Current active programs:
[ {
"id" : 344,
"adminName" : "state_of391",
"adminDescription" : "program-adminDescription-TO-BE-EDITED",
"externalLink" : "",
"displayMode" : "PUBLIC",
"notificationPreferences" : [ "EMAIL_PROGRAM_ADMIN_ALL_SUBMISSIONS" ],
"localizedName" : {
"translations" : {
"en_US" : "State of Alabama Food Assistance Application"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "This application is for the State of Alabama Food Assistance Program (SNAP). Please read the instructions carefully before proceeding."
},
"isRequired" : true
},
"localizedShortDescription" : {
"translations" : {
"en_US" : "This application is for the State of Alabama Food Assistance Program (SNAP). Please read the instructions carefully before proceeding."
},
"isRequired" : true
},
"localizedConfirmationMessage" : {
"translations" : {
"en_US" : "program-localizedConfirmationMessageTO-BE-EDITED"
},
"isRequired" : true
},
"blockDefinitions" : [ {
"id" : 1,
"name" : "Interview Preference",
"description" : "Check here if you prefer a telephone interview or a face-to-face interview. If you do, indicate your preference below.",
"localizedName" : {
"translations" : {
"en_US" : "Interview Preference"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Check here if you prefer a telephone interview or a face-to-face interview. If you do, indicate your preference below."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2174,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2175,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 2,
"name" : "Applicant Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Applicant Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2137,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2176,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2177,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2178,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2179,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2180,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2181,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2153,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 3,
"name" : "Expedited Services",
"description" : "You may get food assistance benefits within 7 calendar days if your food assistance household has less than $150 in monthly gross income and liquid resources (cash, checking or savings accounts) of $100 or less; or your rent/mortgage and utilities are more than your household's combined monthly income and liquid resources; or a member of your household is a migrant or seasonal farm worker. Failure to answer the questions on this application may result in our inability to determine your eligibility for expedited services.",
"localizedName" : {
"translations" : {
"en_US" : "Expedited Services"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "You may get food assistance benefits within 7 calendar days if your food assistance household has less than $150 in monthly gross income and liquid resources (cash, checking or savings accounts) of $100 or less; or your rent/mortgage and utilities are more than your household's combined monthly income and liquid resources; or a member of your household is a migrant or seasonal farm worker. Failure to answer the questions on this application may result in our inability to determine your eligibility for expedited services."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2182,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2183,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2184,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2185,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2186,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2187,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2188,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2189,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2190,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2191,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2192,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2193,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2194,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2195,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2196,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2197,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2198,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2199,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 4,
"name" : "Household Members",
"description" : "Household Members",
"localizedName" : {
"translations" : {
"en_US" : "Household Members"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "INSTRUCTIONS: Please print clearly. List everyone who lives in your household and answer all questions for each member you are asking to get food assistance. You only need SSN and citizenship/immigration for those seeking benefits. You will need to give income information for non-applicants to determine eligibility. Some items to bring to your interview: proof of identity (driver's license, birth certificate), proof of income (check stubs), and proof of expenses (rent receipts, medical bills). Failure to report expenses will result in no deduction."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2200,
"optional" : false,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 5,
"name" : "Household Members - Details",
"description" : "Fields for Household Members",
"localizedName" : {
"translations" : {
"en_US" : "Household Members - Details"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Details for repeated section."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : 4,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2201,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2202,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2203,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2204,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2205,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2206,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2207,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2208,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2209,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 6,
"name" : "Other People in Household (Not Seeking Benefits)",
"description" : "Other People in Household (Not Seeking Benefits)",
"localizedName" : {
"translations" : {
"en_US" : "Other People in Household (Not Seeking Benefits)"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "List below any other people who live in the same house with you but you do not want included in your food assistance household because they do not purchase and prepare food with you."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2210,
"optional" : false,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 7,
"name" : "Other People in Household (Not Seeking Benefits) - Details",
"description" : "Fields for Other People in Household (Not Seeking Benefits)",
"localizedName" : {
"translations" : {
"en_US" : "Other People in Household (Not Seeking Benefits) - Details"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Details for repeated section."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : 6,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2211,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2212,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2213,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2214,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2215,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 8,
"name" : "Authorized Representative",
