initial commit, first ones completed to test
Daniel Martinez
commit
fb05918810
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---
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objects:
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||||||
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- user: Individual
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||||||
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---
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||||||
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question: What is your name?
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||||||
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fields:
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||||||
|
- First Name: user.name.first
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||||||
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- Middle Name: user.name.middle
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||||||
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- Last Name: user.name.last
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||||||
|
---
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||||||
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question: What is your contact info?
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||||||
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fields:
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||||||
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- Email: user.email
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||||||
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- Mobile Number: user.mobilephone
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||||||
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---
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mandatory: True
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code: |
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user.name.first
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user.name.last
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user.email
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user.mobilephone
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||||||
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---
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question: Here is your document.
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attachment:
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- name: g-1145
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filename: g-1145-${ user.name.last }-${ user.name.first }
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pdf template file: g-1145.pdf
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template password: ""
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valid formats: pdf
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||||||
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pdf/a: True
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editable: False
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language: en
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fields:
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- "form1[0].#subform[0].LastName[0]": ${ user.name.last }
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- "form1[0].#subform[0].FirstName[0]": ${ user.name.first }
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- "form1[0].#subform[0].MiddleName[0]": ${ user.name.middle }
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- "form1[0].#subform[0].Email[0]": ${ user.email }
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- "form1[0].#subform[0].MobilePhoneNumber[0]": ${ user.mobilephone }
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mandatory: True
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---
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@ -0,0 +1,688 @@
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---
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metadata:
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title: Application to Replace Permanent Resident Card
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short title: I-90
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revision_date: 2019-12-01
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sessions are unique: True
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---
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default screen parts:
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title: I-90 Application to Replace Permanent Resident Card
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---
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imports:
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- datetime
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objects:
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||||||
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- user: Individual
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||||||
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- interpreter: Individual
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- preparer: Individual
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---
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sections:
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- intro: Introductions
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- pt1: Part 1. Information About You
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- pt2: Part 2. Application Type
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- pt3: Part 3. Processing Information
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- pt4: Part 4. Accomodations for Individuals with Disabilities and/or Impairments
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- pt5: Part 5. Statement, Contact Info, Certification, Signature
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- final: Final Steps
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---
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||||||
|
features:
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||||||
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navigation: True
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||||||
|
progress bar: True
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||||||
|
---
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||||||
|
mandatory: True
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||||||
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code: |
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menu_items = [ action_menu_item('Roadmap', 'road_map') ]
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---
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initial: True
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code: |
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if returning_user(minutes=0.5):
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welcome_back
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---
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event: welcome_back
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question: |
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Welcome back!
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subquestion: |
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|
You are currently in the
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|
**${ nav.get_section(display=True) }**
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|
section.
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${ nav }
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Press "Continue" to pick up
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where you left off.
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buttons:
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|
Continue: continue
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|
---
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|
event: road_map
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question: |
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|
Roadmap
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subquestion: |
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|
You are currently in the
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**${ nav.get_section(display=True) }**
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|
section.
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${ nav }
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Press "Continue" to resume the
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interview.
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buttons:
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Continue: continue
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---
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question: |
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Welcome to the I-90 Application
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subquestion: |
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If you are not on a
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smartphone-sized device,
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|
you should see a navigation
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|
bar to the left.
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field: sees_nav_bar
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---
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interview help:
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heading: How to use this website
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content: Please create an account and contact a DasQ staff member.
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---
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default language: en
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---
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||||||
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question: What language would you prefer? ¿Cual idioma prefieres?
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field: user_language
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buttons:
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- English: en
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- Español: es
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|
---
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code: |
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if user_language == "es":
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set_language(es)
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---
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question: |
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I-90 Application to Replace Permanent Resident Card
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subquestion: |
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This interview will fill out a USCIS form I-90 with your provided information. Please be accurate with all information.
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pre: |
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Part 1. Information about you.
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help: |
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For more help, please contact us at 777-777-777, or email the site administrator, danny@keybored_co
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field: user_saw_intro
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section: pt1
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---
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question: |
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What is your Alien Registration Number?
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fields:
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- Alien Registration Number A-: user_aliennumber
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hint: A-
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---
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question: If you have a USCIS Online Account number, please provide below. Otherwise, press continue.
