initial commit, first ones completed to test

master
Daniel Martinez 2020-03-04 02:09:39 -05:00
commit fb05918810
3 changed files with 729 additions and 0 deletions

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---
objects:
- user: Individual
---
question: What is your name?
fields:
- First Name: user.name.first
- Middle Name: user.name.middle
- Last Name: user.name.last
---
question: What is your contact info?
fields:
- Email: user.email
- Mobile Number: user.mobilephone
---
mandatory: True
code: |
user.name.first
user.name.last
user.email
user.mobilephone
---
question: Here is your document.
attachment:
- name: g-1145
filename: g-1145-${ user.name.last }-${ user.name.first }
pdf template file: g-1145.pdf
template password: ""
valid formats: pdf
pdf/a: True
editable: False
language: en
fields:
- "form1[0].#subform[0].LastName[0]": ${ user.name.last }
- "form1[0].#subform[0].FirstName[0]": ${ user.name.first }
- "form1[0].#subform[0].MiddleName[0]": ${ user.name.middle }
- "form1[0].#subform[0].Email[0]": ${ user.email }
- "form1[0].#subform[0].MobilePhoneNumber[0]": ${ user.mobilephone }
mandatory: True
---

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---
metadata:
title: Application to Replace Permanent Resident Card
short title: I-90
revision_date: 2019-12-01
sessions are unique: True
---
default screen parts:
title: I-90 Application to Replace Permanent Resident Card
---
imports:
- datetime
objects:
- user: Individual
- interpreter: Individual
- preparer: Individual
---
sections:
- intro: Introductions
- pt1: Part 1. Information About You
- pt2: Part 2. Application Type
- pt3: Part 3. Processing Information
- pt4: Part 4. Accomodations for Individuals with Disabilities and/or Impairments
- pt5: Part 5. Statement, Contact Info, Certification, Signature
- final: Final Steps
---
features:
navigation: True
progress bar: True
---
mandatory: True
code: |
menu_items = [ action_menu_item('Roadmap', 'road_map') ]
---
initial: True
code: |
if returning_user(minutes=0.5):
welcome_back
---
event: welcome_back
question: |
Welcome back!
subquestion: |
You are currently in the
**${ nav.get_section(display=True) }**
section.
${ nav }
Press "Continue" to pick up
where you left off.
buttons:
Continue: continue
---
event: road_map
question: |
Roadmap
subquestion: |
You are currently in the
**${ nav.get_section(display=True) }**
section.
${ nav }
Press "Continue" to resume the
interview.
buttons:
Continue: continue
---
question: |
Welcome to the I-90 Application
subquestion: |
If you are not on a
smartphone-sized device,
you should see a navigation
bar to the left.
field: sees_nav_bar
---
interview help:
heading: How to use this website
content: Please create an account and contact a DasQ staff member.
---
default language: en
---
question: What language would you prefer? ¿Cual idioma prefieres?
field: user_language
buttons:
- English: en
- Español: es
---
code: |
if user_language == "es":
set_language(es)
---
question: |
I-90 Application to Replace Permanent Resident Card
subquestion: |
This interview will fill out a USCIS form I-90 with your provided information. Please be accurate with all information.
pre: |
Part 1. Information about you.
help: |
For more help, please contact us at 777-777-777, or email the site administrator, danny@keybored_co
field: user_saw_intro
section: pt1
---
question: |
What is your Alien Registration Number?
fields:
- Alien Registration Number A-: user_aliennumber
hint: A-
---
question: If you have a USCIS Online Account number, please provide below. Otherwise, press continue.
fields:
- USCIS Account Number: user_uscisaccount
required: False
---
question: |
What is your name?
fields:
- First Name: user_name_first
- Last Name: user_name_last
- Middle Name: user_name_middle
required: False
under: |
NOTE: Your card will be issued in this name.
