001	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Instructions Understand
			CAS0045413A002	Partially	A
			CAS0045413A003	No	A
CAS0045414	A	Please explain what you did not understand about my Social Security's registration instructions				Text area, no char limit		N	Skip Logic Group	OE_Instructions
CAS0045415		Did you see any information describing my Social Security's security policies or features?	CAS0045415A001	Yes		Radio button, one-up vertical	Single	Y		Security Policies
			CAS0045415A002	No
CAS0045424		Do you have any concerns about the security of the personal information contained in your my Social Security account?	CAS0045424A001	No		Radio Button, One-up	Single	Y	Skip Logic Group	Security Concerns
			CAS0045424A002	Yes	A
CAS0045425	A	Please describe your security concerns.				Text area, no char limit		N		OE_Security Concern
CAS0045422		Did the information obtained during your my Social Security account visit enable you to accomplish what you wanted to do?	CAS0045422A001	Yes		Radio button, one up	single	Yes	Skip Logic Group	Ability to Accomplish
			CAS0045422A002	No	A,B
CAS0045426	A	What specifically were you trying to accomplish?				Text area, no char limit		N	Skip Logic	OE_Trying to accomplish
CAS0045427	B	Since you were not able to accomplish what you wanted to do, what do you plan to do next? (Please select all that apply)	CAS0045427A001	Return and try again		Check box vertical	Multi	Y	Skip Logic	Do Next
			CAS0045427A002	Visit a local Social Security office
			CAS0045427A003	Call a local Social Security office
			CAS0045427A004	Call Social Security's 800 number
			CAS0045427A005	Submit an e-mail to Social Security
			CAS0045427A006	Write a letter to Social Security
			CAS0045427A007	Take no action
			CAS0045427A008	Other, please specify	BB
CAS0045428	BB	Please tell us what "other" action you plan to take next.				Text area, no char limit		N		OPS_Do Next
CAS0045373		Was the information in your my Social Security account clear to you?	CAS0045373A001	Yes		radial button, one up vertical	Single	Y	skip logic	AccountClarity
			CAS0045373A002	No	A
CAS0045374	A	Please tell us what information or instructions were not clear				Text area, no Char limit		N		OE_Account Clarity
CAS0045375		Please select the category that includes your age.	CAS0045375A001	Under 25		Drop down, select one	Single	N		New Age
			CAS0045375A002	26 to 45
			CAS0045375A003	46 to 55
			CAS0045375A004	56 to 60
			CAS0045375A005	61 to 64
			CAS0045375A006	65 to 66
			CAS0045375A007	67 or older
			CAS0045375A008	Prefer not to answer
CAS0045416		Do you have any suggestions for improving the my Social Security registration process?				Text area, no char limit		N		OE_Improve Reg
CAS0045417		Do you have any suggestions for improving my Social Security's content and features?				Text area, no char limit		N		OE_Improve Contents

---

Sheet 7: V2 Current CQs (12-12-13)

