30908 SSA Mobile W 30908 SSA Mobile Wages Questionnaire 1-27-2022

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Overview

Welcome and Thank You Text
Model Questions
Custom Questions
CQs (1-27-21)
CQs (12-1-21)
Attributes

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Sheet 1: Welcome and Thank You Text

	The text you see here will appear at the top and bottom of your survey, examples below.
	Default text is included and you may modify this text as needed.
	Welcome and Thank You Text
		Welcome Text		Welcome Text - Tablet / Phone
		Thank you for using the SSI Mobile Wage Reporting app. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.		Thank you for visiting . You've been selected to participate in a brief survey to let us know how we can improve your experience. Please take a minute to share your opinions.
		Thank You Text		Thank You Text - Tablet / Phone
		Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.		Thank you for taking our survey - and for helping us serve you better. We appreciate your input!
		Example Desktop		Example Mobile

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Sheet 2: Model Questions

Model Name		SSA Mobile Wage Reporting 2021			Red & Strike-Through: Delete
Model ID		85IBo9EdgJo4ldpsYEMIAQ4C			Underlined & Italicized: Re-order
Partitioned					Pink: Addition
Date		6/1/2021
Model Version		18.1.J			Blue: Reword
	Label	Satisfaction Questions		Label	Future Behaviors
		Satisfaction			Recommend (1=Very Unlikely, 10=Very Likely)
1	Satisfaction - Overall	What is your overall satisfaction with this mobile app? (1=Very Dissatisfied, 10=Very Satisfied)	4	Recommend (NPS)	How likely are you to recommend this mobile app to someone else?
2	Satisfaction - Expectations	How well does this mobile app meet your expectations? (1=Falls Short, 10=Exceeds)
3	Satisfaction - Ideal	How does this mobile app compare to an ideal mobile app? (1=Not Very Close, 10=Very Close)

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Sheet 3: Custom Questions

Model Name			SSA Mobile Wage Reporting 2021				Red & Strike-Through: Delete
Model ID			85IBo9EdgJo4ldpsYEMIAQ4C				Underlined & Italicized: Re-order
Partitioned			0				Pink: Addition
Date			6/1/2021				Blue: Reword
QID	AP Question Tag	Skip From	Question Text	Answer Choices	Skip To	AP Answer Tag	Required Y/N	Type	Special Instructions	CQ Label
SBD9263Q001			Who are you reporting wages for?	Myself			Y	Radio button, one-up vertical	Skip Logic Group*	Reporting for
				My Spouse
				Myself and Spouse
				Myself and Other	Q1
				Other	Q1
SBD9263Q002		Q1	What is your relationship to the individual you are reporting wages for?				N	Text field, <100 char	Skip Logic Group*	OE_Relationship
SBD9263Q003			Are you reporting for more than one employer for the same person?	Yes			Y	Radio button, one-up vertical		Reporting multiple employers
				No
				Don't know
SBD9263Q004			Is this your first time using this app?	Yes			Y	Radio button, one-up vertical		First Time Using App
				No
SBD9263Q005			How helpful was the instruction package you received?	Very helpful			Y	Radio button, one-up vertical		Instructions Packet
				Helpful
				Not helpful
				I did not receive an instruction package.
SBD9263Q006			Have you ever used your mobile device to access other online Social Security applications or services?	Yes	A		Y	Radio button, one-up vertical	Skip Logic Group*	Use Other Apps with Mobile
				No
SBD9263Q007		A	Which online Social Security application(s) or service(s) did you use? (Select all that apply.)	Get a Benefit Verification Letter			N	Checkbox, one-up vertical	Skip Logic Group*	Other app used
				View my Benefits and Payment Details
				Enroll in or update my direct deposit
				Change my address with SSA
				Print or view my online Social Security Statement
				Make sure my earnings record is correct
				Replace my Social Security Card or get a new card
				Check the Status of my recently filed application for benefits
				Learn about the benefits to which I might be entitled
				Apply only for Social Security or Medicare Only benefits
				Report my wages
				Request a replacement SSA-1099 (or SSA-10425) for tax purposes
				Add Extra Security to my online account
				None of these					Mutually exclusive
SBD9263Q008			Did you accomplish what you wanted to with the SSA app?	Yes			Y	Radio button, one-up vertical	Skip Logic Group*	Accomplish
				Partially	A
				No	A
SBD9263Q009		A	What do you plan to do next?	Try again to complete my task online			Y	Radio button, one-up vertical	Skip Logic Group*	Do next
				Call Social Security's 1-800 number
				Visit my local Social Security office
				Call my local Social Security office
				Other (please specify)	B
SBD9263Q010		B	What do you plan to do next?				N	Text area, no char limit	Skip Logic Group*	OE_Other plan next
SBD9263Q011			Please indicate your level of agreement with the following statements about your interaction today: I am satisfied with the service I received from the Social Security Administration.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Satisfied
				2
				3
				4
				Strongly Agree=5
SBD9263Q012			This interaction increased my confidence in the Social Security Administration.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Trust
				2
				3
				4
				Strongly Agree=5
SBD9263Q013			My need was addressed.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Quality
				2
				3
				4
				Strongly Agree=5
SBD9263Q014			It was easy to complete what I needed to do.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Ease
				2
				3
				4
				Strongly Agree=5
SBD9263Q015			It took a reasonable amount of time to do what I needed to do.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Speed
				2
				3
				4
				Strongly Agree=5
SBD9263Q016			Please provide any suggestions you may have to improve this mobile site.				N	Text area, no char limit		OE_Improvement. OCBO-Cx: Sentiment Analysis