---
question: Has your name changed since the issuance of your Permanent Resident Card?
field: name_change
buttons:
- "Yes": True
- "No": False
- "N/A - I never received my previous card": False
---
if: name_change == True
question: Please provide your name exactly as it is printed on your current Permanent Resident Card.
fields:
- First Name: user_name_first1
- Last Name: user_name_last1
- Middle Name: user_name_middle1
required: False
---
question: What is your mailing address?
fields:
- In Care of Name: user_addr_name
- Street Number and Name: user_addr_street
- Apt/Ste/Flr Number: user_addr_aptno
required: False
- Apt Type: user_addr_type
datatype: radio
hide if:
variable: user_addr_aptno
is: null
choices:
- Apartment: apt
- Suite: suite
- Floor: floor
- City or Town: user_addr_city
- State: user_addr_state
- ZIP Code: user_addr_zip
datatype: integer
- Province: user_addr_province
required: False
- Postal Code: user_addr_postcode
required: False
- Country: user_addr_country
---
question: Is your physical address different than your mailing address?
field: phys_addr
buttons:
- "Yes": True
- "No": False
---
if: phys_addr == True
question: What is your physical address?
fields:
- Street Number and Name: user_physaddr_street
- Apt/Ste/Flr: user_physaddr_aptno
required: False
- AptType: user_physaddr_type
datatype: radio
hide if:
variable: user_physaddr_aptno
is: null
choices:
- Apartment: apt
- Suite: suite
- Floor: floor
- City or Town: user_physaddr_city
- State: user_physaddr_state
- ZIP Code: user_physaddr_zip
- Province: user_physaddr_province
- Postal Code: user_physaddr_postcode
- Country: user_physaddr_country
---
question: Please Answer the Following Regarding your Background
fields:
- What is your gender?: user_gender
input type: radio
choices:
- Male: user_gender_male
- Female: user_gender_female
- What is your date of birth?: user_birth_date
datatype: date
- What is your town or city of birth?: user_birth_city
- What is your country of birth?: user_birth_country
- What is your mother's first name?: user_mother_name
- What is your father's first name?: user_father_name
---
question: Please answer the following details regarding your admission to the United States.
fields:
- Class of Admission: user_admission_class
- Date of Admission: user_admission_date
datatype: date
- U_S. Social Security Number: user_admission_ssn
---
question: Part 2 Application Type
subquestion: |
NOTE: If your conditional permanent resident status (for example: CR1, CR2, CF1, CF2) is expiring within the next 90 days, then do not file this application. (See the What is the Purpose of This Application section of the Form I-90 Instructions for further information.)
pre: |
Part 2. Application Type
field: user_readpt2
section: pt2
---
question: What is your current status?
field: user_status
buttons:
- Lawful Permanent Resident: permanent
- Permanent Resident - In Commuter Status: commuter
- Conditional Permanent Resident: conditional
---
if: user_status != 'conditional'
question: What is the reason for your application?
field: user_reason
input type: radio
choices:
- My previous card has been lost, stolen, or destroyed: lost
- My previous card was issued but never received: notreceived
- My existing card has been mutilated: mutilated
- My existing card has incorrect data because of Department of Homeland Security (DHS) error.: incorrect
- My name or other biographic information has been legally changed since issuance of my existing card.: biochanged
- My existing card has already expired or will expire within six months.: expire
- I have reached my 14th birthday and am registering as required. My existing card will expire AFTER my 16th birthday.: fourteenbdayafter
- I have reached my 14th birthday and am registeringas required. My existing card will expire BEFORE my 16th birthday.: fourteenbdaybefore
- I am a permanent resident who is taking up commuter status: permtocommuter
- I am a commuter who is taking up actual residence in the United States.: commutertoresident
- I have been automatically converted to lawful permanent resident status.: autopermresident
- I have a prior edition of the Alien Registration Card, or I am applying to replace my current Permanent Resident Card for a reason that is not specified above.: priorother
---
if: user_reason == 'permtocommuter'
question: What will your port of entry into the United States be?
fields:
- City, State: user_status_poe
---
if: user_status == "conditional"
question: What is the reason for your application?
