Form 1083 2014 838 SSA Retirement Estimator

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Overview

Welcome and Thank You Text
v4 Model Qsts (EE)
v4 Model Qsts (EN)
v4 Model Qsts (SP)
v4 Current Custom Qsts EE
v4 Custom Qsts EE (5-9-14)
v4 Custom Qsts EE (3-14-14)
v4 Current Custom Qsts EN
v4 Custom Qsts EN (5-9-14)
v4 Custom Qsts EN (3-14-14)
v4 Current Custom Qsts SP
v4 Custom Qsts SP (5-9-14)
v4 Custom Qsts SP (3-14-14)
Element Rotations
v3 Custom Qsts EE
v3 Custom Qsts EN
v3 Custom Qsts SP

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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 Model Qsts (EN)

Model Instance Name:
SSA Retirement Estimator v4
MID:		xAxNcEo455ZVQ1FNlUNsog4C
Partitioned (Y/N)?		N			Element rotation scheme has been added
FPI Included(Y/N)?
NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research.
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	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)			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	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)			How likely are you to apply for Social Security Benefits online?
		Site Performance (1=Poor, 10=Excellent, Don't Know)					Recommend	Recommend (1=Very Unlikely, 10=Very Likely)
	Site Performance - Loading	Please rate how quickly pages load in this online Retirement Estimator.						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	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.						How likely are you to return to the Retirement Estimator?
		Plain Language (1=Poor, 10=Excellent, Don't Know)					Use Other Online Services	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.						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 4: v4 Model Qsts (SP)

Model Instance Name:
SSA Retirement Estimator v4
MID:		p00IdwE4ssR1MA9UUtZ5Ng4C
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?
		Apariencia y función (1=Mala, 10=Excelente, No sé)			Satisfacción		Apply in Office	Visitar la oficina local para solicitar los beneficios (1=Muy improbablemente, 10=Muy probablemente)
	Look and Feel - Appeal	Por favor califique la apariencia del Calculador de beneficios de jubilación por Internet.		Satisfaction - Overall	¿Cómo calificaría su satisfacción en general del Calculador de beneficios de jubilación por Internet? (1=Totalmente insatisfecho, 10=Totalmente satisfecho)			¿Cuáles son las posibilidades de que visite la oficina personalmente la oficina local del Seguro Social para solicitar los beneficios?
	Look and Feel - Balance	Por favor califique el equilibrio entre gráficas y texto del Calculador de beneficios de jubilación por Internet.		Satisfaction - Expectations	¿Con cuánta exactitud el Calculador de beneficios de jubilación por Internet satisfizo sus expectativas? (1=No llenó mis expectativas, 10=Totalmente satisfecho)		Apply Online	Solicitar los beneficios de Seguro Social por Internet (1=Muy improbablemente, 10=Muy probablemente)
	Look and Feel - Readability	Por favor califique la fluidez del texto del Calculador de beneficios de jubilación por Internet.		Satisfaction - Ideal	¿Cómo se compara el Calculador de beneficios de jubilación por Internet con lo que se imaginaría que sería su programa de computadora ideal? (1=No se asemeja, 10=Se asemeja)			¿Cuáles son las posibilidades de que solicite los beneficios de Seguro Social usando la Internet?
		Rendimiento del sitio de Internet (1=Mala, 10=Excelente, No sé)					Recommend	Recomendar (1=Muy improbablemente, 10=Muy probablemente)
	Site Performance - Loading	Por favor califique la rapidez con que suben las páginas el Calculador de beneficios de jubilación por Internet.						¿Cuáles son las posibilidades de que le recomiende el Calculador de beneficios de jubilación por Internet a otra persona?
	Site Performance - Consistency	Por favor califique la consistencia de la rapidez para moverse de una página a la otra del Calculador de beneficios de jubilación por Internet.					Return	Regresar (si procede) (1=Muy improbablemente, 10=Muy probablemente)
	Site Performance - Errors	Por favor califique la capacidad para subir las páginas sin que reciba un error del Calculador de beneficios de jubilación por Internet.						¿Cuáles son las posibilidades de que regrese a usar el Calculador de beneficios de jubilación por Internet?
		Simpleza del vocabulario (1=Malo, 10=Excelente, No sé)					Use Other Online Services	Usar por Internet otros programas de computadora del Seguro Social (1=Muy improbablemente, 10=Muy probablemente)
	Plain Language - Clear	Por favor califique la claridad de las palabras usadas en el Calculador de beneficios de jubilación por Internet.						¿Cuáles son las posibilidades de que use otros programas de computadora en este sitio de Internet del Seguro Social?
	Plain Language - Understandable	Por favor califique su comprensión de las palabras usadas en el Calculador de beneficios de jubilación por Internet.
	Plain Language - Concise	Por favor califique el Calculador de beneficios de jubilación por Internet basado en el uso de oraciones cortas y claras.

