| Survey: | 
		SSA Disability | 
		
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		| IA#: | 
		30688 Amend 4 | 
		
  | 
	
	
		| 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 |