input type: radio
field: user_condreason
choices:
- My previous card has been lost, stolen, or destroyed.: lost
- My previous card was issued but never received.: notreceived
- My existing card has been mutilated.: mutilated
- My existing card has incorrect data because of DHS error.: incorrect
- My name or other biographic information has legally changed since the issuance of my existing card.: biochange
---
question: Please provide the following information
pre: |
Part 3. Processing Information
fields:
- "Where did you apply for an immigrant visa or adjustment of status?": user_processing_applocation
- "Where was your immigrant visa issued, or which USCIS office were you granted adjustment of status?": user_processing_issuelocation
- "Did you enter the United States with an immigrant Visa?": user_processing_visaentry
datatype: yesnoradio
- "What was your U.S. destination at the time of admission?" : user_processing_destination
show if:
variable: user_processing_visaentry
is: true
- "What was the port-of-entry where you were admitted to the United States? [City or Town and State]": user_processing_poecity
show if:
variable: user_processing_visaentry
is: true
- "Have you ever been in exclusion, deportation, or removal proceedings or ordered removed from the United States?": user_processing_deportation
datatype: yesnoradio
- "Since you were granted permanent residence, have you ever filed Form I-407, Abandonment by Alien of Status as Lawful Permanent Resident, or otherwise been determined to have abandoned your status?": user_processing_abandoned
datatype: yesnoradio
- "Please provide additional detailed information about your exclusion, deporation, or removal proceedings or removal order." : user_additional_deportorabandon
datatype: area
hide if:
variable: user_processing_deportation
is: false
- "Please provide additional detailed information about your abandonment status" : user_additional_deportorabandon
datatype: area
hide if:
variable: user_processing_abandoned
is: false
section: pt3
---
question: Please provide the following information.
pre: |
Biographic Information
fields:
- Ethnicity: user_ethnicity_hispanic
input type: radio
choices:
- Hispanic or Latino: True
- Not Hispanic or Latino: False
- Race: user_race
datatype: checkboxes
choices:
- Asian: asian
- Black: black
- Hawaiian / Pacific Islander: hawaiian
- Indian: indian
- White: white
- Other: other
- "Height (feet)": user_processing_heightft
datatype: integer
- "Height (inches)": user_processing_heightin
datatype: integer
- "Weight (pounds)": user_weight
datatype: integer
- Eye Color: user_eye
input type: radio
choices:
- Black: black
- Gray: gray
- Maroon: maroon
- Blue: blue
- Green: green
- Pink: pink
- Brown: brown
- Hazel: hazel
- Unknown or Other: other
- Hair Color: user_hair
input type: radio
choices:
- Bald - "No" hair: bald
- Brown: brown
- Sandy: sandy
- Black: black
- Gray: gray
- White: white
- Blond: blond
- Red: red
- Unknown or Other: other
---
question: Please provide the following information
pre: |
Part 4. Accommodations for Individuals with Disabilities and/or Impairments
fields:
- "Are you requesting an accomodation because of your disabilities and/or impairments?": user_disability
datatype: yesnoradio
- "I am deaf or hard of hearing": user_disability_deaf
datatype: yesnoradio
show if:
variable: user_disability
is: true
- "I am requesting the following accommodation (If you are requesting a sign-language interpreter, indicate for which language (for example, American Sign Language))": user_deaf_request
datatype: area
show if: user_disability_deaf
- "I am blind or have low vision.": user_disability_blind
datatype: yesnoradio
show if: user_disability
- "I am requesting the following accomodation.": user_blind_request
datatype: area
show if: user_disability_blind
- "I have another type of disability and/or impairment": user_disability_other
datatype: yesnoradio
show if: user_disability
- "Describe the nature of your disability and/or impairment and the accomodation you are requesting.": user_disability_request
datatype: area
show if: user_disability_other
section: pt4
---
question: |
Preparation Acknowledgement
subquestion: |
At my request, the preparer at Dominico American Society named Daniel Martinez prepared this application for me based only upon information I provided or authorized
pre: |
Part 5. Applicant Statement, Contact Information, Certification, Signature.
field: user_statement_preparerread
section: pt5
---
question: |
I can read and understand English, and I have read and understand every question and instruction on this application and my answer to every question.
pre: |
Part 5. Applicant Statement, Contact Information, Certification, Signature.
field: user_statement_readunderstand
---
question: |
Please provide your contact information if you would like to be notified of your application status.
fields:
- "Applicant's Daytime Telephone Number": user_phone_day
required: False
- "Applicant's Mobile Telephone Number": user_phone_mobile
required: False
- "Applicant's Email Address": user_email
required: False
---
question: Applicant Certification
subquestion: |
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS may require that I submit original documents to USCIS at a later date. Furthermore, I authorize the release of any information from any of my records that USCIS may need to determine my eligibility for the immigration benefit I seek.
