@@ -7,7 +7,157 @@ module PdfFill
77 # Section II: Claimant Information
88 class Section2 < Section
99 # Section configuration hash
10- KEY = { } . freeze
10+ KEY = {
11+ 'claimantFullName' => { # start claimant information
12+ 'first' => {
13+ key : 'form1[0].#subform[82].ClaimantsFirstName[0]' ,
14+ limit : 12 ,
15+ question_num : 7 ,
16+ question_label : "Claimant's First Name" ,
17+ question_text : "CLAIMANT'S FIRST NAME"
18+ } ,
19+ 'middleInitial' => {
20+ key : 'form1[0].#subform[82].ClaimantsMiddleInitial1[0]'
21+ } ,
22+ 'last' => {
23+ key : 'form1[0].#subform[82].ClaimantsLastName[0]' ,
24+ limit : 18 ,
25+ question_num : 7 ,
26+ question_label : "Claimant's Last Name" ,
27+ question_text : "CLAIMANT'S LAST NAME"
28+ } ,
29+ 'suffix' => {
30+ key : 'form1[0].#subform[82].ClaimantSuffix[0]' ,
31+ question_num : 7 ,
32+ limit : 0 ,
33+ question_label : "Claimant's Suffix" ,
34+ question_text : "CLAIMANT'S SUFFIX"
35+ }
36+ } ,
37+ 'claimantSocialSecurityNumber' => {
38+ 'first' => {
39+ key : 'form1[0].#subform[82].Claimants_SocialSecurityNumber_FirstThreeNumbers[0]'
40+ } ,
41+ 'second' => {
42+ key : 'form1[0].#subform[82].Claimants_SocialSecurityNumber_SecondTwoNumbers[0]'
43+ } ,
44+ 'third' => {
45+ key : 'form1[0].#subform[82].Claimants_SocialSecurityNumber_LastFourNumbers[0]'
46+ }
47+ } ,
48+ 'claimantDateOfBirth' => {
49+ 'month' => {
50+ key : 'form1[0].#subform[82].Claimants_DOBmonth[0]' ,
51+ limit : 2 ,
52+ question_num : 9 ,
53+ question_suffix : 'A' ,
54+ question_label : "Veteran/Claimant's Identification Information > Claimant's Date Of Birth (Mm-Dd-Yyyy)" ,
55+ question_text : 'VETERAN/CLAIMANT\'S IDENTIFICATION INFORMATION > CLAIMANT\'S DATE OF BIRTH (MM-DD-YYYY)'
56+ } ,
57+ 'day' => {
58+ key : 'form1[0].#subform[82].Claimants_DOBday[0]' ,
59+ limit : 2 ,
60+ question_num : 9 ,
61+ question_suffix : 'B' ,
62+ question_label : "Veteran/Claimant's Identification Information > Claimant's Date Of Birth (Mm-Dd-Yyyy)" ,
63+ question_text : 'VETERAN/CLAIMANT\'S IDENTIFICATION INFORMATION > CLAIMANT\'S DATE OF BIRTH (MM-DD-YYYY)'
64+ } ,
65+ 'year' => {
66+ key : 'form1[0].#subform[82].Claimants_DOByear[0]' ,
67+ limit : 4 ,
68+ question_num : 9 ,
69+ question_suffix : 'C' ,
70+ question_label : "Veteran/Claimant's Identification Information > Claimant's Date Of Birth (Mm-Dd-Yyyy)" ,
71+ question_text : 'VETERAN/CLAIMANT\'S IDENTIFICATION INFORMATION > CLAIMANT\'S DATE OF BIRTH (MM-DD-YYYY)'
72+ }
73+ } ,
74+ 'claimantAddress' => {
75+ 'street' => {
76+ key : 'form1[0].#subform[82].CurrentMailingAddress_NumberAndStreet[0]' ,
77+ limit : 30 ,
78+ question_num : 10 ,
79+ question_label : "Claimant's Address - Street" ,
80+ question_text : "CLAIMANT'S ADDRESS - STREET"
81+ } ,
82+ 'street2' => {
83+ key : 'form1[0].#subform[82].CurrentMailingAddress_ApartmentOrUnitNumber[0]' ,
84+ limit : 5 ,
85+ question_num : 10 ,
86+ question_label : "Claimant's Address - Apt/Unit No." ,
87+ question_text : "CLAIMANT'S ADDRESS - APT/UNIT NO."