"description" : "You may appoint someone outside your household to act for your household, to make an application and to be interviewed. This person should know your household's situation well enough to give any information needed to determine your eligibility for food assistance. You are still responsible for the information that anyone acting as your authorized representative gives, including any information that may be incorrect.",
"localizedName" : {
"translations" : {
"en_US" : "Authorized Representative"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "You may appoint someone outside your household to act for your household, to make an application and to be interviewed. This person should know your household's situation well enough to give any information needed to determine your eligibility for food assistance. You are still responsible for the information that anyone acting as your authorized representative gives, including any information that may be incorrect."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2216,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 9,
"name" : "Voter Registration Choice",
"description" : "IF YOU ARE NOT REGISTERED TO VOTE WHERE YOU LIVE NOW, WOULD YOU LIKE TO APPLY TO REGISTER TO VOTE HERE TODAY?",
"localizedName" : {
"translations" : {
"en_US" : "Voter Registration Choice"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "IF YOU ARE NOT REGISTERED TO VOTE WHERE YOU LIVE NOW, WOULD YOU LIKE TO APPLY TO REGISTER TO VOTE HERE TODAY?"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2217,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 10,
"name" : "Alabama SNAP Employment & Training Participant Consent",
"description" : "Please note this program may provide you some reimbursement for your participation.",
"localizedName" : {
"translations" : {
"en_US" : "Alabama SNAP Employment & Training Participant Consent"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Please note this program may provide you some reimbursement for your participation."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2218,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2219,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2220,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2221,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2222,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2223,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2224,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2225,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2226,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2227,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2228,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 11,
"name" : "State of Alabama Agency-Based Voter Registration",
"description" : "FOR USE BY U.S. CITIZENS ONLY. FILL IN ALL BOXES ON THIS FORM. PLEASE USE INK. PRINT LEGIBLY. To register, you must be a US citizen, live in Alabama, be 18 by election day, not have a disqualifying felony (or rights restored), and not be mentally incompetent. You may send a copy of valid photo ID. You will need valid photo ID to vote. More info: www.alabamavotes.gov or 800-274-8683. If you answer 'No' to the citizen or age questions, do not complete this application.",
"localizedName" : {
"translations" : {
"en_US" : "State of Alabama Agency-Based Voter Registration"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "FOR USE BY U.S. CITIZENS ONLY. FILL IN ALL BOXES ON THIS FORM. PLEASE USE INK. PRINT LEGIBLY. To register, you must be a US citizen, live in Alabama, be 18 by election day, not have a disqualifying felony (or rights restored), and not be mentally incompetent. You may send a copy of valid photo ID. You will need valid photo ID to vote. More info: www.alabamavotes.gov or 800-274-8683. If you answer 'No' to the citizen or age questions, do not complete this application."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2229,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2230,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2231,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2232,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2233,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2234,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2235,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2236,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2237,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2238,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2239,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2240,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2241,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2242,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2243,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2244,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2245,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2246,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2247,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 12,
"name" : "Penalty Warnings, Perjury Statement and Signature",
"description" : "When your household receives food assistance benefits, you must follow all rules. Provide true and complete information and documents if requested. Breaking rules on purpose can lead to being barred from SNAP for 1 year (1st offense), 2 years (2nd), permanently (3rd); fined up to $250,000, imprisoned up to 20 years, or both. Do not give false information, hide information, trade/sell EBT cards, or use benefits for ineligible items. Misuse can lead to permanent ineligibility for SNAP benefits.",
"localizedName" : {
"translations" : {
"en_US" : "Penalty Warnings, Perjury Statement and Signature"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "When your household receives food assistance benefits, you must follow all rules. Provide true and complete information and documents if requested. Breaking rules on purpose can lead to being barred from SNAP for 1 year (1st offense), 2 years (2nd), permanently (3rd); fined up to $250,000, imprisoned up to 20 years, or both. Do not give false information, hide information, trade/sell EBT cards, or use benefits for ineligible items. Misuse can lead to permanent ineligibility for SNAP benefits."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2248,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2249,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2250,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2251,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 13,
"name" : "Required Document Uploads",
"description" : "Please upload copies of necessary documents to support your application. Examples include: proof of identity (driver's license, birth certificate), proof of income (check stubs, award letter, child support statement, signed statement from person that gives you money), and proof of expenses (rent receipts, mortgage, property tax, house insurance premium, day care receipts, child support orders and receipts, and medical bills for disabled and aging members). We will tell you during your interview if we need additional documents.",
"localizedName" : {
"translations" : {
"en_US" : "Required Document Uploads"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Please upload copies of necessary documents to support your application. Examples include: proof of identity (driver's license, birth certificate), proof of income (check stubs, award letter, child support statement, signed statement from person that gives you money), and proof of expenses (rent receipts, mortgage, property tax, house insurance premium, day care receipts, child support orders and receipts, and medical bills for disabled and aging members). We will tell you during your interview if we need additional documents."
