1. What is your age? (Please tick)
Under 20 20-30 31-40 41-50 51-60 Over 60

2. What is your gender? (Please tick)
Male Female

3. What is your family status? (Please tick)
Married, living together Married, living apart Unmarried Divorced Widowed Living with a partner

4. How many children do you have? (Please tick)
0 1 2 3 more than 3

5. In which way are you currently employed? (Please tick)
Full-time Part-time employed In Full-time Education Military Service Community Service Not employed Unemployed Parental leave Housewife Welfare recipient Retired Early retirement Other

6. Which branches (in alphabetical order) were you working in or are you working in at the moment? (Please tick)
Advertising/Marketing/PR Lectureship/Professorship Agriculture/Chemicals Media/Publishing/Entertainment Automotive Medical/Health Services Construction Pharmaceuticals Consumer Goods Retail Computers/Electronics Services Energy/Mining Telecommunications/Networking Finance/Insurance/Real Estate Travel/Transportation Government/Military/Public Service Other Hospitality/Recreation

7. Have you ever visited your community’s website?
Yes No

8. Have you ever heard of the term „e-Government“?
Yes No

9. Have you ever heard of the term “Speech enablement”? (Speech enablement means the control of electronic devices and programs by natural voice.
Yes No

10. Please fill out the following table

Possible answers to Question QI: a) Personal visit to the authorit d) Internet (Download form, print it out and then send it by letter or fax to the appropriate authority) b) Phone Call to the authority e) Internet (Filling out form and submitting it online, no physical action needed) c) Paper form sent to you by mail, filled out manually, sent back by letter or fax f) Have you done this task by filling out a form?   QI QII QIII     Have you ever performed the following tasks? If yes, how? Would it be advantageous for you to be able to carry out these tasks at home? Would speech enablement help you to carry out this task? 1. Fiscal Authority                             1.1 Submit tax returns a b c d e f No Yes No Don't Know Yes No Don't Know 1.2 Apply for children’s allowance a b c d e f No Yes No Don't Know Yes No Don't Know 2. Social Welfare and Labour Office                             2.1 Apply for social insurance (card) a b c d e f No Yes No Don't Know Yes No Don't Know 2.2 Apply for unemployment benefit a b c d e f No Yes No Don't Know Yes No Don't Know 3. Public Press and Information Office                             3.1 Announce events a b c d e f No Yes No Don't Know Yes No Don't Know 3.2 Writing press articles a b c d e f No Yes No Don't Know Yes No Don't Know 4. Registry Office                             4.1 Notify change of address a b c d e f No Yes No Don't Know Yes No Don't Know 4.2 Apply for birth certificate a b c d e f No Yes No Don't Know Yes No Don't Know 5. Public Health Department                             5.1 Arrange appointment for physical examination a b c d e f No Yes No Don't Know Yes No Don't Know 5.2 Retrieve general health information a b c d e f No Yes No Don't Know Yes No Don't Know 6. Elections                             6.1 On federal / national / regional / communal level a b c d e f No Yes No Don't Know Yes No Don't Know 6.2 Sign petitions and initiatives a b c d e f No Yes No Don't Know Yes No Don't Know 7. Building Authority / Land Registry Office                             7.1 Retrieve building plans a b c d e f No Yes No Don't Know Yes No Don't Know 7.2 Apply for planning permission a b c d e f No Yes No Don't Know Yes No Don't Know 8. Office for Culture and Leisure                             8.1 Order ticket for events a b c d e f No Yes No Don't Know Yes No Don't Know 8.2 Retrieve information about leisure activities a b c d e f No Yes No Don't Know Yes No Don't Know 9. General Services                             9.1 Pay fines a b c d e f No Yes No Don't Know Yes No Don't Know 9.2 Register events a b c d e f No Yes No Don't Know Yes No Don't Know 10. Youth welfare office                             10.1 Obtain information about kindergartens a b c d e f No Yes No Don't Know Yes No Don't Know 10.2 Obtain information about protection of minors a b c d e f No Yes No Don't Know Yes No Don't Know 11. Environmental protection authority                             11.1 Obtain information about water protection a b c d e f No Yes No Don't Know Yes No Don't Know 11.2 Retrieve information about grants for environmentally sound technologies a b c d e f No Yes No Don't Know Yes No Don't Know 12. Traffic authority                             12.1 Apply for driving licence a b c d e f No Yes No Don't Know Yes No Don't Know 12.2 Register vehicle a b c d e f No Yes No Don't Know Yes No Don't Know 13. Education authority                             13.1 Apply for school / university / academy a b c d e f No Yes No Don't Know Yes No Don't Know 13.2 Retrieve entry requirements for school / university / academy a b c d e f No Yes No Don't Know Yes No Don't Know 14. Fire department                             14.1 Report fire a b c d e f No Yes No Don't Know Yes No Don't Know 14.2 Obtain information about fire prevention a b c d e f No Yes No Don't Know Yes No Don't Know 15. Police                             15.1 Report accident / crime a b c d e f No Yes No Don't Know Yes No Don't Know 15.2 Submit complaints a b c d e f No Yes No Don't Know Yes No Don't Know 16. E-Gov Department                             16.1 Apply for visa a b c d e f No Yes No Don't Know Yes No Don't Know 16.2 Apply for work permit a b c d e f No Yes No Don't Know Yes No Don't Know                                 12. Please tell us how in your opinion voice enabled e-Government services could help people who have personal restrictions or disabilities? (1 ’ “very helpful” 5 ’ “not helpful at all”) 1 2 3 4 5