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Sheet 4: CQs (1-27-21)

Model Name			SSA Mobile Wage Reporting 2021				Red & Strike-Through: Delete
Model ID			85IBo9EdgJo4ldpsYEMIAQ4C				Underlined & Italicized: Re-order
Partitioned			0				Pink: Addition
Date			6/1/2021				Blue: Reword
QID	AP Question Tag	Skip From	Question Text	Answer Choices	Skip To	AP Answer Tag	Required Y/N	Type	Special Instructions	CQ Label
SBD9263Q001			Who are you reporting wages for?	Myself			Y	Radio button, one-up vertical	Skip Logic Group*	Reporting for
				My Spouse
				Myself and Spouse
				Myself and Other	Q1
				Other	Q1
SBD9263Q002		Q1	What is your relationship to the individual you are reporting wages for?				N	Text field, <100 char	Skip Logic Group*	OE_Relationship
SBD9263Q003			Are you reporting for more than one employer for the same person?	Yes			Y	Radio button, one-up vertical		Reporting multiple employers
				No
				Don't know
SBD9263Q004			Is this your first time using this app?	Yes	A		Y	Radio button, one-up vertical	Skip Logic Group*	First Time Using App
				No
		A	Did you receive an instruction package prior to using the app?	Yes			N	Radio button, one-up vertical	Skip Logic Group*	Receive Instruction Packet
				No
				Don't know
SBD9263Q005			How helpful was the instruction package you received?	Very helpful			Y	Radio button, one-up vertical		Instructions Packet
				Helpful
				Not helpful
				I did not receive an instruction package.
			How was your experience using the camera feature to take a picture of your paystub?	1=Poor			Y	Radio button, scale, has don't know		Camera Feature
				2
				3
				4
				Excellent=5
				Did not use.
			How was your experience using the file upload tool to upload your paystub?	1=Poor			Y	Radio button, scale, has don't know		File Upload Tool
				2
				3
				4
				Excellent=5
				Did not use.
SBD9263Q006			Have you ever used your mobile device to access other online Social Security applications or services?	Yes	A		Y	Radio button, one-up vertical	Skip Logic Group*	Use Other Apps with Mobile
				No
SBD9263Q007		A	Which online Social Security application(s) or service(s) did you use? (Select all that apply.)	Get a Benefit Verification Letter			N	Checkbox, one-up vertical	Skip Logic Group*	Other app used
				View my Benefits and Payment Details
				Enroll in or update my direct deposit
				Change my address with SSA
				Print or view my online Social Security Statement
				Make sure my earnings record is correct
				Replace my Social Security Card or get a new card
				Check the Status of my recently filed application for benefits
				Learn about the benefits to which I might be entitled
				Apply only for Social Security or Medicare Only benefits
				Report my wages
				Request a replacement SSA-1099 (or SSA-10425) for tax purposes
				Add Extra Security to my online account
				None of these					Mutually exclusive
SBD9263Q008			Did you accomplish what you wanted to with the SSA app?	Yes			Y	Radio button, one-up vertical	Skip Logic Group*	Accomplish
				Partially	A
				No	A
SBD9263Q009		A	What do you plan to do next?	Try again to complete my task online			Y	Radio button, one-up vertical	Skip Logic Group*	Do next
				Call Social Security's 1-800 number
				Visit my local Social Security office
				Call my local Social Security office
				Other (please specify)	B
SBD9263Q010		B	What do you plan to do next?				N	Text area, no char limit	Skip Logic Group*	OE_Other plan next
SBD9263Q011			Please indicate your level of agreement with the following statements about your interaction today: I am satisfied with the service I received from the Social Security Administration.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Satisfied
				2
				3
				4
				Strongly Agree=5
SBD9263Q012			This interaction increased my confidence in the Social Security Administration.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Trust
				2
				3
				4
				Strongly Agree=5
SBD9263Q013			My need was addressed.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Quality
				2
				3
				4
				Strongly Agree=5
SBD9263Q014			It was easy to complete what I needed to do.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Ease
				2
				3
				4
				Strongly Agree=5
SBD9263Q015			It took a reasonable amount of time to do what I needed to do.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Speed
				2
				3
				4
				Strongly Agree=5
SBD9263Q016			Please provide any suggestions you may have to improve this mobile site.				N	Text area, no char limit		OE_Improvement. OCBO-Cx: Sentiment Analysis