I further authorize release of information contained in this application, in supporting documents, and in my USCIS records to other entities and persons where necessary for the administration and enforcement of U_S. immigration laws. I understand that USCIS will require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, I will be required to sign an oath reaffirming that:
1) I reviewed and provided or authorized all of theinformation in my application;
2) I understood all of the information contained in, and submitted with, my application; and
3) All of this information was complete, true, and correct at the time of filing.
I certify, under penalty of perjury, that I provided or authorized all of the information in my application, I understand all of the information contained in, and submitted with, my application, and that all of this information is complete, true, and correct.
field: agree_certification
---
question: |
Please sign your name below.
signature: user_signature
under: |
${ user_name_first + " " + user_name_middle + " " + user_name_last }
---
mandatory: True
code: |
sees_nav_bar
user_language
user_saw_intro
user_aliennumber
user_name_first
user_name_last
name_change
user_addr_street
user_addr_city
user_addr_state
user_addr_zip
user_addr_province
user_addr_postcode
user_addr_country
user_gender
user_birth_date
user_birth_country
user_mother_name
user_father_name
user_admission_class
user_admission_date
user_admission_ssn
user_readpt2
user_status
user_processing_applocation
user_weight
user_disability
user_statement_preparerread
user_email
agree_certification
user_signature
---
question: Here is your document. A copy has been emailed to Dominico-American Society Staff and an encrypted copy placed in our database. Have a great day.
attachment:
- name: I-90 Application to Replace Permanent Resident Card
filename: i-90-${ user_name_last }-${ user_name_first }
pdf template file: i-90.pdf
template password: ""
editable: False
language: en
variable name: complete_i_90
valid formats: pdf
pdf/a: True
fields:
- "form1[0].#subform[0].#area[1].P1_Line1_AlienNumber[0]": ${ user_aliennumber }
- "form1[0].#subform[0].P1_checkbox4[0]": ${ 'Yes' if name_change == True else 'No' }
- "form1[0].#subform[0].P1_checkbox4[1]": ${ 'Yes' if name_change == False else 'No' }
- "form1[0].#subform[0].P1_checkbox4[2]": ${ 'Yes' if name_change == False else 'No' }
- "form1[0].#subform[0].P1_checkbox6c_Unit[0]": ${ 'Yes' if user_addr_type == "apt" else 'No' }
- "form1[0].#subform[0].P1_checkbox6c_Unit[1]": ${ 'Yes' if user_addr_type == "suite" else 'No' }
- "form1[0].#subform[0].P1_checkbox6c_Unit[2]": ${ 'Yes' if user_addr_type == "floor" else 'No' }
- "form1[0].#subform[0].P1_Line2_AcctIdentifier[0]": ${ user_uscisaccount if user_uscisaccount != "" else '' }
- "form1[0].#subform[0].P1_Line3a_FamilyName[0]": ${ user_name_last }
- "form1[0].#subform[0].P1_Line3b_GivenName[0]": ${ user_name_first }
- "form1[0].#subform[0].P1_Line3c_MiddleName[0]": ${ user_name_middle }
- "form1[0].#subform[0].P1_Line5a_FamilyName[0]": ${ user_name_last1 if user_name_last1 != "" else '' }
- "form1[0].#subform[0].P1_Line5b_GivenName[0]": ${ user_name_first1 if user_name_first1 != "" else '' }
- "form1[0].#subform[0].P1_Line5c_MiddleName[0]": ${ user_name_middle1 if user_name_middle1 != "" else '' }
