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