| Model Instance Name: | 
 | 
 | 
 | 
	
		| IRS ACH Mobile | 
 | 
 | 
   | 
	
		| MID: | 
 | 
 | 
	
		| Partitioned (Y/N)? Y | 
 | 
 | 
	
		| Date:  08/14/2015 | 
 | 
 | 
 | 
	
		| IRS ACH Mobile | 
	
		| Model questions utilize the ACSI methodology to determine scores and impacts | 
	
		| 
 | ELEMENTS (drivers of satisfaction) | 
 | CUSTOMER SATISFACTION | 
 | FUTURE BEHAVIORS | 
	
		| 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | Site Information (1=Poor, 10=Excellent, Don't Know) | 
 | Satisfaction | 
 | Recommend (1=Very Unlikely, 10=Very Likely) | 
	
		| 1 | Please rate the thoroughness of information provided on IRS Direct Pay. | 16 | What is your overall satisfaction with IRS Direct Pay? (1=Very Dissatisfied, 10=Very Satisfied) | 19 | How likely are you to recommend IRS Direct Pay to someone else? | 
	
		| 2 | Please rate how understandable information is on IRS Direct Pay. | 17 | How well does IRS Direct Pay meet your expectations? (1=Falls Short, 10=Exceeds) | 
 | Return (1=Very Unlikely, 10=Very Likely) | 
	
		| 3 | Please rate how well IRS Direct Pay information provides answers to your questions. | 18 | How does IRS Direct Pay compare to your idea of an ideal pay service? (1=Not Very Close, 10=Very Close) | 20 | How likely are you to return to IRS Direct Pay using your mobile device? | 
	
		| 
 | Site Performance (1=Poor, 10=Excellent, Don't Know) | 
 | 
 | 
 | 
 | 
	
		| 4 | Please rate how quickly pages load on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 5 | Please rate the consistency of speed from page to page on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 6 | Please rate the ability to load pages without getting error messages on IRS Direct Pay. | 
   | 
   | 
 | 
	
		| 
 | Navigation (1=Poor, 10=Excellent, Don't Know) | 
 | 
	
		| 7 | Please rate how well IRS Direct Pay is organized. | 
 | 
	
		| 8 | Please rate the options available for navigating IRS Direct Pay. | 
 | 
	
		| 9 | Please rate how well IRS Direct Pay layout helps you find what you are looking for. | 
 | 
 | 
 | 
 | 
	
		| 
 | Look and Feel (1=Poor, 10=Excellent, Don't Know) | 
 | 
 | 
 | 
 | 
	
		| 10 | Please rate the visual appeal of IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 11 | Please rate the balance of graphics and text on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 12 | Please rate the readability of the pages on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 
 | Tasks/ Transactions (1=Poor, 10=Excellent, Don't Know) | 
 | 
 | 
 | 
 | 
	
		| 13 | Please rate the simplicity of the process for completing task(s) on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 14 | Please rate the clarity of instructions for completing task(s) on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
		| 15 | Please rate the verification of task completion on IRS Direct Pay. | 
 | 
 | 
 | 
 | 
	
	
	
	
	
	
	
	
	
	
	
		| Model Instance Name: | red & strike-through:  DELETE | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| IRS ACH Mobile | underlined & italicized: RE-ORDER | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| MID: | pink: ADDITION | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| Date:  08/14/2015 | blue + -->: REWORDING | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 
 | 
 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| IRS ACH Mobile 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 | 
	
		| MAC5167Q001 | 
 | Is this your first time using IRS Direct Pay? | Yes | 
 | Radio button,  one-up vertical | S | Y | 
 | First time | 
	
		| 
 | 
 | No | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q002 | 
 | What features or benefits prompted you to use IRS Direct Pay? (Check all that apply) | Online payment option | 
 | Checkbox,  one-up vertical | M | Y | Skip Logic Group* | Features | 
	
		| 
 | 
 | No fees | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | No registration | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Look up status, edit or cancel my payment | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | All of the above | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | None of the above | 
 | 
 | 
 | 
 | Mutually Exclusive | 
 | 
	
		| 
 | 
 | Other, please specify | A | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q003 | A | Please specify other features or benefits that prompted you to use IRS Direct Pay. | 
 | 
 | Text area,  no char limit | 
 | N | Skip Logic Group* | Other features | 
	
		| MAC5167Q004 | 
 | Did you previously use an alternative method to submit payments to the IRS? | Yes | A | Radio button,  one-up vertical | S | Y | Skip Logic Group* | Alternate method | 
	