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Sheet 5: 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 Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BJL2254		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE
			Linked from another website	C2
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
BJL2255	C	Please specify how you first learned about the Retirement Estimator.			Text field, <100 char		N	Skip Logic Group	Other learned about
STE0050206	C2	Please specify the website that led you to the Retirement Estimator			Text field, <100 char		N	Skip Logic Group	OE_Website
STE0050207		How often do you use the Retirement Estimator?	This was the first time		Radio button, one-up vertical	Single	Y		Frequency
			Every few months or less often
			Monthly
			Weekly
			Several times a week
			Daily/more than once a day
BJL2263		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File
			1 to 3 years
			More than 3 but less than 6 years
			6 years or more
			Don't Know
BJL2264		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
BJL2265		Did the Retirement Estimator provide you with all the benefit estimates you were seeking today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal
			No	F
BJL2266	F	What other benefit estimates were you trying to obtain?			Text area, no char limit	Single	N	Skip Logic Group	OE_Did not accomplish
STE0057596		Do you believe the retirement estimate(s) provided to you was/were based on your entire Social Security earnings record?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	RE Based on Earnings
			No	G
STE0057597	G	Please explain why you think that the retirement estimate(s) was/were not based on your entire Social Security earnings record?			Text area, no char limit	Single	N	Skip Logic Group	OE_Not based on earnings
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)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			I had difficulty because the links did not take me where I expected
			I had difficulty because I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
BJL2268	A	Please describe your navigation difficulty and identify where on the Social Security website this problem occurred			Text area, no char limit		N	Skip Logic Group	Other Difficulty
MAD0043083		Prior to visiting the Retirement Estimator, have you used any of the following resources to prepare for your application for retirement?  (Please select all that apply)	Social Security’s Online Retirement Planner		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Home Page
			The Online Social Security Statement in  the my Social Security section
			Frequently Asked Questions (FAQ)
			Instructional video on the online application page
			Other resource on the SSA website	A
			I did not use any resources to prepare
MAD0043084	A	Please describe what other resources you used to help prepare for your retirement application			Text area, no char limit		N		OPS Other Resources
BJL2270		What do you plan to do next on the Social Security website to continue your pre-retirement preparations?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
			Other	A
MAD0043085	A	Please describe what you plan to do next to continue your pre-retirement preparation			Text area, no char limit		N		OPS Do Next
BJL2273		What is your age?	Under 25		Drop down, select one	Single	N		Age
			26 to 50
			51 to 55
			56 to 60
			61
			62
			63
			64
			65
			66
			67 and over
			Prefer not to answer
BJL2278		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
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

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Sheet 6: v4 Custom Qsts EE (5-9-14)