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fields:
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- USCIS Account Number: user_uscisaccount
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required: False
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|
---
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question: |
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What is your name?
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fields:
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- First Name: user_name_first
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- Last Name: user_name_last
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- Middle Name: user_name_middle
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required: False
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under: |
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NOTE: Your card will be issued in this name.
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---
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question: Has your name changed since the issuance of your Permanent Resident Card?
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field: name_change
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buttons:
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- "Yes": True
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- "No": False
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- "N/A - I never received my previous card": False
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---
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if: name_change == True
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question: Please provide your name exactly as it is printed on your current Permanent Resident Card.
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fields:
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- First Name: user_name_first1
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- Last Name: user_name_last1
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- Middle Name: user_name_middle1
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|
required: False
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||||||
|
---
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|
question: What is your mailing address?
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||||||
|
fields:
|
||||||
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- In Care of Name: user_addr_name
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|
- Street Number and Name: user_addr_street
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- Apt/Ste/Flr Number: user_addr_aptno
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required: False
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||||||
|
- Apt Type: user_addr_type
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datatype: radio
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|
hide if:
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variable: user_addr_aptno
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is: null
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choices:
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|
- Apartment: apt
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- Suite: suite
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- Floor: floor
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- City or Town: user_addr_city
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- State: user_addr_state
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- ZIP Code: user_addr_zip
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datatype: integer
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- Province: user_addr_province
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required: False
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- Postal Code: user_addr_postcode
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required: False
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- Country: user_addr_country
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|
---
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question: Is your physical address different than your mailing address?
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field: phys_addr
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|
buttons:
|
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- "Yes": True
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- "No": False
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||||||
|
---
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|
if: phys_addr == True
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|
question: What is your physical address?
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||||||
|
fields:
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- Street Number and Name: user_physaddr_street
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- Apt/Ste/Flr: user_physaddr_aptno
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required: False
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|
- AptType: user_physaddr_type
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datatype: radio
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||||||
|
hide if:
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|
variable: user_physaddr_aptno
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||||||
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is: null
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||||||
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choices:
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||||||
|
- Apartment: apt
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|
- Suite: suite
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|
- Floor: floor
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|
- City or Town: user_physaddr_city
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- State: user_physaddr_state
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- ZIP Code: user_physaddr_zip
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- Province: user_physaddr_province
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- Postal Code: user_physaddr_postcode
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- Country: user_physaddr_country
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|
---
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question: Please Answer the Following Regarding your Background
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fields:
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||||||
|
- What is your gender?: user_gender
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input type: radio
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|
choices:
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||||||
|
- Male: user_gender_male
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||||||
|
- Female: user_gender_female
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||||||
|
- What is your date of birth?: user_birth_date
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|
datatype: date
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||||||
|
- What is your town or city of birth?: user_birth_city
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||||||
|
- What is your country of birth?: user_birth_country
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||||||
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- What is your mother's first name?: user_mother_name
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||||||
|
- What is your father's first name?: user_father_name
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||||||
|
---
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||||||
|
question: Please answer the following details regarding your admission to the United States.
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||||||
|
fields:
|
||||||
|
- Class of Admission: user_admission_class
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||||||
|
- Date of Admission: user_admission_date
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||||||
|
datatype: date
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||||||
|
- U_S. Social Security Number: user_admission_ssn
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||||||
|
---
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||||||
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question: Part 2 Application Type
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||||||
|
subquestion: |
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||||||
|
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.)
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||||||
|
pre: |
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||||||
|
Part 2. Application Type
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||||||
|
field: user_readpt2
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||||||
|
section: pt2
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||||||
|
---
|
||||||
|
question: What is your current status?
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||||||
|
field: user_status
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||||||
|
buttons:
|
||||||
|
- Lawful Permanent Resident: permanent
|
||||||
|
- Permanent Resident - In Commuter Status: commuter
|
||||||
|
- Conditional Permanent Resident: conditional
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||||||
|
---
|
||||||
|
if: user_status != 'conditional'
|
||||||
|
question: What is the reason for your application?
|
||||||
|
field: user_reason
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||||||
|
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
|
||||||
|
|
||||||
|
|
||||||
|
|
||||||
|
|
||||||
|
|
||||||
Loading…
Reference in New Issue