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2252,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
} ],
"programType" : "DEFAULT",
"eligibilityIsGating" : true,
"acls" : {
"tiProgramViewAcls" : [ ]
},
"localizedSummaryImageDescription" : {
"translations" : {
"en_US" : "Colorful plate"
},
"isRequired" : true
},
"categories" : [ ],
"applicationSteps" : [ {
"title" : {
"translations" : {
"en_US" : "Application"
},
"isRequired" : true
},
"description" : {
"translations" : {
"en_US" : "Apply using this digital application"
},
"isRequired" : true
}
}, {
"title" : {
"translations" : {
"en_US" : "Interview"
},
"isRequired" : true
},
"description" : {
"translations" : {
"en_US" : "You may choose your preferred interview method. If you require assistance due to disability, an interpreter, or translated materials, please contact your local Food Assistance Office for help. For individuals who are deaf, hard of hearing, or have speech disabilities, please call 1-833-822-2202 using the Alabama Relay Service at 711 or 1-800-548-2546 (TTY) to reach your local office."
},
"isRequired" : true
}
} ],
"bridgeDefinitions" : { }
}, {
"id" : 345,
"adminName" : "preschool",
"adminDescription" : "",
"externalLink" : "",
"displayMode" : "PUBLIC",
"notificationPreferences" : [ ],
"localizedName" : {
"translations" : {
"en_US" : "Preschool Discount Program"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Get free or reduced preschool tuition based on your income. Up to 70% off the costs if you are a working or student parent with an income that qualifies. "
},
"isRequired" : true
},
"localizedShortDescription" : {
"translations" : {
"en_US" : "Get free or reduced preschool tuition based on your income. "
},
"isRequired" : true
},
"localizedConfirmationMessage" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"blockDefinitions" : [ {
"id" : 1,
"name" : "Contact Information",
"description" : "Screen 1 description",
"localizedName" : {
"translations" : {
"en_US" : "Contact Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Screen 1 description"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2121,
"optional" : false,
"addressCorrectionEnabled" : false
}, {
"id" : 2122,
"optional" : false,
"addressCorrectionEnabled" : false
}, {
"id" : 2120,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 2,
"name" : "Income Information",
"description" : "Screen 2 description",
"localizedName" : {
"translations" : {
"en_US" : "Income Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Screen 2 description"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"eligibilityDefinition" : {
"predicate" : {
"rootNode" : {
"node" : {
"type" : "or",
"children" : [ {
"node" : {
"type" : "and",
"children" : [ {
"node" : {
"type" : "leaf",
"questionId" : 2124,
"scalar" : "CURRENCY_CENTS",
"operator" : "LESS_THAN_OR_EQUAL_TO",
"value" : {
"value" : "30000",
"type" : "LONG"
}
}
}, {
"node" : {
"type" : "leaf",
"questionId" : 2125,
"scalar" : "NUMBER",
"operator" : "EQUAL_TO",
"value" : {
"value" : "1",
"type" : "LONG"
}
}
} ]
}
}, {
"node" : {
"type" : "and",
"children" : [ {
"node" : {
"type" : "leaf",
"questionId" : 2125,
"scalar" : "NUMBER",
"operator" : "EQUAL_TO",
"value" : {
"value" : "2",
"type" : "LONG"
}
}
}, {
"node" : {
"type" : "leaf",
"questionId" : 2124,
"scalar" : "CURRENCY_CENTS",
"operator" : "LESS_THAN_OR_EQUAL_TO",
"value" : {
"value" : "40000",
"type" : "LONG"
}
}
} ]
}
} ]
}
},
"action" : "ELIGIBLE_BLOCK"
}
},
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2124,
"optional" : false,
"addressCorrectionEnabled" : false
}, {
"id" : 2125,
"optional" : false,
"addressCorrectionEnabled" : false
} ]
} ],
"programType" : "DEFAULT",
"eligibilityIsGating" : true,
"acls" : {
"tiProgramViewAcls" : [ ]
},
"localizedSummaryImageDescription" : {
"translations" : {
"en_US" : "Children playing with blocks"
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"en_US" : "Gather the required documents"
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},
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"en_US" : "You will need to provide the following documents to verify your identity and income: valid driver's license or state ID card, copy of your last paycheck(s), and your child's birth certificate. "
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}
}, {
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"translations" : {
"en_US" : "Confirm your eligibility"
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},
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"en_US" : "Please review the information provided about income eligibility before you start the application. This program only provides financial support for those who are within certain income brackets. "
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}
}, {
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"translations" : {
"en_US" : "Consider preschool which locations are acceptable to you and your family "
},
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},
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"translations" : {
"en_US" : "You will need to select individual preschools as part of this application. Please consider which areas you are able to access. "
},
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}
} ],
"bridgeDefinitions" : { }
}, {
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"adminName" : "elevator-permit",
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"en_US" : "Elevator Permit"
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},
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"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"localizedShortDescription" : {
"translations" : {
"en_US" : "A permit"
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},
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"en_US" : ""
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},
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"en_US" : "Screen 1"
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"en_US" : "Screen 1 description"
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}, {
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"translations" : {
"en_US" : "Applicant Info"
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"en_US" : "Applicant Info desc"
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} ],
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},
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"en_US" : "None at the moment"
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},