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Sheet 5: CQs (12-1-21)

Model Name			SSA Mobile Wage Reporting 2021				Red & Strike-Through: Delete
Model ID			85IBo9EdgJo4ldpsYEMIAQ4C				Underlined & Italicized: Re-order
Partitioned			0				Pink: Addition
Date			6/1/2021				Blue: Reword
QID	AP Question Tag	Skip From	Question Text	Answer Choices	Skip To	AP Answer Tag	Required Y/N	Type	Special Instructions	CQ Label
SBD9263Q001			Who are you reporting wages for?	Myself			Y	Radio button, one-up vertical	Skip Logic Group*	Reporting for
				My Spouse
				Myself and Spouse
				Myself and Other	Q1
				Other	Q1
SBD9263Q002		Q1	What is your relationship to the individual you are reporting wages for?				N	Text field, <100 char	Skip Logic Group*	OE_Relationship
SBD9263Q003			Are you reporting for more than one employer for the same person?	Yes			Y	Radio button, one-up vertical		Reporting multiple employers
				No
				Don't know
SBD9263Q004			Is this your first time using this app?	Yes	A		Y	Radio button, one-up vertical	Skip Logic Group*	First Time Using App
				No
		A	Did you receive an instruction package prior to using the app?	Yes			N	Radio button, one-up vertical	Skip Logic Group*	Receive Instruction Packet
				No
				Don't know
SBD9263Q005			How helpful was the instruction package you received?	Very helpful			Y	Radio button, one-up vertical		Instructions Packet
				Helpful
				Not helpful
				I did not receive an instruction package.
SBD9263Q006			Have you ever used your mobile device to access other online Social Security applications or services?	Yes	A		Y	Radio button, one-up vertical	Skip Logic Group*	Use Other Apps with Mobile
				No
SBD9263Q007		A	Which online Social Security application(s) or service(s) did you use? (Select all that apply.)	Get a Benefit Verification Letter			N	Checkbox, one-up vertical	Skip Logic Group*	Other app used
				View my Benefits and Payment Details
				Enroll in or update my direct deposit
				Change my address with SSA
				Print or view my online Social Security Statement
				Make sure my earnings record is correct
				Replace my Social Security Card or get a new card
				Check the Status of my recently filed application for benefits
				Learn about the benefits to which I might be entitled
				Apply only for Social Security or Medicare Only benefits
				Report my wages
				Request a replacement SSA-1099 (or SSA-10425) for tax purposes
				Add Extra Security to my online account
				None of these					Mutually exclusive
SBD9263Q008			Did you accomplish what you wanted to with the SSA app?	Yes			Y	Radio button, one-up vertical	Skip Logic Group*	Accomplish
				Partially	A
				No	A
SBD9263Q009		A	What do you plan to do next?	Try again to complete my task online			Y	Radio button, one-up vertical	Skip Logic Group*	Do next
				Call Social Security's 1-800 number
				Visit my local Social Security office
				Call my local Social Security office
				Other (please specify)	B
SBD9263Q010		B	What do you plan to do next?				N	Text area, no char limit	Skip Logic Group*	OE_Other plan next
SBD9263Q011			Please indicate your level of agreement with the following statements about your interaction today: I am satisfied with the service I received from the Social Security Administration.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Satisfied
				2
				3
				4
				Strongly Agree=5
SBD9263Q012			This interaction increased my confidence in the Social Security Administration.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Trust
				2
				3
				4
				Strongly Agree=5
SBD9263Q013			My need was addressed.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Quality
				2
				3
				4
				Strongly Agree=5
SBD9263Q014			It was easy to complete what I needed to do.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Ease
				2
				3
				4
				Strongly Agree=5
SBD9263Q015			It took a reasonable amount of time to do what I needed to do.	1=Strongly Disagree			Y	Radio button, scale, no don't know		A11-Speed
				2
				3
				4
				Strongly Agree=5
SBD9263Q016			Please provide any suggestions you may have to improve this mobile site.				N	Text area, no char limit		OE_Improvement. OCBO-Cx: Sentiment Analysis

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Sheet 6: Attributes

Attribute	Value
Channel	Web
Touchpoint Name	Informational
Hierarchy	No
Model Type	CSAT+FB Web
Journey Phase	Awareness
Touchpoint Type	Standard
Partner Involved	No
Replay	No
Version Number of Model Template	18.1.J
Survey Type	PREDCSAT_NODR
Look and Feel	Single Page
Theme Color	#009fea