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 Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BJL2254		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE
			Linked from another website	C2
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
BJL2255	C	Please specify how you first learned about the Retirement Estimator.			Text field, <100 char		N	Skip Logic Group	Other learned about
STE0050206	C2	Please specify the website that led you to the Retirement Estimator			Text field, <100 char		N	Skip Logic Group	OE_Website
STE0050207		How often do you use the Retirement Estimator?	This was the first time		Radio button, one-up vertical	Single	Y		Frequency
			Every few months or less often
			Monthly
			Weekly
			Several times a week
			Daily/more than once a day
BJL2263		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File
			1 to 3 years
			More than 3 but less than 6 years
			6 years or more
			Don't Know
BJL2264		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
BJL2265		Did you accomplish your primary purpose in using the Retirement Estimator? Did the Retirement Estimator provide you with all the benefit estimates you were seeking today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal
			No	F
			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. What other benefit estimates were you trying to obtain?			Text area, no char limit	Single	N	Skip Logic Group	OE_Did not accomplish
		Do you believe the retirement estimate(s) provided to you was/were based on your entire Social Security earnings record?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	RE Based on Earnings
			No	G
	G	Please explain why you think that the retirement estimate(s) was/were not based on your entire Social Security earnings record?			Text area, no char limit	Single	N	Skip Logic Group	OE_Not based on earnings
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)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			I had difficulty because the links did not take me where I expected
			I had difficulty because I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
BJL2268	A	Please describe your navigation difficulty and identify where on the Social Security website this problem occurred			Text area, no char limit		N	Skip Logic Group	Other Difficulty
MAD0043083		Prior to visiting the Retirement Estimator, have you used any of the following resources to prepare for your application for retirement?  (Please select all that apply)	Social Security’s Online Retirement Planner		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Home Page
			The Online Social Security Statement in  the my Social Security section
			Frequently Asked Questions (FAQ)
			Instructional video on the online application page
			Other resource on the SSA website	A
			I did not use any resources to prepare
MAD0043084	A	Please describe what other resources you used to help prepare for your retirement application			Text area, no char limit		N		OPS Other Resources
BJL2270		What do you plan to do next on the Social Security website to continue your pre-retirement preparations?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
			Other	A
MAD0043085	A	Please describe what you plan to do next to continue your pre-retirement preparation			Text area, no char limit		N		OPS Do Next
BJL2273		What is your age?	Under 25		Drop down, select one	Single	N		Age
			26 to 50
			51 to 55
			56 to 60
			61
			62
			63
			64
			65
			66
			67 and over
			Prefer not to answer
BJL2278		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
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

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Sheet 7: v4 Custom Qsts EE (3-14-14)

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 Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BJL2254		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE
			Linked from another website	C2
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
BJL2255	C	Other learned about Please specify how you first learned about the Retirement Estimator.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Please specify the website that led you to the Retirement Estimator			Text field, <100 char		N	Skip Logic Group	OE_Website
		How often do you use the Retirement Estimator?	This was the first time		Radio button, one-up vertical	Single	Y		Frequency
			Every few months or less often
			Monthly
			Weekly
			Several times a week
			Daily/more than once a day
BJL2263		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years 6 years or more
			Don't Know
BJL2264		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
BJL2265		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal
			No	F
			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)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			I had difficulty because the links did not take me where I expected
			I had difficulty because I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
BJL2268	A	Please describe your navigation difficulty and identify where on the Social Security website this problem occurred			Text area, no char limit		N	Skip Logic Group	Other Difficulty
MAD0043083		Prior to visiting the Retirement Estimator, have you used any of the following resources to prepare for your application for retirement?  (Please select all that apply)	Social Security’s Online Retirement Planner		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Home Page
			The Online Social Security Statement in  the my Social Security section
			Frequently Asked Questions (FAQ)
			Instructional video on the online application page
			Other resource on the SSA website	A
			I did not use any resources to prepare
MAD0043084	A	Please describe what other resources you used to help prepare for your retirement application			Text area, no char limit		N		OPS Other Resources
BJL2270		What do you plan to do next on the Social Security website to continue your pre-retirement preparations?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
			Other	A
MAD0043085	A	Please describe what you plan to do next to continue your pre-retirement preparation			Text area, no char limit		N		OPS Do Next
BJL2273		What is your age?	Under 25		Drop down, select one	Single	N		Age
			26 to 50
			51 to 55
			56 to 60
			61
			62
			63
			64
			65
			66
			67 and over
			Prefer not to answer
BJL2278		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
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

