initial commit, first ones completed to test
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								interviews/.g-1145_enotify.yml.swp
									
									
									
									
									
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								interviews/g1145_enotify.yml
									
									
									
									
									
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								interviews/g1145_enotify.yml
									
									
									
									
									
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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
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			||||||
 | 
					  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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								interviews/i90_replaceprmres.yml
									
									
									
									
									
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								interviews/i90_replaceprmres.yml
									
									
									
									
									
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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
 | 
				
			||||||
 | 
					    
 | 
				
			||||||
 | 
					    
 | 
				
			||||||
 | 
					    
 | 
				
			||||||
 | 
					    
 | 
				
			||||||
 | 
					
 | 
				
			||||||
		Reference in New Issue
	
	Block a user