Model Instance Name:			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
MID:	R9JQtMNl09w1VJAZFxsVYQ4C		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
		How did you learn about my Social Security?	Learned about my Social Security on the SSA website		check box, one up	Multi	Y	Skip	Learn about
			SSA field office representative encouraged me to sign up
			SSA 800 Number representative encouraged me to sign up
			Other, please explain	A
	A	How did you learn about my Social Security			Text area, no char limit		N		OPS_Learn about
		Including today, how often have you accessed your my Social Security account?	This is my first time		radial button, one up vertical	Single	Y		Access Freq
			2-4 times
			5-8 times
			9 or more times
		How often do you plan to access your my Social Security account in the future?	At least once a month		radial button, one up vertical	Single	Y		Future Use
			Once every three months
			Once every six months
			9 or more times
BJL1497		Did you register for a username and password today?	Yes	A,B,C,D,DD,E	Radio button, one-up vertical		Y	Skip Logic Group	Password Registration
			No
BJL1498	A	Please tell us how long it took you to complete your registration:	Less than 10 minutes		Radio button, one-up vertical	Single	N	Skip Logic Group	Registration SAT
			11 minutes - 15 minutes
			16 minutes - 30 minutes
			31 minutes - 1 hour
			Greater than 1 hour
BJL1499	B	Did you register for Extra Security today?	Yes		Radio button, one-up vertical		N	Skip Logic Group	ExtraSecurityReg
			No
			I don't know
BJL1500	C	Did you understand all the instructions for registering for a username and password today?	Yes		Radio button, one-up vertical	Single	N	Skip Logic Group	Instructions
			Partially	CC
			No	CC
BJL1501	CC	Please explain what you did not understand about the instructions.			Text area, no char limit		N	Skip Logic Group	OE_Instructions
BJL1502	D	Did you see any information describing the website's security policies or features?	Yes		Radio button, one-up vertical	Single	N	Skip Logic Group	Security
			No
BJL1503	DD	Do you have any concerns about the security of transactions on this website?	Yes	DDD	Radio button, one-up vertical	Single	N	Skip Logic Group	Security Concerns
			No
BJL1504	DDD	Please describe your concerns with the security of this site.			Text area, no char limit		N		OE_Security Concerns
BJL1505	E	What would you like us to improve, if anything, about this site's registration process?			Text area, no char limit		N	Skip Logic Group	OE_Reg Improvement
BJL1506		Are you currently receiving cash benefits?	Yes, I am receiving Supplemental Security Income (SSI)	A	Radio button, one-up vertical	Single	Y	Skip Logic Group	Cash Benefits
			Yes, I am receiving Social Security Benefits (retirement, Disability, or Survivors)	B
			Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors)	A
			Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI	C
			I am entitled to Medicare Only coverage - no cash benefits
			I am not entitled to monthly benefits or Medicare
			No (not receiving any benefit or receiving Medicare Only)	C
			I don't know or prefer not to answer	C
BJL1507	A	What was your primary reason for visiting today? (Check all that apply)	To print my Social Security Statement		Checkbox, one-up vertical	Single	Y	Skip Logic Group	SSI Only Primary Reason
			To check my earnings record
			To view my Benefits and Payment Details
			To get a Benefit Verification Letter
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	AA
BJL1508	AA	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_SSI Only Other Primary Reason
BJL1509	B	What was your primary reason for visiting today? (Check all that apply)	To print my Social Security Statement		Checkbox, one-up vertical	Single	Y	Skip Logic Group	Cash Benefit Primary Reason
			To check my earnings record
			To view my Benefits and Payment Details
			To get a Benefit Verification Letter
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			To update my address
			To enroll or update my direct deposit
			Other reason for visiting today:	BB
BJL1510	BB	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Cash Benefit primary reason
BJL1511	C	What was your primary reason for visiting today? (Check all apply)	To print my Social Security Statement		Checkbox, one-up vertical	Single	Y	Skip Logic Group	No cash Benefit
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	CC
BJL1512	CC	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_No cash Benefit Primary Reason
		What is your primary reason for visiting my Social Security today? (Check all that apply)	To print or view my online Social Security Statement	A	check box one up vertical	Multi	Yes	Skip Logic Group	Primary Reason
			To make sure my earnings record is correct
			To view my Benefits and Payment Details
			To get a Benefit Verification Letter	B
			Add Extra Security to my online account
			To use SSA's online benefit calculators
			To apply online for Social Security or Medicare Only benefits
			To change my address with SSA
			To enroll in or update my direct deposit
			To learn about the benefits to which I might be entitled
			Just curious - wanted to see what information was contained in my Social Security account
			Other reason for visiting today:	Z
	A	How often do you review your online Social Security Statement?	This is my first time	AA	check box one up vertical	Single	Y	Skip Logic Group	Freq View Statement
			Less frequently than once a year
			At least once a year
			Every 6 months
			Every 3 months
			Once a month
			More frequently than once a month
			Other
	AA	Do you plan to view your Social Security Statement online again?	Yes		radio button one up vertical			skip logic group	Plan to View State again