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"en_US" : "step 1"
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"en_US" : "step 1 desc"
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} ],
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}, {
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"en_US" : "test"
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},
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"en_US" : ""
},
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"en_US" : "test"
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},
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"en_US" : ""
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"en_US" : "Screen 1"
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"en_US" : "Screen 1 description"
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}, {
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"en_US" : "Screen 2"
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},
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"en_US" : "Screen 2 description"
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}, {
"id" : 2122,
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"addressCorrectionEnabled" : false
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} ],
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},
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"en_US" : "a"
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"en_US" : "a"
},
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}
} ],
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}, {
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"notificationPreferences" : [ "EMAIL_PROGRAM_ADMIN_ALL_SUBMISSIONS" ],
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"translations" : {
"en_US" : "Comprehensive Sample Program"
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},
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"translations" : {
"en_US" : "display description"
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},
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"en_US" : "short description"
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},
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"en_US" : ""
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},
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"en_US" : "Screen 1"
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},
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"en_US" : "one of each question type - part 1"
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"addressCorrectionEnabled" : false
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"optional" : false,
"addressCorrectionEnabled" : false
}, {
"id" : 2106,
"optional" : false,
"addressCorrectionEnabled" : false
}, {
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"optional" : false,
"addressCorrectionEnabled" : false
} ]
}, {
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"en_US" : "Screen 2"
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},
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"en_US" : "one of each question type - part 2"
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"isRequired" : true
},
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}, {
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"addressCorrectionEnabled" : false
}, {
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"addressCorrectionEnabled" : false
}, {
"id" : 2130,
"optional" : false,
"addressCorrectionEnabled" : false
}, {
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"optional" : false,
"addressCorrectionEnabled" : false
} ]
}, {
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"en_US" : "enumerator"
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},
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"en_US" : "this is for an enumerator"
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"optional" : false,
"addressCorrectionEnabled" : false
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}, {
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"en_US" : "repeated screen for enumerator"
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"en_US" : "this is a repeated screen for an enumerator"
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},
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}, {
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"en_US" : "Screen 3"
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},
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"en_US" : "Random information"
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"isRequired" : true
},
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"optional" : false,
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}, {
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"translations" : {
"en_US" : "Screen with Predicate"
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"isRequired" : true
},
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"translations" : {
"en_US" : "May be hidden"
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},
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"value" : "[\"2\", \"3\"]",
"type" : "LIST_OF_STRINGS"
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}
},
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}, {
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"en_US" : "file upload"
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"isRequired" : true
},
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"translations" : {
"en_US" : "this is for file upload"
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},
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"optional" : true,
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} ],
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"en_US" : "step 1 title"
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"en_US" : "step 1 description"
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}
} ],
"bridgeDefinitions" : { }
}, {
"id" : 330,
"adminName" : "fresh-bucks",
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"en_US" : "Community Health Worker Certification Application"
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"en_US" : "Application to become a certified CHW. It is valid for 2 years from the date of issuance. An Individual may apply for the reinstatement of an expired CHW certificate by submitting a complete CHW Renewal application up to two (2) years after the certificate expiration date."