88+ } ,
89+ 'city' => {
90+ key : 'form1[0].#subform[82].CurrentMailingAddress_City[0]' ,
91+ limit : 18 ,
92+ question_num : 10 ,
93+ question_label : "Claimant's Address - City" ,
94+ question_text : "CLAIMANT'S ADDRESS - CITY"
95+ } ,
96+ 'state' => {
97+ key : 'form1[0].#subform[82].CurrentMailingAddress_StateOrProvince[0]'
98+ } ,
99+ 'country' => {
100+ key : 'form1[0].#subform[82].CurrentMailingAddress_Country[0]'
101+ } ,
102+ 'postalCode' => {
103+ 'firstFive' => {
104+ key : 'form1[0].#subform[82].CurrentMailingAddress_ZIPOrPostalCode_FirstFiveNumbers[0]'
105+ } ,
106+ 'lastFour' => {
107+ key : 'form1[0].#subform[82].CurrentMailingAddress_ZIPOrPostalCode_LastFourNumbers[0]' ,
108+ limit : 4 ,
109+ question : 10 ,
110+ question_label : "Claimant's Address - Postal Code - Last Four" ,
111+ question_text : "CLAIMANT's ADDRESS - POSTAL CODE - LAST FOUR"
112+ }
113+ }
114+ } ,
115+ 'claimantPhone' => {
116+ 'first' => {
117+ key : 'form1[0].#subform[82].TelephoneNumber_AreaCode[0]'
118+ } ,
119+ 'second' => {
120+ key : 'form1[0].#subform[82].TelephoneNumber_FirstThreeNumbers[0]'
121+ } ,
122+ 'third' => {
123+ key : 'form1[0].#subform[82].TelephoneNumber_LastFourNumbers[0]'
124+ }
125+ } ,
126+ 'claimantIntPhone' => {
127+ key : 'form1[0].#subform[82].IntTelephoneNumber[0]' ,
128+ question_num : 11 ,
129+ question_label : "Claimant's International Phone Number" ,
130+ question_text : "CLAIMANT'S INTERNATIONAL PHONE NUMBER" ,
131+ limit : 0 # this will force this value that is not on the pdf to appear in the overflow
132+ } ,
133+ 'claimantEmail' => {
134+ key : 'form1[0].#subform[82].E-Mail_Address[0]' ,
135+ limit : 31 ,
136+ question_num : 12 ,
137+ question_label : 'E-Mail Address' ,
138+ question_text : 'E-MAIL ADDRESS'
139+ } ,
140+ 'relationshipToVeteran' => {
141+ 'spouse' => {
142+ key : 'form1[0].#subform[82].CheckboxSpouse[0]'
143+ } ,
144+ 'child' => {
145+ key : 'form1[0].#subform[82].CheckboxChild[0]'
146+ } ,
147+ 'parent' => {
148+ key : 'form1[0].#subform[82].CheckboxParent[0]'
149+ } ,
150+ 'executor' => {
151+ key : 'form1[0].#subform[82].CheckboxExecutor[0]'
152+ } ,
153+ 'funeralDirector' => {
154+ key : 'form1[0].#subform[82].CheckboxFuneralHome[0]'
155+ } ,
156+ 'otherFamily' => {
157+ key : 'form1[0].#subform[82].CheckboxOther[0]'
158+ }
159+ }
160+ } . freeze
11161
12162 ##
13163 # Expands the form data for Section 2.
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