			No
	B	For which Agency or program do you need a Benefit Verification Letter? (Check all that apply)	USDA - SNAP		check box vertical one up	Multiple	Y	skip logic group	Agency Need
			IRS
			HUD - Federal Housing Admin. (FHA)
			Department of Veterans Affairs (VA)
			Requesting a Retirement Visa from another country
			Medicare
			Medicaid
			State or Local Department of Social Services
			Other agency or program	BB
	BB	Which "other" agency or program requested your Benefit Verification information?			Text area, no Char limit		N		OPS_Other Agency
	Z	Please tell us what your primary reason was for visiting today:			Text area, no Char limit		N		OPS_Primary Reason
		Did you register for my Social Security online or in person?	Registered online on my first attempt	A	Radio button, one-up vertical	Single	Y	Skip Logic Group	How Registered
			Registered online after prior unsuccessful attempts	A,B
			Registered with in-person assistance from my local SSA office	A,C
			Not sure or don't remember
	A	Please select the approximate length of time it took for you complete your registration	Less than 15 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Time
			More than 15 but less than 30 minutes
			30 minutes or more
	B	How many prior unsuccessful online registration attempts did you make?	One		Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg Attempts
			Two
			Three or more
	C	Why did you decide to register in-person?	I was unsuccessful registering online and was required to do so in-person	CC	Radio button, one-up vertical	Single	Y	Skip Logic Group	Reg In person
			I preferred registering for my Social Security in-person at my SSA office	CC
			Don't remember or prefer not to say	CC
	CC	Please describe your in-person registration experience.			Text area, no char limit		N		OE_In-person Experience
		Did you register for Extra Security?	Yes		Radio button, one-up vertical	Single	Y		Xtra Security Reg
			No
			I tried but was unsuccessful
			I don't know
		Did you understand all of my Social Security's instructions for registering a username and password?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Instructions Understand
			Partially	A
			No	A
	A	Please explain what you did not understand about my Social Security's registration instructions			Text area, no char limit		N	Skip Logic Group	OE_Instructions
		Did you see any information describing my Social Security's security policies or features?	Yes		Radio button, one-up vertical	Single	Y		Security Policies
			No
		Do you have any concerns about the security of the personal information contained in your my Social Security account?	No		Radio Button, One-up	Single	Y	Skip Logic Group	Security Concerns
			Yes	A
	A	Please describe your security concerns.			Text area, no char limit		N		OE_Security Concern
BJL1513		Now that you've looked at your online statement, how often do you think you'll return to review it?	Less frequently than once a year		Dropdown (Select-one)	Single	Y		View Statement
			At least once a year
			Every 6 months
			Once a quarter
			Once a month
			More frequently than once a month
			Other
		Did the information obtained during your my Social Security account visit enable you to accomplish what you wanted to do?	Yes		Radio button, one up	single	Yes	Skip Logic Group	Ability to Accomplish
			No	A,B
	A	What specifically were you trying to accomplish?			Text area, no char limit		N	Skip Logic	OE_Trying to accomplish
	B	Since you were not able to accomplish what you wanted to do, what do you plan to do next? (Please select all that apply)	Return and try again		Check box vertical	Multi	Y	Skip Logic	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	BB
	BB	Please tell us what "other" action you plan to take next.			Text area, no char limit		N		OPS_Do Next
BJL1514		Were you able to accomplish what you wanted to on the site today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Task Accomplishment
			No	Y
BJL1515	Y	Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply)	Return and try again		Checkbox	Multi	Y	Skip Logic Group	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	YY
BJL1516	YY	Please tell us what other action you plan to take next.			Text area, no char limit		N		OE_Do Next
		Was the information in your my Social Security account clear to you?	Yes		radial button, one up vertical	Single	Y	skip logic	AccountClarity
			No	A
	A	Please tell us what information or instructions were not clear			Text area, no Char limit		N		OE_Account Clarity
BJL1517		Was there any information on the site that was unclear to you?	No, all the information was clear		Checkbox	Multi	N		Clarity of Info
			The language used
			How to print a statement
			Instructions for registering for a username and password
			Instructions for resetting a password and/or recalling a username
			Other
BJL1518		What did you like most about your experience today?			Text area, no char limit		N		OE_Like
BJL1519		What did you like least about your experience today?			Text area, no char limit		N		OE_Dislike
		Please select the category that includes your age.	Under 25		Drop down, select one	Single	N		New Age
			26 to 45
			46 to 55
			56 to 60
			61 to 64
			65 to 66
			67 or older
			Prefer not to answer
BJL1520		Please select the category that includes your age.	18-24		Drop down, select one	Single	N		Age
			25-34
			35-44
			45-54
			55-59
			60-64
			65-74
			75 or older
			Prefer not to answer
		Do you have any suggestions for improving the my Social Security registration process?			Text area, no char limit		N		OE_Improve Reg
		Do you have any suggestions for improving my Social Security's content and features?			Text area, no char limit		N		OE_Improve Contents