},
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},
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"en_US" : "Application to become a certified CHW. It is valid for 2 years from the date of issuance. "
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},
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"en_US" : ""
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"isRequired" : true
},
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"en_US" : "Contact Information"
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},
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"en_US" : "Screen 1 description"
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}, {
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"en_US" : "Income Information"
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},
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"en_US" : "Screen 2 description"
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},
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}
}, {
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}
}, {
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}
}, {
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}
} ]
}
}, {
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}
}, {
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}
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}
} ]
}
},
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},
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}, {
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"en_US" : "Your Documentation"
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},
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"en_US" : "Screen 3 description"
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},
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}, {
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"en_US" : "Screen 4"
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},
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"en_US" : "Screen 4 description"
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} ],
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},
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"en_US" : "Woman shopping for fresh fruit "
},
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},
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"lastModifiedTime" : 1744929120.404000000,
"defaultName" : "Food"
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"en_US" : "Gather the required documents"
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"en_US" : "You will need to provide the following documents to verify your identity and income: valid driver's license or state ID card and copy of your last paycheck(s)"
},
"isRequired" : true
}
}, {
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"en_US" : "Confirm your eligibility"
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"en_US" : "Please review the information provided about income eligibility before you start the application. This program only provides financial support for those who are within certain income brackets. "
},
"isRequired" : true
}
}, {
"title" : {
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"en_US" : "Expect a phone call "
},
"isRequired" : true
},
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"translations" : {
"en_US" : "Look out for a call from the CHW program team. They will contact you to confirm information. "
},
"isRequired" : true
}
} ],
"bridgeDefinitions" : { }
}, {
"id" : 318,
"adminName" : "free-transit",
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"displayMode" : "PUBLIC",
"notificationPreferences" : [ "EMAIL_PROGRAM_ADMIN_ALL_SUBMISSIONS" ],
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"translations" : {
"en_US" : "Free Public Transit Program"
},
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},
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"translations" : {
"en_US" : "Residents who live in the TestCity zip code area with an income that qualifies are eligible to receive an unlimited-use card to take transit at no cost. The program will run through December 31, 2026. "
},
"isRequired" : true
},
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"en_US" : "Free transit for those with qualifying income. "
},
"isRequired" : true
},
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"en_US" : ""
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"isRequired" : true
},
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"en_US" : "Screen 1"
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},
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"en_US" : "Screen 1 description"
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} ],
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},
"localizedSummaryImageDescription" : {
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"en_US" : "public transit"
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},
"categories" : [ {
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"createTime" : 1744929120.465000000,
"lastModifiedTime" : 1744929120.465000000,
"defaultName" : "Transportation"
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"en_US" : "Gather the required documents"
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},
"description" : {
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"en_US" : "You will need to provide the following documents to verify your identity and income: valid driver's license or state ID card and copy of your last paycheck(s)"
},
"isRequired" : true
}
}, {
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"en_US" : "Confirm your eligibility"
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},
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"name" : "Display Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Display Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2132,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2133,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2134,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2135,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2136,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 2,
