| Survey: | SSA Disability | 
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		| IA#: | 30688 Amend 4 | 
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		| Date: | 8/19/2019 | 
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		| SURVEY TYPE: | Relationship (tab 4) | 
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		| Survey Q# | Type# | Type Topic | 
	
		| 1 | Standard | Site Performance -Speed | 
	
		| 2 | Standard | Site Performance - Complete | 
	
		| 3 | Standard | Site Performance - Responsiveness | 
	
		| 4 | Standard | Look and Feel - Appeal | 
	
		| 5 | Standard | Look and Feel - Spacing | 
	
		| 6 | Standard | Look and Feel - Legibility | 
	
		| 7 | Standard | Navigation - Ease of finding | 
	
		| 8 | Standard | Navigation - Page layout | 
	
		| 9 | Standard | Navigation - Links | 
	
		| 10 | Standard | Site Information - Relevance | 
	
		| 11 | Standard | Site Information - Thoroughness | 
	
		| 12 | Standard | Site Information - Readability | 
	
		| 13 | Standard | Account Management - Simplicity | 
	
		| 14 | Standard | Account Management - Efficiency | 
	
		| 15 | Standard | Account Management - Essential Info | 
	
		| 16 | Standard | Sat - Overall | 
	
		| 17 | Standard | Sat - Expectations | 
	
		| 18 | Standard | Sat - Ideal | 
	
		| 19 | Standard | Recommend | 
	
		| 20 | Standard | Use other services | 
	
		| 21 | Custom | Applying for | 
	
		| 22 | Custom | Create or log into mySSA | 
	
		| 23 | Custom | Why not log in mySSA | 
	
		| 24 | Custom | OE_Why not log in mySSA | 
	
		| 25 | Custom | OE_How Linked to SSA (library) | 
	
		| 26 | Custom | OE_How Linked to SSA (library) | 
	
		| 27 | Custom | Learn about App | 
	
		| 28 | Custom | OPS_learned of app | 
	
		| 29 | Custom | First try | 
	
		| 30 | Custom | Prepare for App | 
	
		| 31 | Custom | Rate Statement | 
	
		| 32 | Custom | Rate Video | 
	
		| 33 | Custom | Rate Other Info on Website | 
	
		| 34 | Custom | OPS Prepare for App | 
	
		| 35 | Custom | SSI Apply Today | 
	
		| 36 | Custom | SSI Apply Future | 
	
		| 37 | Custom | SSI Criteria Aware | 
	
		| 38 | Custom | Clearly describe SSI | 
	
		| 39 | Custom | OE_Not clear about SSI | 
	
		| 40 | Custom | App Status | 
	
		| 41 | Custom | Access Saved App | 
	
		| 42 | Custom | Reentry number aware | 
	
		| 43 | Custom | Have mySSA account | 
	
		| 44 | Custom | Create New App | 
	
		| 45 | Custom | Complete App | 
	
		| 46 | Custom | Not Complete App | 
	
		| 47 | Custom | OPS Why Not Complete today | 
	
		| 48 | Custom | Do next | 
	
		| 49 | Custom | OE_Do next | 
	
		| 50 | Custom | Time Spent | 
	
		| 51 | Custom | Number of times | 
	
		| 52 | Custom | Arrive at App | 
	
		| 53 | Custom | OPS Arrive at app | 
	
		| 54 | Custom | Find App | 
	
		| 55 | Custom | Why hard to find | 
	
		| 56 | Custom | OPS Hard to Find | 
	
		| 57 | Custom | Difficulties | 
	
		| 58 | Custom | OPS Hard to Find | 
	
		| 59 | Custom | Disability Starter Kit_Help Complete | 
	
		| 60 | Custom | Role | 
	
		| 61 | Custom | Rate Helpfulness of Checklist | 
	
		| 62 | Custom | OE_Reason for stopping | 
	
		| 63 | Custom | OE_Did not finish Report | 
	
		| 64 | Custom | Why Online | 
	
		| 65 | Custom | OPS Why Online | 
	
		| 66 | Custom | Marital Status | 
	
		| 67 | Custom | OPS_Why Not Have mySSA Account | 
	
		| 68 | Custom | Age | 
	
		| 69 | Custom | OE_Improvement |