---

Sheet 8: v4 Current Custom Qsts EN

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 Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE
			Linked from another website	C2
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
	C	Please specify how you first learned about the Retirement Estimator.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Please specify the website that led you to the Retirement Estimator			Text field, <100 char		N	Skip Logic Group	OE_Website
		How often do you use the Retirement Estimator?	This was the first time		Radio button, one-up vertical	Single	Y		Frequency
			Every few months or less often
			Monthly
			Weekly
			Several times a week
			Daily/more than once a day
		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File
			1 to 3 years
			More than 3 but less than 6 years
			6 years or more
			Don't Know
		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
		Did the Retirement Estimator provide you with all the benefit estimates you were seeking today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal
			No	F
	F	What other benefit estimates were you trying to obtain?			Text area, no char limit	Single	N	Skip Logic Group	OE_Did not accomplish
		Do you believe the retirement estimate(s) provided to you was/were based on your entire Social Security earnings record?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	RE Based on Earnings
			No	G
	G	Please explain why you think that the retirement estimate(s) was/were not based on your entire Social Security earnings record?			Text area, no char limit	Single	N	Skip Logic Group	OE_Not based on earnings
		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			I had difficulty because the links did not take me where I expected
			I had difficulty because I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
	A	Please describe your navigation difficulty and identify where on the Social Security website this problem occurred			Text area, no char limit		N	Skip Logic Group	Other Difficulty
		Prior to visiting the Retirement Estimator, have you used any of the following resources to prepare for your application for retirement?  (Please select all that apply)	Social Security’s Online Retirement Planner		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Home Page
			The Online Social Security Statement in  the my Social Security section
			Frequently Asked Questions (FAQ)
			Instructional video on the online application page
			Other resource on the SSA website	A
			I did not use any resources to prepare
	A	Please describe what other resources you used to help prepare for your retirement application			Text area, no char limit		N		OPS Other Resources
		What do you plan to do next on the Social Security website to continue your pre-retirement preparations?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
			Other	A
	A	Please describe what you plan to do next to continue your pre-retirement preparation			Text area, no char limit		N		OPS Do Next
		What is your age?	Under 25		Drop down, select one	Single	N		Age
			26 to 50
			51 to 55
			56 to 60
			61
			62
			63
			64
			65
			66
			67 and over
			Prefer not to answer
		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital
		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.			Text area, no char limit		N		Improvement

---

Sheet 9: v4 Custom Qsts EN (5-9-14)

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 Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE
			Linked from another website	C2
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
	C	Please specify how you first learned about the Retirement Estimator.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Please specify the website that led you to the Retirement Estimator			Text field, <100 char		N	Skip Logic Group	OE_Website
		How often do you use the Retirement Estimator?	This was the first time		Radio button, one-up vertical	Single	Y		Frequency
			Every few months or less often
			Monthly
			Weekly
			Several times a week
			Daily/more than once a day
		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File
			1 to 3 years
			More than 3 but less than 6 years
			6 years or more
			Don't Know
		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
		Did you accomplish your primary purpose in using the Retirement Estimator? Did the Retirement Estimator provide you with all the benefit estimates you were seeking today?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal
			No	F
			Still Trying	F
	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. What other benefit estimates were you trying to obtain?			Text area, no char limit	Single	N	Skip Logic Group	OE_Did not accomplish
		Do you believe the retirement estimate(s) provided to you was/were based on your entire Social Security earnings record?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	RE Based on Earnings
			No	G
	G	Please explain why you think that the retirement estimate(s) was/were not based on your entire Social Security earnings record?			Text area, no char limit	Single	N	Skip Logic Group	OE_Not based on earnings
		How would you describe your navigation experience on the SSA site today prior to arriving at the Retirement Estimator? (Please select all that apply)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			I had difficulty because the links did not take me where I expected
			I had difficulty because I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
	A	Please describe your navigation difficulty and identify where on the Social Security website this problem occurred			Text area, no char limit		N	Skip Logic Group	Other Difficulty
		Prior to visiting the Retirement Estimator, have you used any of the following resources to prepare for your application for retirement?  (Please select all that apply)	Social Security’s Online Retirement Planner		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Home Page
			The Online Social Security Statement in  the my Social Security section
			Frequently Asked Questions (FAQ)
			Instructional video on the online application page
			Other resource on the SSA website	A
			I did not use any resources to prepare
	A	Please describe what other resources you used to help prepare for your retirement application			Text area, no char limit		N		OPS Other Resources
		What do you plan to do next on the Social Security website to continue your pre-retirement preparations?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
			Other	A
	A	Please describe what you plan to do next to continue your pre-retirement preparation			Text area, no char limit		N		OPS Do Next
		What is your age?	Under 25		Drop down, select one	Single	N		Age
			26 to 50
			51 to 55
			56 to 60
			61
			62
			63
			64
			65
			66
			67 and over
			Prefer not to answer
		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
	X	Other marital status			Text field, <100 char		N	OPS Group	Other Marital
		Please tell us if there are any improvements/changes you would make to the Retirement Estimator.			Text area, no char limit		N		Improvement