- "form1[0].#subform[0].P1_Line6a_InCareofName[0]": ${ user_addr_name }
- "form1[0].#subform[0].P1_Line6b_StreetNumberName[0]": ${ user_addr_street }
- "form1[0].#subform[0].P1_Line6c_AptSteFlrNumber[0]": ${ user_addr_aptno }
- "form1[0].#subform[0].P1_Line6d_CityOrTown[0]": ${ user_addr_city }
- "form1[0].#subform[0].P1_Line6e_State[0]": ${ user_addr_state }
- "form1[0].#subform[0].P1_Line6f_ZipCode[0]": ${ user_addr_zip }
- "form1[0].#subform[0].P1_Line6g_Province[0]": ${ user_addr_province }
- "form1[0].#subform[0].P1_Line6h_PostalCode[0]": ${ user_addr_postcode }
- "form1[0].#subform[0].P1_Line6i_Country[0]": ${ user_addr_country }
- "form1[0].#subform[0].P1_Line7a_StreetNumberName[0]": ${ user_physaddr_street if phys_addr else '' }
- "form1[0].#subform[0].P1_Line7b_AptSteFlrNumber[0]": ${ user_physaddr_aptno if phys_addr else '' }
- "form1[0].#subform[0].P1_Line7c_CityOrTown[0]": ${ user_physaddr_city if phys_addr else '' }
- "form1[0].#subform[0].P1_Line7d_State[0]": ${ user_physaddr_state if phys_addr else '' }
- "form1[0].#subform[0].P1_Line7e_ZipCode[0]": ${ user_physaddr_zip if phys_addr else '' }
- "form1[0].#subform[0].P1_Line7f_Province[0]": ${ user_physaddr_province if user_physaddr_province else '' }
- "form1[0].#subform[0].P1_Line7g_PostalCode[0]": ${ user_physaddr_postcode if user_physaddr_postcode else '' }
- "form1[0].#subform[0].P1_Line7h_Country[0]": ${ user_physaddr_country if user_physaddr_country != "" else '' }
- "form1[0].#subform[0].P1_checkbox7b_Unit[0]": ${ 'Yes' if user_physaddr_type == "apt" else 'No' }
- "form1[0].#subform[0].P1_checkbox7b_Unit[1]": ${ 'Yes' if user_physaddr_type == "suite" else 'No' }
- "form1[0].#subform[0].P1_checkbox7b_Unit[2]": ${ 'Yes' if user_physaddr_type == "floor" else 'No' }
- "form1[0].#subform[1].P1_Line10_CityTownOfBirth[0]": ${ user_birth_city }
- "form1[0].#subform[1].P1_Line11_CountryofBirth[0]": ${ user_birth_country }
- "form1[0].#subform[1].P1_Line12_MotherGivenName[0]": ${ user_mother_name }
- "form1[0].#subform[1].P1_Line13_FatherGivenName[0]": ${ user_father_name }
- "form1[0].#subform[1].P1_Line14_ClassOfAdmission[0]": ${ user_admission_class }
- "form1[0].#subform[1].P1_Line15_DateOfAdmission[0]": ${ user_admission_date }
- "form1[0].#subform[1].P1_Line16_SSN[0]": ${ user_admission_ssn }
- "form1[0].#subform[1].P1_Line8_female[0]": ${ 'Yes' if user_gender == "female" else 'No' }
- "form1[0].#subform[1].P1_Line8_male[0]": ${ 'Yes' if user_gender == "male" else 'No' }
- "form1[0].#subform[1].P1_Line9_DateOfBirth[0]": ${ user_birth_date }
- "form1[0].#subform[1].P2_checkbox1[0]": ${ 'Yes' if user_status == "permanent" else 'No' }
- "form1[0].#subform[1].P2_checkbox1[1]": ${ 'Yes' if user_status == "commuter" else 'No' }
- "form1[0].#subform[1].P2_checkbox1[2]": ${ 'Yes' if user_status == "conditional" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[0]": ${ 'Yes' if user_reason == "lost" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[10]": ${ 'Yes' if user_reason == "autopermresident" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[11]": ${ 'Yes' if user_reason == "priorother" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[1]": ${ 'Yes' if user_reason == "notreceived" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[2]": ${ 'Yes' if