---

Sheet 8: CQs (1-7-13)

#REF!			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
#REF!	Z5w0N58sJ5AkRkYUg4pVFg==		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
SAC7234		Did you register for a username and password today?	Yes	A,B,C,D,DD,E,F			Y	Skip Logic Group	Password Registration
			No	X
SAC7235	A	Please tell us how long it took you to complete your registration:	Less than 10 minutes		Radio button, one-up vertical	Single	N	Skip Logic Group	Registration SAT
			11 minutes - 15 minutes
			16 minutes - 30 minutes
			31 minutes - 1 hour
			Greater than 1 hour
SAC7236	B	Did you register for Extra Security today?	Yes				N	Skip Logic Group	ExtraSecurityReg
			No
			I don't know
SAC7237	C	Did you understand all the instructions for registering for a username and password today?	Yes			Single	N	Skip Logic Group	Instructions
			Partially	CC
			No	CC
SAC7238	CC	Please explain what you did not understand about the instructions.			Text area, no char limit		N	Skip Logic Group	OE_Instructions
SAC7239	D	Did you see any information describing the website's security policies or features?	Yes		Radio button, one-up vertical	Single	N	Skip Logic Group	Security
			No
SAC7240	DD	Do you have any concerns about the security of transactions on this website?	Yes	DDD		Single	N	Skip Logic Group	Security Concerns
			No
SAC7241	DDD	Please describe your concerns with the security of this site.			Text area, no char limit		N		OE_Security Concerns
SAC7242	E	What would you like us to improve, if anything, about this site's registration process?			Text area, no char limit		N	Skip Logic Group	OE_Reg Improvement
		Are you currently receiving cash benefits?	Yes, I am receiving Supplemental Security Income (SSI)	A	Radio button, one-up vertical	Single	Y	Skip Logic Group	Cash Benefits
			Yes, I am receiving Social Security Benefits (retirement, Disability, or Survivors)	B
			Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors)	A
			Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI	C
			No (not receiving any benefit or receiving Medicare Only)	C
			I don't know or prefer not to answer	C
	A	What was your primary reason for visiting today? (Check all that apply)	To print my Social Security Statement		Radio button, one-up vertical	Single	Y	Skip Logic Group	SSI Only Primary Reason
			To check my earnings record
			To view my Benefits and Payment Details
			To get a Benefit Verification Letter
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	AA
	AA	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_SSI Only Other Primary Reason
	B	What was your primary reason for visiting today? (Check all that apply)	To print my Social Security Statement		Radio button, one-up vertical	Single	Y	Skip Logic Group	Cash Benefit Primary Reason
			To check my earnings record
			To view my Benefits and Payment Details
			To get a Benefit Verification Letter
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			To update my address
			To enroll or update my direct deposit
			Other reason for visiting today:	BB
	BB	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Cash Benefit primary reason
	C	What was your primary reason for visiting today? (Check all apply)	To print my Social Security Statement		Radio button, one-up vertical	Single	Y	Skip Logic Group	No cash Benefit
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	CC
	CC	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_No cash Benefit Primary Reason
ACQwil0011885	F	What was your primary reason for visiting today?	To print my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_Yes
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	FF
ACQwil0011886	FF	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Primary Reason Yes
SAC7243	X	What was your primary reason for visiting today?	To print my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_No
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	AA
SAC7244	AA	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Primary Reason No
ACQhar0016936		Now that you've looked at your online statement, how often do you think you'll return to review it?	Less frequently than once a year		Dropdown (Select-one)	Single	Y		View Statement
			At least once a year
			Every 6 months
			Once a quarter
			Once a month
			More frequently than once a month
			Other
SAC7245		Were you able to accomplish what you wanted to on the site today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Task Accomplishment
			No	Y
SAC7246	Y	Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply)	Return and try again		Checkbox	Multi	Y	Skip Logic Group	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	YY
SAC7247	YY	Please tell us what other action you plan to take next.			Text area, no char limit		N		OE_Do Next
SAC7248		Was there any information on the site that was unclear to you?	No, all the information was clear		Checkbox	Multi	N	Skip Logic Group	Clarity of Info
			The language used
			How to print a statement
			Instructions for registering for a username and password
			Instructions for resetting a password and/or recalling a username
			Other
SAC7250		What did you like most about your experience today?			Text area, no char limit		N		OE_Like
SAC7251		What did you like least about your experience today?			Text area, no char limit		N		OE_Dislike
SAC7253		Please select the category that includes your age.	18-24		Drop down, select one	Single	N		Age
			25-34
			35-44
			45-54
			55-59
			60-64
			65-74
			75 or older
			Prefer not to answer