---

Sheet 10: v4 Custom Qsts EN (3-14-14)

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 Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BJL2254		How did you first learn about the Retirement Estimator?	Search engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE
			Linked from another website	C2
			From an SSA representative
			SSA publication
			From my Annual Social Security Statement
			Newspaper, magazine or other media
			My employer or Human Resources department
			My financial advisor
			Word of mouth
			Other, please specify	C
BJL2255	C	Other learned about Please specify how you first learned about the Retirement Estimator.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Please specify the website that led you to the Retirement Estimator			Text field, <100 char		N	Skip Logic Group	OE_Website
		How often do you use the Retirement Estimator?	This was the first time		Radio button, one-up vertical	Single	Y		Frequency
			Every few months or less often
			Monthly
			Weekly
			Several times a week
			Daily/more than once a day
BJL2263		When do you expect to file for retirement benefits?	Within 12 months		Radio button, one-up vertical	Single	Y		Expect to File
			1 to 3 years
			More than 3 but less than 6 years
			More than 6 years 6 years or more
			Don't Know
BJL2264		How do you plan to file for retirement benefits?	I prefer to file my retirement application online		Radio button, one-up vertical	Single	Y		How to File
			By telephone interview
			Face-to-face in my local SSA field office
			Online with telephone or in-person assistance, if needed
			Don't Know
BJL2265		Did you accomplish your primary purpose in using the Retirement Estimator?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Accomplish Goal
			No	F
			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)	I had no difficulty navigating/browsing to the Retirement Estimator		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			I had difficulty finding the links to the Retirement Estimator
			I had difficulty because the links did not take me where I expected
			I had difficulty because I experienced technical difficulties (error messages, broken links, etc.)
			I had a navigation difficulty not listed above:	A
BJL2268	A	Please describe your navigation difficulty and identify where on the Social Security website this problem occurred			Text area, no char limit		N	Skip Logic Group	Other Difficulty
MAD0043083		Prior to visiting the Retirement Estimator, have you used any of the following resources to prepare for your application for retirement?  (Please select all that apply)	Social Security’s Online Retirement Planner		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Home Page
			The Online Social Security Statement in  the my Social Security section
			Frequently Asked Questions (FAQ)
			Instructional video on the online application page
			Other resource on the SSA website	A
			I did not use any resources to prepare
MAD0043084	A	Please describe what other resources you used to help prepare for your retirement application			Text area, no char limit		N		OPS Other Resources
BJL2270		What do you plan to do next on the Social Security website to continue your pre-retirement preparations?	Nothing, the Retirement Estimator provided what I needed		Radio button, one-up vertical	Single	Y		Do Next
			Call Social Security's 800 number
			Call my local Social Security office
			Visit my local Social Security office
			Try finding the answers on the Social Security website
			Try the Retirement Estimator again
			Don't Know
			Other	A
MAD0043085	A	Please describe what you plan to do next to continue your pre-retirement preparation			Text area, no char limit		N		OPS Do Next
BJL2273		What is your age?	Under 25		Drop down, select one	Single	N		Age
			26 to 50
			51 to 55
			56 to 60
			61
			62
			63
			64
			65
			66
			67 and over
			Prefer not to answer
BJL2278		What is your current marital status?	Married		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separated
			Divorced
			Widowed
			Never married
			Prefer not to answer
			Other, please specify	x
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