user_reason == "mutilated" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[3]": ${ 'Yes' if user_reason == "incorrect" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[4]": ${ 'Yes' if user_reason == "biochanged" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[5]": ${ 'Yes' if user_reason == "expire" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[6]": ${ 'Yes' if user_reason == "fourteenbdayafter" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[7]": ${ 'Yes' if user_reason == "fourteenbdaybefore" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[8]": ${ 'Yes' if user_reason == "permtocommuter" else 'No' }
- "form1[0].#subform[1].P2_checkbox2[9]": ${ 'Yes' if user_reason == "commutertoresident" else 'No' }
- "form1[0].#subform[1].P2_Line2h1_CityandState[0]": ${ user_status_poe if user_reason == "commutertoresident" else '' }
- "form1[0].#subform[2].P2_checkbox3[0]": ${ 'Yes' if user_condreason == "lost" else 'No' }
- "form1[0].#subform[2].P2_checkbox3[1]": ${ 'Yes' if user_condreason == "notreceived" else 'No' }
- "form1[0].#subform[2].P2_checkbox3[2]": ${ 'Yes' if user_condreason == "mutilated" else 'No' }
- "form1[0].#subform[2].P2_checkbox3[3]": ${ 'Yes' if user_condreason == "incorrect" else 'No' }
- "form1[0].#subform[2].P2_checkbox3[4]": ${ 'Yes' if user_condreason == "biochange" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[0]": ${ 'Yes' if user_eye == "black" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[1]": ${ 'Yes' if user_eye == "gray" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[2]": ${ 'Yes' if user_eye == "maroon" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[3]": ${ 'Yes' if user_eye == "blue" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[4]": ${ 'Yes' if user_eye == "green" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[5]": ${ 'Yes' if user_eye == "pink" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[6]": ${ 'Yes' if user_eye == "brown" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[7]": ${ 'Yes' if user_eye == "hazel" else 'No' }
- "form1[0].#subform[2].P3_checkbox10[8]": ${ 'Yes' if user_eye == "other" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[0]": ${ 'Yes' if user_hair == "bald" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[1]": ${ 'Yes' if user_hair == "brown" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[2]": ${ 'Yes' if user_hair == "sandy" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[3]": ${ 'Yes' if user_hair == "black" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[4]": ${ 'Yes' if user_hair == "gray" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[5]": ${ 'Yes' if user_hair == "white" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[6]": ${ 'Yes' if user_hair == "blond" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[7]": ${ 'Yes' if user_hair == "red" else 'No' }
- "form1[0].#subform[2].P3_checkbox11[8]": ${ 'Yes' if user_hair == "other" else 'No' }
- "form1[0].#subform[2].P3_checkbox4[0]": ${ 'Yes' if user_processing_deportation else 'No' }
- "form1[0].#subform[2].P3_checkbox4[1]": ${ 'Yes' if user_processing_deportation == False else 'No' }
- "form1[0].#subform[2].P3_checkbox5[0]": ${ 'Yes' if user_processing_abandoned else 'No' }