---

Sheet 9: CQs

#REF!			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
#REF!	Z5w0N58sJ5AkRkYUg4pVFg==		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
SAC7234		Did you register for a username and password today?	Yes	A,B,C,D,DD,E,F			Y	Skip Logic Group	Password Registration
			No	X
SAC7235	A	Please tell us how long it took you to complete your registration:	Less than 10 minutes		Radio button, one-up vertical	Single	N	Skip Logic Group	Registration SAT
			11 minutes - 15 minutes
			16 minutes - 30 minutes
			31 minutes - 1 hour
			Greater than 1 hour
SAC7236	B	Did you register for Extra Security today?	Yes				N	Skip Logic Group	ExtraSecurityReg
			No
			I don't know
SAC7237	C	Did you understand all the instructions for registering for a username and password today?	Yes			Single	N	Skip Logic Group	Instructions
			Partially	CC
			No	CC
SAC7238	CC	Please explain what you did not understand about the instructions.			Text area, no char limit		N	Skip Logic Group	OE_Instructions
SAC7239	D	Did you see any information describing the website's security policies or features?	Yes		Radio button, one-up vertical	Single	N	Skip Logic Group	Security
			No
SAC7240	DD	Do you have any concerns about the security of transactions on this website?	Yes	DDD		Single	N	Skip Logic Group	Security Concerns
			No
SAC7241	DDD	Please describe your concerns with the security of this site.			Text area, no char limit		N		OE_Security Concerns
SAC7242	E	What would you like us to improve, if anything, about this site's registration process?			Text area, no char limit		N	Skip Logic Group	OE_Reg Improvement
ACQwil0011885	F	What was your primary reason for visiting today?	To print my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_Yes
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	FF
ACQwil0011886	FF	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Primary Reason Yes
SAC7243	X	What was your primary reason for visiting today?	To print my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_No
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	AA
SAC7244	AA	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Primary Reason No
ACQhar0016936		Now that you've looked at your online statement, how often do you think you'll return to review it?	Less frequently than once a year		Dropdown (Select-one)	Single	Y		View Statement
			At least once a year
			Every 6 months
			Once a quarter
			Once a month
			More frequently than once a month
			Other
SAC7245		Were you able to accomplish what you wanted to on the site today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Task Accomplishment
			No	Y
SAC7246	Y	Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply)	Return and try again		Checkbox	Multi	Y	Skip Logic Group	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	YY
SAC7247	YY	Please tell us what other action you plan to take next.			Text area, no char limit		N		OE_Do Next
SAC7248		Was there any information on the site that was unclear to you?	No, all the information was clear		Checkbox	Multi	N	Skip Logic Group	Clarity of Info
			The language used
			How to print a statement
			Instructions for registering for a username and password
			Instructions for resetting a password and/or recalling a username
			Other
SAC7250		What did you like most about your experience today?			Text area, no char limit		N		OE_Like
SAC7251		What did you like least about your experience today?			Text area, no char limit		N		OE_Dislike
SAC7253		Please select the category that includes your age.	18-24		Drop down, select one	Single	N		Age
			25-34
			35-44
			45-54
			55-59
			60-64
			65-74
			75 or older
			Prefer not to answer