---

Sheet 11: v4 Current Custom Qsts SP

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v4			underlined & italicized: RE-ORDER
MID: p00IdwE4ssR1MA9UUtZ5Ng4C			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator v4 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label	SSA Comments from Sue (8/12/10)
		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.	C2
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
	C	Por favor, especifique cómo se enteró del Calculador de beneficios jubilación.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Por favor, especifique el sitio web que llevó a la Calculador de beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	OE Website	This is a new question
		¿Con qué frecuencia se utiliza el Estimador de la jubilción?	Esta fue la primera vez		Radio button, one-up vertical	Single	Y		Frequency	This is a new question
			Cada pocos meses o con menor frecuencia
			Mensual
			Semanal
			Varias veces a la semana
			diario / más de una vez a la semana
		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			6 años o más.
			No sé
		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
		¿El Calculador de Beneficios por Jubilación le proporcionan todas las estimaciones de beneficios que estaban buscando hoy?	Sí		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
	F	¿Qué otras estimaciones de beneficios estabas tratando de obtener?			Text area, no char limit	Single	N		OE_Did not accomplish
		¿Cree usted que la estimación de la jubilación previsto para que el se basó en todo su registro de ganancias del Seguro Social?	Sí		Radio button, one-up vertical	Single	Y	Skip Logic Group	RE Based on Earnings
			No	G
	G	Por favor, explique por qué piensa que la estimación de la jubilación no se basó en todo su registro de ganancias del Seguro Social?			Text area, no char limit	Single	N	Skip Logic Group	OE_Not based on earnings
		¿Cómo describiría su experiencia navegando el sitio de Internet del Seguro Social hoy antes de llegar al Calculador de beneficios por jubilación? (Por favor seleccione todo lo que aplique.)	No tuve dificultad navegando hacia el Calculador de beneficios por jubilación.		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			Tuve dificultad encontrando los enlaces hacia el Calculador de beneficios por jubilación.
			Los enlaces a veces no me llevaban a donde esperaba llegar.
			Experimenté dificultades técnicas (mensajes de error, enlaces rotos, etc.).
			Tuve una dificultad navegando el sistema que no está listada arriba:	A
	A	Other navigation difficulty			Text area, no char limit		N	Skip Logic Group	Other Difficulty
		Antes d visitar el Retirement Estimator, ¿ha utilizado alguna de los suguientes recursos para prepararse para su jubilacione? (Seleccione todas las que apliquen)	Retirement Estimator del Seguro Social		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Página de Iniciao
			La Declaración de Seguro Social en línea en la sección de mi Seguro Social.
			Preguntas más frecuentes
			Vídeo instructivo en la página de solicitud en línea
			Otros recursos en el sitio web SSA	A
			No hice uso de los recursos para preparar.
	A	Por favor describa qué otros recursos que ha utilizado para ayudar a prepararse para la aplicación de la jubilación			Text area, no char limit		N		OPS Other Resources
		¿Qué va a hacer ahora en la página web de la Seguridad Social para continuar los preparativos previos a la jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sitio de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
			Otro
		¿Qué edad tiene?	Menores de 25		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.
			26 al 50
			51 al 55
			56 al 60
			61
			62
			63
			64
			65
			66
			67 y más
			Prefiero no responder
		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital
		Por favor díganos si hay alguna mejora/cambio que le gustaría que se hiciera al Calculador de beneficios por jubilación.			Text area, no char limit		N		Improvement