- "form1[0].#subform[2].P3_checkbox5[1]": ${ 'Yes' if user_processing_abandoned == False else 'No' }
- "form1[0].#subform[2].P3_checkbox6[0]": ${ 'Yes' if user_ethnicity_hispanic else 'No' }
- "form1[0].#subform[2].P3_checkbox6[1]": ${ 'Yes' if user_ethnicity_hispanic == False else 'No' }
- "form1[0].#subform[2].P3_checkbox7_Asian[0]": ${ 'Yes' if user_race['asian'] else 'No' }
- "form1[0].#subform[2].P3_checkbox7_Black[0]": ${ 'Yes' if user_race['black'] else 'No' }
- "form1[0].#subform[2].P3_checkbox7_Hawaiian[0]": ${ 'Yes' if user_race['hawaiian'] else 'No' }
- "form1[0].#subform[2].P3_checkbox7_Indian[0]": ${ 'Yes' if user_race['indian'] else 'No' }
- "form1[0].#subform[2].P3_checkbox7_White[0]": ${ 'Yes' if user_race['white'] else 'No' }
- "form1[0].#subform[2].P3_Line1_LocationAppliedVisa[0]": ${ user_processing_applocation }
- "form1[0].#subform[2].P3_Line2_LocationIssuedVisa[0]": ${ user_processing_issuelocation }
- "form1[0].#subform[2].P3_Line3a1_CityandState[0]": ${ user_processing_poecity }
- "form1[0].#subform[2].P3_Line3a_Destination[0]": ${ user_processing_destination }
- "form1[0].#subform[2].P3_Line8_HeightFeet[0]": ${ user_processing_heightft }
- "form1[0].#subform[2].P3_Line8_HeightInches[0]": ${ user_processing_heightin }
- "form1[0].#subform[2].P3_Line9_HeightInches1[0]": ${ weight1 }
- "form1[0].#subform[2].P3_Line9_HeightInches2[0]": ${ weight2 }
- "form1[0].#subform[2].P3_Line9_HeightInches3[0]": ${ weight3 }
- "form1[0].#subform[2].P4_checkbox1[0]": ${ 'Yes' if user_disability else 'No' }
- "form1[0].#subform[2].P4_checkbox1[1]": ${ 'Yes' if user_disability else 'No' }
- "form1[0].#subform[2].P4_checkbox1a[0]": ${ 'Yes' if user_disability_deaf else 'No' }
- "form1[0].#subform[2].P4_Line1a_AccomodationRequested[0]": ${ user_deaf_request }
- "form1[0].#subform[3].P4_checkbox1b[0]": ${ 'Yes' if user_disability_blind else 'No' }
- "form1[0].#subform[3].P4_checkbox1c[0]": ${ 'Yes' if user_disability_other else 'No' }
- "form1[0].#subform[3].P4_Line1b_AccomodationRequested[0]": ${ user_blind_request }
- "form1[0].#subform[3].P4_Line1c_AccomodationRequested[0]": ${ user_disability_request }
- "form1[0].#subform[3].P5_Checkbox1a[0]": ${ 'Yes' if user_statement_readunderstand else 'No' }
- "form1[0].#subform[3].P5_Checkbox1b[0]": ${ 'Yes' if user_language == "es" else 'No' }
- "form1[0].#subform[3].P5_Checkbox2[0]": "Yes"
- "form1[0].#subform[3].P5_Line1b_Language[0]": ${ 'Spanish' if user_language == "es" else '' }
- "form1[0].#subform[3].P5_Line2_NameofRepresentative[0]": Daniel Martinez
- "form1[0].#subform[3].P5_Line3_DaytimePhoneNumber[0]": ${ user_phone_day }
- "form1[0].#subform[3].P5_Line4_MobilePhoneNumber[0]": ${ user_phone_mobile }
- "form1[0].#subform[3].P5_Line5_EmailAddress[0]": ${ user_email }
- "form1[0].#subform[3].P5_Line6a_SignatureofApplicant[0]": ${ user_signature }
- "form1[0].#subform[3].P5_Line6b_DateofSignature[0]": ${ today() }
- "form1[0].#subform[4].P6_checkbox3b_Unit[0]": "No"
- "form1[0].#subform[4].P6_checkbox3b_Unit[1]": "No"
- "form1[0].#subform[4].P6_checkbox3b_Unit[2]": "Yes"
- "form1[0].#subform[4].P6_Line1a_InterpretersFamilyName[0]": "Martinez"
- "form1[0].#subform[4].P6_Line1b_InterpretersGivenName[0]": "Daniel"
- "form1[0].#subform[4].P6_Line2_NameofBusinessor[0]": "Dominico-American Society of Queens"