---

Sheet 10: Current CQs (10-2-12)

#REF!			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
#REF!	Z5w0N58sJ5AkRkYUg4pVFg==		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
SAC7233		How often do you access your online statement?	This is my first time		Dropdown (Select-one)	Single	Y		Visit Frequency
			Daily
			Two to three times per week
			About once a month
			Every few months
			Every 6 months or less often
SAC7234		Did you register for a username and password today?	Yes	A,B,C,D,DD,E,F			Y	Skip Logic Group	Password Registration
			No	X
SAC7235	A	Please tell us how long it took you to complete your registration:	Less than 10 minutes		Radio button, one-up vertical	Single	N	Skip Logic Group	Registration SAT
			11 minutes - 15 minutes
			16 minutes - 30 minutes
			31 minutes - 1 hour
			Greater than 1 hour
SAC7236	B	Did you register for Extra Security today?	Yes				N	Skip Logic Group	ExtraSecurityReg
			No
			I don't know
SAC7237	C	Did you understand all the instructions for registering for a username and password today?	Yes			Single	N	Skip Logic Group	Instructions
			Partially	CC
			No	CC
SAC7238	CC	Please explain what you did not understand about the instructions.			Text area, no char limit		N	Skip Logic Group	OE_Instructions
SAC7239	D	Did you see any information describing the website's security policies or features?	Yes		Radio button, one-up vertical	Single	N	Skip Logic Group	Security
			No
SAC7240	DD	Do you have any concerns about the security of transactions on this website?	Yes	DDD		Single	N	Skip Logic Group	Security Concerns
			No
SAC7241	DDD	Please describe your concerns with the security of this site.			Text area, no char limit		N		OE_Security Concerns
SAC7242	E	What would you like us to improve, if anything, about this site's registration process?			Text area, no char limit		N	Skip Logic Group	OE_Reg Improvement
ACQwil0011885	F	What was your primary reason for visiting today?	To print obtain my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_Yes
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	FF
ACQwil0011886	FF	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Primary Reason Yes
SAC7243	X	What was your primary reason for visiting today?	To print obtain my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_No
			To check my earnings record
			To view my estimated benefits
			Add Extra Security to my online account
			Just curious - wanted to see what information was available with an online account
			Other reason for visiting today:	AA
SAC7244	AA	Please tell us what your primary reason was for visiting today:			Text area, no char limit		N	Skip Logic Group	OE_Primary Reason No
		Now that you've looked at your online statement, how often do you think you'll return to review it?	Less frequently than once a year		Dropdown (Select-one)	Single	Y		View Statement
			At least once a year
			Every 6 months
			Once a quarter
			Once a month
			More frequently than once a month
			Other
SAC7245		Were you able to accomplish what you wanted to on the site today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Task Accomplishment
			No	Y
SAC7246	Y	Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply)	Return and try again		Checkbox	Multi	Y	Skip Logic Group	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	YY
SAC7247	YY	Please tell us what other action you plan to take next.			Text area, no char limit		N		OE_Do Next
SAC7248		Was there any information on the site that was unclear to you?	No, all the information was clear		Checkbox	Multi	N	Skip Logic Group	Clarity of Info
			The language used
			How to print a statement
			Instructions for registering for a username and password
			Instructions for resetting a password and/or recalling a username
			Other, please specify	Z
SAC7249	Z	Please specify what information was unclear to you today.			Text area, no char limit		N	Skip Logic Group	OE_Clarity
SAC7250		What did you like most about your experience today?			Text area, no char limit		N		OE_Like
SAC7251		What did you like least about your experience today?			Text area, no char limit		N		OE_Dislike
SAC7252		Please specify what additional information or services you would like to have available on this site.			Text area, no char limit		N		OE_Add Info/Service
SAC7253		Please select the category that includes your age.	18-24		Drop down, select one	Single	N		Age
			25-34
			35-44
			45-54
			55-59 64
			60-64
			65-74
			75 or older
			Prefer not to answer