---

Sheet 12: v4 Custom Qsts SP (5-9-14)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v4			underlined & italicized: RE-ORDER
MID: p00IdwE4ssR1MA9UUtZ5Ng4C			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator v4 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label	SSA Comments from Sue (8/12/10)
		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.	C2
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
	C	Por favor, especifique cómo se enteró del Calculador de beneficios jubilación.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Por favor, especifique el sitio web que llevó a la Calculador de beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	OE Website	This is a new question
		¿Con qué frecuencia se utiliza el Estimador de la jubilción?	Esta fue la primera vez		Radio button, one-up vertical	Single	Y		Frequency	This is a new question
			Cada pocos meses o con menor frecuencia
			Mensual
			Semanal
			Varias veces a la semana
			diario / más de una vez a la semana
		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			6 años o más.
			No sé
		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
		¿Logró lo que quería al usar el Calculador de beneficios por jubilación? ¿El Calculador de Beneficios por Jubilación le proporcionan todas las estimaciones de beneficios que estaban buscando hoy?	Sí		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo. ¿Qué otras estimaciones de beneficios estabas tratando de obtener?			Text area, no char limit	Single	N		OE_Did not accomplish
		¿Cree usted que la estimación de la jubilación previsto para que el se basó en todo su registro de ganancias del Seguro Social?	Sí		Radio button, one-up vertical	Single	Y	Skip Logic Group	RE Based on Earnings
			No	G
	G	Por favor, explique por qué piensa que la estimación de la jubilación no se basó en todo su registro de ganancias del Seguro Social?			Text area, no char limit	Single	N	Skip Logic Group	OE_Not based on earnings
		¿Cómo describiría su experiencia navegando el sitio de Internet del Seguro Social hoy antes de llegar al Calculador de beneficios por jubilación? (Por favor seleccione todo lo que aplique.)	No tuve dificultad navegando hacia el Calculador de beneficios por jubilación.		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			Tuve dificultad encontrando los enlaces hacia el Calculador de beneficios por jubilación.
			Los enlaces a veces no me llevaban a donde esperaba llegar.
			Experimenté dificultades técnicas (mensajes de error, enlaces rotos, etc.).
			Tuve una dificultad navegando el sistema que no está listada arriba:	A
	A	Other navigation difficulty			Text area, no char limit		N	Skip Logic Group	Other Difficulty
		Antes d visitar el Retirement Estimator, ¿ha utilizado alguna de los suguientes recursos para prepararse para su jubilacione? (Seleccione todas las que apliquen)	Retirement Estimator del Seguro Social		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Página de Iniciao
			La Declaración de Seguro Social en línea en la sección de mi Seguro Social.
			Preguntas más frecuentes
			Vídeo instructivo en la página de solicitud en línea
			Otros recursos en el sitio web SSA	A
			No hice uso de los recursos para preparar.
	A	Por favor describa qué otros recursos que ha utilizado para ayudar a prepararse para la aplicación de la jubilación			Text area, no char limit		N		OPS Other Resources
		¿Qué va a hacer ahora en la página web de la Seguridad Social para continuar los preparativos previos a la jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sitio de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
			Otro
		¿Qué edad tiene?	Menores de 25		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.
			26 al 50
			51 al 55
			56 al 60
			61
			62
			63
			64
			65
			66
			67 y más
			Prefiero no responder
		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital
		Por favor díganos si hay alguna mejora/cambio que le gustaría que se hiciera al Calculador de beneficios por jubilación.			Text area, no char limit		N		Improvement

---

Sheet 13: v4 Custom Qsts SP (3-14-14)