"name" : "Applicant Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Applicant Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2137,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2138,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2139,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2140,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2141,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 3,
"name" : "Display Site Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Display Site Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2142,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2143,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2144,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 4,
"name" : "Fireworks Company",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Fireworks Company"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2145,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2146,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 5,
"name" : "Shooter Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Shooter Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2147,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2148,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2149,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2150,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 6,
"name" : "Insurance Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Insurance Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2151,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2152,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2153,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 7,
"name" : "Inspection Authority",
"description" : "Important - To Be Completed By the Inspection Authority Having Jurisdiction Prior to Submitting Application: Display site must be inspected and approved by the Authority Having Jurisdiction (AHJ): (attach AHJ inspection report)",
"localizedName" : {
"translations" : {
"en_US" : "Inspection Authority"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "Important - To Be Completed By the Inspection Authority Having Jurisdiction Prior to Submitting Application: Display site must be inspected and approved by the Authority Having Jurisdiction (AHJ): (attach AHJ inspection report)"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2154,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2155,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2156,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2157,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2158,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2159,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2160,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 8,
"name" : "Fire Department Information",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Fire Department Information"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2161,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2162,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2163,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2164,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2165,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2166,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2167,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2168,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
}, {
"id" : 9,
"name" : "Attachments",
"description" : "",
"localizedName" : {
"translations" : {
"en_US" : "Attachments"
},
"isRequired" : true
},
"localizedDescription" : {
"translations" : {
"en_US" : "block-localizedDescription-TO-BE-EDITED"
},
"isRequired" : true
},
"localizedEligibilityMessage" : null,
"repeaterId" : null,
"hidePredicate" : null,
"optionalPredicate" : null,
"questionDefinitions" : [ {
"id" : 2169,
"optional" : true,
"addressCorrectionEnabled" : false
}, {
"id" : 2170,
"optional" : true,
"addressCorrectionEnabled" : false
} ]
} ],
"programType" : "DEFAULT",
"eligibilityIsGating" : true,
"acls" : {
"tiProgramViewAcls" : [ ]
},
"localizedSummaryImageDescription" : {
"translations" : {
"en_US" : "Fireworks"
},
"isRequired" : true
},
"categories" : [ ],
"applicationSteps" : [ {
"title" : {
"translations" : {
"en_US" : "program-applicationSteps TO-BE-EDITED"
},
"isRequired" : true
},
"description" : {
"translations" : {
"en_US" : "program-applicationSteps description TO-BE-EDITED"
},
"isRequired" : true
}
} ],
"bridgeDefinitions" : { }
} ]Current questions:
[ {
"config" : {
"name" : "migrant_seasonal_farm_worker",
"description" : "Is anyone in your household a migrant or seasonal farm worker?",
"questionText" : {
"translations" : {
"en_US" : "Is anyone in your household a migrant or seasonal farm worker?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate if anyone in your household is a migrant or seasonal farm worker."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2186,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "applicant_mailing_address",
"description" : "Mailing Address",
"questionText" : {
"translations" : {
"en_US" : "Mailing Address"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Enter your full mailing address including Street, City, County, State, and Zip Code."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2177,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_sex",
"description" : "Sex",
"questionText" : {
"translations" : {
"en_US" : "Sex"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select your sex."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2241,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "female",
"localizedOptionText" : {
"translations" : {
"en_US" : "Female"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "male",
"localizedOptionText" : {
"translations" : {
"en_US" : "Male"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "female", "male" ],
"options" : [ {
"id" : 1,
"adminName" : "female",
"localizedOptionText" : {
"translations" : {
"en_US" : "Female"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "male",
"localizedOptionText" : {
"translations" : {
"en_US" : "Male"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "ahj_signature",
"description" : "AHJ Signature",
"questionText" : {
"translations" : {
"en_US" : "AHJ Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2159,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "inspection_title",
"description" : "Title:",
"questionText" : {
"translations" : {