---

Sheet 11: CQs (4-2-12)

#REF!			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
#REF!	Z5w0N58sJ5AkRkYUg4pVFg==		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
SAC7233		How often do you access your online statement?	This is my first time		Dropdown (Select-one)	Single	Y		Visit Frequency
			Daily
			Two to three times per week
			About once a month
			Every few months
			Every 6 months or less often
SAC7234		Did you register for a username and password today?	Yes	A			Y		Password Registration
			No	X
SAC7235	A	Please tell us how long it took you to complete your registration:	Less than 10 minutes	B	Radio button, one-up vertical	Single	Y	Skip Logic Group	Registration SAT
			11 minutes - 15 minutes	B
			16 minutes - 30 minutes	B
			31 minutes - 1 hour	B
			Greater than 1 hour	B
SAC7236	B	Did you register for Extra Security today?	Yes	C			Y	Skip Logic Group	ExtraSecurityReg
			No	C
			I don't know	C
SAC7237	C	Did you understand all the instructions for registering for a username and password today?	Yes	D		Single	N	Skip Logic Group	Instructions
			Partially	CC, D
			No	CC, D
SAC7238	CC	Please explain what you did not understand about the instructions.			Text area, no char limit			Skip Logic Group	OE_Instructions
SAC7239	D	Did you see any information describing the website's security policies or features?	Yes	DD	Radio button, one-up vertical	Single	N	Skip Logic Group	Security
			No	DD
SAC7240	DD	Do you have any concerns about the security of transactions on this website?	Yes	DDD,E, F		Single	N	Skip Logic Group	Security Concerns
			No	E,F
SAC7241	DDD	Please describe your concerns with the security of this site.			Text area, no char limit		N		OE_Security Concerns
SAC7242	E	What would you like us to improve, if anything, about this site's registration process?			Text area, no char limit		N	Skip Logic Group	OE_Reg Improvement
	F	What was your primary reason for visiting today?	To obtain my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_Yes
			To check my earnings record
			To view my estimated benefits
			Other reason for visiting today:	FF
	FF	Please tell us what your primary reason was for visiting today:					N	Skip Logic Group	OE_Primary Reason Yes
SAC7243	X	What was your primary reason for visiting today?	To obtain my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason_No
			To check my earnings record
			To view my estimated benefits
			Other reason for visiting today:	AA
SAC7244	AA	Please tell us what your primary reason was for visiting today:					N	Skip Logic Group	OE_Primary Reason No
SAC7245		Were you able to accomplish what you wanted to on the site today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Task Accomplishment
			No	Y
SAC7246	Y	Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply)	Return and try again		Checkbox	Multi	Y	Skip Logic Group	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	YY
SAC7247	YY	Please tell us what other action you plan to take next.			Text area, no char limit		N		OE_Do Next
SAC7248		Was there any information on the site that was unclear to you?	No, all the information was clear		Checkbox	Multi	N	Skip Logic Group	Clarity of Info
			The language used
			How to print a statement
			Instructions for registering for a username and password
			Instructions for resetting a password and/or recalling a username
			Other, please specify	Z
SAC7249	Z	Please specify what information was unclear to you today.			Text area, no char limit		N	Skip Logic Group	OE_Clarity
SAC7250		What did you like most about your experience today?			Text area, no char limit		N		OE_Like
SAC7251		What did you like least about your experience today?			Text area, no char limit		N		OE_Dislike
SAC7252		Please specify what additional information or services you would like to have available on this site.			Text area, no char limit		N		OE_Add Info/Service
SAC7253		Please select the category that includes your age.	18-24		Drop down, select one	Single	N		Age
			25-34
			35-44
			45-54
			55-64
			65-74
			75 or older
			Prefer not to answer