- "form1[0].#subform[4].P6_Line3a_StreetNumberName[0]": "40-27 97th St"
- "form1[0].#subform[4].P6_Line3b_AptSteFlrNumber[0]": 1
- "form1[0].#subform[4].P6_Line3c_CityTown[0]": "Corona"
- "form1[0].#subform[4].P6_Line3d_State[0]": "NY"
- "form1[0].#subform[4].P6_Line3e_ZipCode[0]": "11368"
- "form1[0].#subform[4].P6_Line3h_Country[0]": "USA"
- "form1[0].#subform[4].P6_Line4_InterpretersDaytimePhoneNumber[0]": "718-457-5395"
- "form1[0].#subform[4].P6_Line5_InterpretersEmailAddress[0]": "danny@keybored.co"
- "form1[0].#subform[4].P6_Line6b_DateofSignature[0]": ${ today() }
- "form1[0].#subform[4].P7_checkbox3b_Unit[0]": "No"
- "form1[0].#subform[4].P7_checkbox3b_Unit[1]": "No"
- "form1[0].#subform[4].P7_checkbox3b_Unit[2]": "Yes"
- "form1[0].#subform[4].P7_Line1a_FamilyName[0]": "Martinez"
- "form1[0].#subform[4].P7_Line1b_PreparersGivenName[0]": "Daniel"
- "form1[0].#subform[4].P7_Line2_NameofBusinessor[0]": "Dominico-American Society of Queens"
- "form1[0].#subform[4].P7_Line3a_StreetNumberName[0]": "40-27 97th St"
- "form1[0].#subform[4].P7_Line3b_AptSteFlrNumber[0]": 1
- "form1[0].#subform[4].P7_Line3c_CityTown[0]": "Corona"
- "form1[0].#subform[4].P7_Line3d_State[0]": "NY"
- "form1[0].#subform[4].P7_Line3e_ZipCode[0]": "11368"
- "form1[0].#subform[4].P7_Line3h_Country[0]": "USA"
- "form1[0].#subform[4].P7_Line4_PreparersDaytimePhoneNumber[0]": "718-457-5395"
- "form1[0].#subform[4].P7_Line6_PreparersEmailAddress[0]": "danny@keybored.co"
- "form1[0].#subform[5].P7_checkbox7[0]": "Yes"
- "form1[0].#subform[5].P7_checkbox7[1]": "No"
- "form1[0].#subform[5].P7_checkbox7Extend[0]": "No"
- "form1[0].#subform[5].P7_checkbox7Extend[1]": "No"
- "form1[0].#subform[5].P7_Line8b_DateofSignature[0]": ${ today() }
- name: g-1145
filename: g-1145-${ user_name_last }-${ user_name_first }
pdf template file: g-1145.pdf
template password: ""
valid formats: pdf
pdf/a: True
editable: False
language: en
fields:
- "form1[0].#subform[0].LastName[0]": ${ user_name_last }
- "form1[0].#subform[0].FirstName[0]": ${ user_name_first }
- "form1[0].#subform[0].MiddleName[0]": ${ user_name_middle }
- "form1[0].#subform[0].Email[0]": ${ user_email }
- "form1[0].#subform[0].MobilePhoneNumber[0]": ${ user_phone_mobile }
field: last_screen
mandatory: True
---
code: |
phys_data = [ "user_physaddr_street", "user_physaddr_aptno", "user_physaddr_city", "user_physaddr_state", "user_physaddr_zip", "user_physaddr_province", "user_physaddr_postcode", "user_physaddr_country", "user_physaddr_type" ]
if phys_addr == False:
for datum in phys_data:
datum = ""
mandatory: True
---
code: |
if user_reason != "permtocommuter":
user_status_poe = ""
mandatory: True
---
code: |
if user_status != "conditional":
user_condreason = ""
mandatory: True
---
code: |
if user_processing_visaentry == False:
user_processing_poecity = ""
user_processing_destination = ""
mandatory: True
---
code: |
user_weight1 = str(user_weight)
weight = list(user_weight1)
if len(weight) == 3:
weight1 = weight[0]
weight2 = weight[1]
weight3 = weight[2]
if len(weight) == 2:
weight1 = 0
weight2 = weight[0]
weight3 = weight[1]
mandatory: True
---
code: |
if user_disability == False:
user_disability_deaf = False
user_deaf_request = ""
user_disability_blind = False
user_blind_request = ""
user_disability_other = False
user_disability_request = ""
mandatory: True