		| 
 | 
 | No | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q005 | A | Which of the following method(s) did you use? (Check all that apply) | Paper process | 
 | Checkbox,  one-up vertical | M | Y | Skip Logic Group* | Methods | 
	
		| 
 | 
 | Online Credit Card Payment | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | EFTPS | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Other | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| CAS0059204 | 
 | What would be your preferred choice of payment if Direct Pay was not available? | Mail in check | 
 | Drop down,  select one | S | Y | 
 | Preferred payment | 
	
		| 
 | 
 | Pay in person | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Credit card | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Electronic funds transfer (have it taken directly out of your account | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Pay when you e-file | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Don’t know | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q006 | 
 | What is the reason for your payment today? | Installment Agreement | 
 | Drop down,  select one | S | Y | Skip Logic Group* | Reason | 
	
		| 
 | 
 | Tax Return | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Estimated Tax | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Adjusted Balance Due | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Extension | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Amended Return | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Other, please specify | A | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q007 | A | Please specify other reason for your payment today. | 
 | 
 | Text area,  no char limit | 
 | N | Skip Logic Group* | Other reason | 
	
		| MAC5167Q008 | 
 | How easy was the IRS Direct Pay payment transaction process today? | Very easy | 
 | Radio button,  one-up vertical | S | Y | Skip Logic Group* | Ease of transaction | 
	
		| 
 | 
 | Somewhat easy | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Somewhat difficult | B | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Very difficult | B | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | I did not complete a payment transaction at this time | A | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | No opinion | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q009 | A | Please tell us what prevented you from completing the payment transaction today. | 
 | 
 | Text area,  no char limit | 
 | N | Skip Logic Group* | Incomplete transaction | 
	
		| MAC5167Q010 | B | Please describe the difficulties you encountered with the payment transaction today. Be as specific as possible. | 
 | 
 | Text area,  no char limit | 
 | N | Skip Logic Group* | Difficult transaction | 
	
		| MAC5167Q011 | 
 | From the following list, what additional services would you like to have within IRS Direct Pay? | Save your bank account information for easier future payments | 
 | Checkbox,  one-up vertical | M | Y | Skip Logic Group* | Additional services | 
	
		| 
 | 
 | Look up your payment history | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | View your outstanding payment balance due to the IRS | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Receive an email confirmation | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Set up recurring payment | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Other, please specify | A | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q012 | A | What other additional service(s) would you like to have within IRS Direct Pay. | 
 | 
 | Text area,  no char limit | 
 | N | Skip Logic Group* | Other service | 
	
		| MAC5167Q013 | 
 | How can we further improve the IRS Direct Pay feature to better serve your needs in the future? | 
 | 
 | Text area,  no char limit | 
 | N | 
 | Improvement | 
	
		| 
 | 
 | How do you prefer to access the IRS Direct Pay? | Computer/laptop | 
 | Drop down,  select one | S | Y | 
 | Access preference | 
	
		| 
 | 
 | Mobile phone | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Mobile tablet | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | No preference | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q014 | 
 | How likely are you to call customer service as a result of your visit today? | 1=Very Unlikely | 
 | Radio button,  scale, has don't know | S | Y | 
 | Customer service | 
	
		| 
 | 
 | 2 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 3 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 4 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 5 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 6 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 7 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 8 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 9 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 10=Very Likely | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Don’t know | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q015 | 
 | What is your age? | 17 years and under | 
 | Drop down,  select one | S | N | 
 | Age | 
	
		| 
 | 
 | 18 to 24 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 25 to 34 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 35 to 44 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 45 to 54 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 55 to 64 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | 65 to 74 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Above 75 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Prefer not to respond | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q016 | 
 | What is your gender? | Male | 
 | Drop down,  select one | S | N | 
 | Gender | 
	
		| 
 | 
 | Female | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Prefer not to respond | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| MAC5167Q017 | 
 | Which of the following categories describes your household income level? | Less than $30,000 | 
 | Drop down,  select one | S | N | 
 | Income | 
	
		| 
 | 
 | $30,000 but less than $50,000 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | $50,000 but less than $80,000 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | $80,000 but less than $100,000 | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | $100,000 or more | 
 | 
 | 
 | 
 | 
 | 
 | 
	
		| 
 | 
 | Prefer not to respond | 
 | 
 | 
 | 
 | 
 | 
 |