---

Sheet 12: CQs (3-13-12)

#REF!			red & strike-through: DELETE
SSA My Social Security v2			underlined & italicized: RE-ORDER
#REF!	Z5w0N58sJ5AkRkYUg4pVFg==		pink: ADDITION
Partitioned Yes	2/8/2012		blue + -->: REWORDING
SSA My Social Security v2 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
SAC7233		How often do you access your online statement?	This is my first time		Dropdown (Select-one)	Single	Y		Visit Frequency
			Daily
			Two to three times per week
			About once a month
			Every few months
			Every 6 months or less often
SAC7234		Did you register for a username and password today?	Yes	A			Y		Password Registration
			No	X
SAC7235	A	Please tell us how long it took you to complete your registration:	Less than 10 minutes	B	Radio button, one-up vertical	Single	Y	Skip Logic Group	Registration SAT
			11 minutes - 15 minutes	B
			16 minutes - 30 minutes	B
			31 minutes - 1 hour	B
			Greater than 1 hour	B
SAC7236	B	Did you register for Extra Security today?	Yes	C			Y	Skip Logic Group	ExtraSecurityReg
			No	C
			I don't know	C
SAC7237	C	Did you understand all the instructions for registering for a username and password today?	Yes	D		Single	N	Skip Logic Group	Instructions
			Partially	CC, D
			No	CC, D
SAC7238	CC	Please explain what you did not understand about the instructions.			Text area, no char limit			Skip Logic Group	OE_Instructions
SAC7239	D	Did you see any information describing the website's security policies or features?	Yes	DD	Radio button, one-up vertical	Single	N	Skip Logic Group	Security
			No	DD
SAC7240	DD	Do you have any concerns about the security of transactions on this website?	Yes	DDD		Single	N	Skip Logic Group	Security Concerns
			No	E
SAC7241	DDD	Please describe your concerns with the security of this site.			Text area, no char limit		N		OE_Security Concerns
SAC7242	E	What would you like us to improve, if anything, about this site's registration process?			Text area, no char limit		N	Skip Logic Group	OE_Reg Improvement
SAC7243	X	What was your primary reason for visiting today?	To obtain my Social Security Statement		Checkbox	Multi	Y	Skip Logic Group	Primary Reason
			To check my earnings record
			To view my estimated benefits
			Other reason for visiting today:	AA
SAC7244	AA	Please tell us what your primary reason was for visiting today:					N	Skip Logic Group	OE_Primary Reason
SAC7245		Were you able to accomplish what you wanted to on the site today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Task Accomplishment
			No	Y
SAC7246	Y	Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply)	Return and try again		Checkbox	Multi	Y	Skip Logic Group	Do Next
			Visit a local Social Security office
			Call a local Social Security office
			Call Social Security's 800 number
			Submit an e-mail to Social Security
			Write a letter to Social Security
			Take no action
			Other, please specify	YY
SAC7247	YY	Please tell us what other action you plan to take next.			Text area, no char limit		N		OE_Do Next
SAC7248		Was there any information on the site that was unclear to you?	No, all the information was clear		Checkbox	Multi	N	OPS	Clarity of Info
			The language used					Skip Logic Group
			How to print a statement
			Instructions for registering for a username and password
			Instructions for resetting a password and/or recalling a username
			Other, please specify	Z
SAC7249	Z	Please specify what information was unclear to you today.			<100 text field Text area, no char limit		N	OPS Skip Logic Group	OE_Clarity
SAC7250		What did you like most about your experience today?			Text area, no char limit		N		OE_Like
SAC7251		What did you like least about your experience today?			Text area, no char limit		N		OE_Dislike
SAC7252		Please specify what additional information or services you would like to have available on this site.			Text area, no char limit		N		OE_Add Info/Service
SAC7253		Please select the category that includes your age.	18-24		Drop down, select one	Single	N		Age
			25-34
			35-44
			45-54
			55-64
			65-74
			75 or older
			Prefer not to answer