Social Security Administration			red & strike-through: DELETE
SSA Retirement Estimator v4			underlined & italicized: RE-ORDER
MID: p00IdwE4ssR1MA9UUtZ5Ng4C			pink: ADDITION
Date:	10/6/2010		blue + -->: REWORDING
SSA Retirement Estimator v4 CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label	SSA Comments from Sue (8/12/10)
		¿Cómo se enteró del Calculador de beneficios por jubilación?	Por un motor de búsqueda		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learned about RE	This is not a new question
			Un enlace de otra página de Internet.	C2
			De un agente del Seguro Social.
			De una publicación del Seguro Social.
			De mi Declaración del Seguro Social anual.
			Por un periódico, revista u otro medio informático
			Fue sugerido por mi empleador o por el Departamento de Recursos Humanos
			Fue sugerido por mi asesor financiero
			Alguien me lo comentó
			Otro (especifique)	C
	C	Otra manera de enterarse Por favor, especifique cómo se enteró del Calculador de beneficios jubilación.			Text field, <100 char		N	Skip Logic Group	Other learned about
	C2	Por favor, especifique el sitio web que llevó a la Calculador de beneficios por jubilación.			Text field, <100 char		N	Skip Logic Group	OE Website	This is a new question
		¿Con qué frecuencia se utiliza el Estimador de la jubilción?	Esta fue la primera vez		Radio button, one-up vertical	Single	Y		Frequency	This is a new question
			Cada pocos meses o con menor frecuencia
			Mensual
			Semanal
			Varias veces a la semana
			diario / más de una vez a la semana
		¿Cuándo espera solicitar beneficios por jubilación?	Dentro de 12 meses		Radio button, one-up vertical	Single	Y		Expect to File	This is not a new question
			Dentro de 1 a 3 años
			Más de 3 años pero menos de 6 años
			6 años o más.
			No sé
		¿Cómo piensa solicitar sus beneficios por jubilación?	Prefiero presentar mi solicitud por Internet.		Radio button, one-up vertical	Single	Y		How to File	This is not a new question
			Por entrevista telefónica
			Personalmente en la oficina local del Seguro Social.
			Por Internet con la ayuda de alguien por teléfono o en persona, si fuese necesario.
			No sé
		¿Logró lo que quería al usar el Calculador de beneficios por jubilación?	Sí		Radio button, one-up vertical	Single	Y		Accomplish Goal	This is not a new question
			No	F
			Aun lo estoy intentando	F
	F	Si al usar el Calculador de beneficios por jubilación no logró cumplir su propósito primordial, por favor háganos saber por qué no pudo hacerlo.			Text area, no char limit	Single	N		OE_Did not accomplish
		¿Cómo describiría su experiencia navegando el sitio de Internet del Seguro Social hoy antes de llegar al Calculador de beneficios por jubilación? (Por favor seleccione todo lo que aplique.)	No tuve dificultad navegando hacia el Calculador de beneficios por jubilación.		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Navigation Experience
			Tuve dificultad encontrando los enlaces hacia el Calculador de beneficios por jubilación.
			Los enlaces a veces no me llevaban a donde esperaba llegar.
			Experimenté dificultades técnicas (mensajes de error, enlaces rotos, etc.).
			Tuve una dificultad navegando el sistema que no está listada arriba:	A
	A	Other navigation difficulty			Text area, no char limit		N	Skip Logic Group	Other Difficulty
		Antes d visitar el Retirement Estimator, ¿ha utilizado alguna de los suguientes recursos para prepararse para su jubilacione? (Seleccione todas las que apliquen)	Retirement Estimator del Seguro Social		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Other Resources
			SSA Página de Iniciao
			La Declaración de Seguro Social en línea en la sección de mi Seguro Social.
			Preguntas más frecuentes
			Vídeo instructivo en la página de solicitud en línea
			Otros recursos en el sitio web SSA	A
			No hice uso de los recursos para preparar.
	A	Por favor describa qué otros recursos que ha utilizado para ayudar a prepararse para la aplicación de la jubilación			Text area, no char limit		N		OPS Other Resources
		¿Qué va a hacer ahora en la página web de la Seguridad Social para continuar los preparativos previos a la jubilación?	Nada, el Calculador de beneficios por jubilación suministró todo lo que necesitaba		Radio button, one-up vertical	Single	Y		Do Next	This question will provide information about whether people use RE in addition to the toll-free number and visits to the field office, or as a substitute to those services.
			Llamar al número 800 del Seguro Social
			Llamar mi oficina local del Seguro Social
			Visitar mi oficina local del Seguro Social
			Intentar encontrar las respuestas en el sitio de Internet del Seguro Social
			Intentar usar el Calculador de beneficios por jubilación de nuevo
			No sé
			Otro
		¿Qué edad tiene?	Menores de 25		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.
			26 al 50
			51 al 55
			56 al 60
			61
			62
			63
			64
			65
			66
			67 y más
			Prefiero no responder
		¿Cuál es su estado civil?	Casada/o		Radio button, one-up vertical	Single	N	OPS Group	Marital Status
			Separada/o
			Divorciada/o
			Viuda/o
			Nunca se ha casado
			Me reservo el derecho a contestar la pregunta
			Otro (especifique)	x
	X	Otro estado civil			Text field, <100 char		N	OPS Group	Other Marital
		Por favor díganos si hay alguna mejora/cambio que le gustaría que se hiciera al Calculador de beneficios por jubilación.			Text area, no char limit		N		Improvement

---

Sheet 14: Element Rotations

Base Element Order	Version 2	Version 3	Version 4
Look and Feel	Plain Language	Site Performance	Look and Feel
Site Performance	Site Performance	Look and Feel	Plain Language
Plain Language	Look and Feel	Plain Language	Site Performance
1	7	4	1
2	8	5	2
3	9	6	3
4	4	1	7
5	5	2	8
6	6	3	9
7	1	7	4
8	2	8	5
9	3	9	6

---

Sheet 15: v3 Custom Qsts EE

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

---

Sheet 16: v3 Custom Qsts EN

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

---

Sheet 17: v3 Custom Qsts SP

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