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["Model Instance Name: "]
["SSA Retirement Estimator"]
["MID:"]
["Date:","2008-07-16"]
[]
["SSA Retirement Estimator MODEL QUESTION LIST"]
["Model questions utilize the ACSI methodology to determine scores and impacts"]
[null,"ELEMENTS (drivers of satisfaction)",null,"CUSTOMER SATISFACTION",null,"FUTURE BEHAVIORS"]
[null,"NOTE: All questions under each element are required.\nElement questions are partitioned among surveys.",null,"Satisfaction questions are required.\nSatisfaction questions appear on all surveys.",null,"Future behaviors may be modified based on your site's objectives.\nFuture behavior questions appear on all surveys."]
[null,"REQUIRED ELEMENTS (common to all websites)"]
[null,"Site Performance (If applicable)\n(1=Poor, 10=Excellent, Don't Know)",null,"Satisfaction (1=Poor, 10=Excellent)",null,"Apply online for Benefits\n(1=Not Very Likely, 10=Very Likely)"]
[1,"Please rate the speed that pages load on this on-line application.",23,"What is your overall satisfaction with the on-line application process?",26,"How likely are you to apply for Social Security Benefits online?"]
[2,"Please rate the consistency of speed from page-to-page on this on-line application.",24,"How well does the on-line application process on this site meet your expectations?",null,"Recommend \n(1=Not Very Likely, 10=Very Likely)"]
[3,"Please rate the ability to load pages without getting errors on this on-line application.",25,"How does the application process on this site compare to your idea of an ideal on-line application process?",27,"How likely are you to recommend this on-line application process to someone else?"]
[null,"Look and Feel\n(1=Poor, 10=Excellent, Don't Know)",null,null,null,"Return (if applicable)\n(1=Not Very Likely, 10=Very Likely)"]
[4,"Please rate the ease of reading the application form.",null,null,28,"How likely are you to return to the SSA Retirement Estimator?"]
[5,"Please rate the layout of the application form.",null,null,null,"Use Other SSA Applications\n(1=Not Very Likely, 10=Very Likely)"]
[6,"Please rate the amount of information displayed with the application form.",null,null,29,"How likely are you to use other on-line applications on the Social Security web site?"]
[null,"On-Line Application Requirements\n(1=Poor, 10=Excellent, Don't Know)"]
[7,"Please rate the accuracy of the requirements to complete this on-lineapplication."]
[8,"Please rate the clarity of the instructions to complete this on-line application."]
[9,"Please rate the availability of help with questions or problems during the on-line application."]
[null,"On-Line Application Functionality\n(1=Poor, 10=Excellent, Don't Know)"]
[10,"Please rate the ease of completing this on-line application."]
[11,"Please rate the number of steps for entering the information into the on-line application."]
[12,"Please rate the procedure for making corrections."]
[null,"On-Line Application Security\n(1=Poor, 10=Excellent, Don't Know)"]
[13,"Please rate the security of the on-line application process."]
[14,"Please rate the site's commitment to protecting your personal information."]

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["Model Instance Name: ",null,null,"red & strike-through:  DELETE"]
["SSA Retirement Estimator",null,null,"underlined & italicized: RE-ORDER"]
["MID: ",null,null,"pink: ADDITION"]
["Date:","2008-07-16",null,"blue + -->: REWORDING"]
[null,null,null,"violet (bold): SKIP-LOGIC"]
["SSA Retirement Estimator CUSTOM QUESTION LIST"]
["QID","Skip Logic Label","Question Text","Answer Choices \n(limited to 50 characters)","Type (select from list)","Single or Multi","Required\nY/N"]
[null,null,"How did you first learn about the Retirement Estimator?","Search engine","Radio Button One Up Vertical","Single","Y",{"$nulls":6},"Types"]
[null,null,null,"Linked from another website",{"$nulls":9},"Open-ended"]
[null,null,null,"From an SSA representative",{"$nulls":9},"Text Field – limited to 100 characters"]
[null,null,null,"SSA publication",{"$nulls":9},"Text Area – no character limit"]
[null,null,null,"From my Annual Social Security Statement",{"$nulls":9},"Dropdown (Select-one)"]
[null,null,null,"Newspaper, magazine or other media",{"$nulls":9},"Radio Button One Up Vertical"]
[null,null,null,"My employer or Human Resources department",{"$nulls":9},"Radio Button Two Up Vertical"]
[null,null,null,"My financial advisor",{"$nulls":9},"Radio Button Three Up Vertical"]
[null,null,null,"Word of mouth",{"$nulls":9},"Radio Button Scale Has Don’t Know"]
[null,null,null,"Other [ specify ]",{"$nulls":9},"Radio Button Scale No Don’t Know"]
[null,null,"From where are you accessing the Retirement Estimator?","Home","Radio Button One Up Vertical","Single","Y",{"$nulls":6},"Checkbox One Up Vertical"]
[null,null,null,"Work",{"$nulls":9},"Checkbox Two Up Vertical"]
[null,null,null,"Financial Planner's office",{"$nulls":9},"Checkbox Three Up Vertical"]
[null,null,null,"Friend or relative's home",{"$nulls":9},"Select-multiple Show Two"]
[null,null,null,"Other [specify]",{"$nulls":9},"Select-multiple Show Three"]
[null,null,"Which of the following best describes you?","Individual/self","Radio Button One Up Vertical","Single","Y",{"$nulls":6},"Select-multiple Show Four"]
[null,null,null,"Employer (e.g., Human Resources Department)"]
[null,null,null,"Financial Advisor"]
[null,null,null,"Service Agency or Organization (e.g., AARP, Council on Aging, government agency, non-profit organization, etc.)"]
[null,null,null,"Other [ specify"]
[null,null,"When do you expect to file for retirement benefits?","Within 12 months","Radio Button One Up Vertical","Single","Y"]
[null,null,null,"1 to 3 years "]
[null,null,null,"More than 3 but less than 6 years"]
[null,null,null,"More than 6 years"]
[null,null,null,"Not applicable"]
[null,null,"How do you plan to file for retirement benefits?","I prefer to file my retirement application online","Radio Button One Up Vertical","Single","Y"]
[null,null,null,"By telephone interview"]
[null,null,null,"Face-to-face in my local SSA field office"]
[null,null,null,"Online with telephone or in-person assistance, if needed"]
[null,null,null,"Not applicable"]
[null,null,"Did you accomplish your primary purpose in using the Retirement Estimator?","Yes","Radio Button One Up Vertical","Single","Y"]
[null,null,null,"No"]
[null,null,null,"Still Trying"]
[null,null,"If you did not accomplish your primary purpose in using the Retirement Estimator, please tell us why you were not able to do so.",null,"Text Area – no character limit",null,"N"]
[null,null,"What is your overall rating of SSA’s Retirement Estimator? ","scale 1-10","Radio Button Scale No Don’t Know",null,"Y"]
[null,null,"If there were one thing you could change about the SSA’s Retirement Estimator, what would it be?",null,"Text Area – no character limit",null,"N"]