"en_US" : "Title:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2155,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Text Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "What is your favorite color?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2116,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_race",
"description" : "Race",
"questionText" : {
"translations" : {
"en_US" : "Race for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(Optional) *This information is voluntary. List all races that apply only if the person is asking for benefits. Your benefits will not be affected if you don't answer the ethnicity or race items (the agency will choose for you if you do not answer). Giving us this information will help ensure program benefits are distributed without regard to race, color, or national origin."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 5
},
"id" : 2208,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "white",
"localizedOptionText" : {
"translations" : {
"en_US" : "White"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "black_or_african_american",
"localizedOptionText" : {
"translations" : {
"en_US" : "Black or African American"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "asian",
"localizedOptionText" : {
"translations" : {
"en_US" : "Asian"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "native_hawaiian_or_other_pacific_islander",
"localizedOptionText" : {
"translations" : {
"en_US" : "Native Hawaiian or Other Pacific Islander"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
}, {
"id" : 5,
"adminName" : "alaska_native",
"localizedOptionText" : {
"translations" : {
"en_US" : "Alaska Native"
},
"isRequired" : true
},
"displayOrder" : 5,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "CHECKBOX",
"optionAdminNames" : [ "white", "black_or_african_american", "asian", "native_hawaiian_or_other_pacific_islander", "alaska_native" ],
"options" : [ {
"id" : 1,
"adminName" : "white",
"localizedOptionText" : {
"translations" : {
"en_US" : "White"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "black_or_african_american",
"localizedOptionText" : {
"translations" : {
"en_US" : "Black or African American"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "asian",
"localizedOptionText" : {
"translations" : {
"en_US" : "Asian"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "native_hawaiian_or_other_pacific_islander",
"localizedOptionText" : {
"translations" : {
"en_US" : "Native Hawaiian or Other Pacific Islander"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
}, {
"id" : 5,
"adminName" : "alaska_native",
"localizedOptionText" : {
"translations" : {
"en_US" : "Alaska Native"
},
"isRequired" : true
},
"displayOrder" : 5,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "display_time",
"description" : "Time of Display:",
"questionText" : {
"translations" : {
"en_US" : "Time of Display:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2133,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_dob",
"description" : "Date of Birth",
"questionText" : {
"translations" : {
"en_US" : "Date of Birth"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(mm/dd/yyyy)"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2235,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "signature_date",
"description" : "Date",
"questionText" : {
"translations" : {
"en_US" : "Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2153,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "peoplequestion",
"description" : "",
"questionText" : {
"translations" : {
"en_US" : "People in your house $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : { },
"isRequired" : false
},
"validationPredicates" : {
"type" : "enumerator",
"minEntities" : null,
"maxEntities" : null
},
"id" : 2131,
"enumeratorId" : 2108,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"entityType" : {
"translations" : {
"en_US" : "people"
},
"isRequired" : true
}
}, {
"config" : {
"name" : "Other People in Household (Not Seeking Benefits)",
"description" : "Other Household Member",
"questionText" : {
"translations" : {
"en_US" : "Other Household Member"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "enumerator",
"minEntities" : null,
"maxEntities" : null
},
"id" : 2210,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"entityType" : {
"translations" : {
"en_US" : "Other Household Member"
},
"isRequired" : true
}
}, {
"config" : {
"name" : "application_supporting_documents",
"description" : "Application Supporting Documents",
"questionText" : {
"translations" : {
"en_US" : "Application Supporting Documents"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Upload any documents required for your application, such as ID, income proof, or expense proof."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "fileupload",
"maxFiles" : 3
},
"id" : 2252,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_maiden_former_name",
"description" : "Print Maiden Name / Former Name (if reporting a change of name)",
"questionText" : {
"translations" : {
"en_US" : "Print Maiden Name / Former Name (if reporting a change of name)"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "First, Middle, Last, Suffix"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2233,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_name",
"description" : "Name",
"questionText" : {
"translations" : {
"en_US" : "Name"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2218,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_no_driver_id_or_ssn",
"description" : "I do not have an Alabama driver's license or Alabama non-driver ID or a social security number.",
"questionText" : {
"translations" : {
"en_US" : "I do not have an Alabama driver's license or Alabama non-driver ID or a social security number."
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Check this box if you do not have an Alabama driver's license, non-driver ID, or a social security number."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2234,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "i_do_not_have_an_alabama_driver_s_license_or_alabama_non_driver_id_or_a_social_security_number_",
"localizedOptionText" : {
"translations" : {
"en_US" : "I do not have an Alabama driver's license or Alabama non-driver ID or a social security number."
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "CHECKBOX",
"optionAdminNames" : [ "i_do_not_have_an_alabama_driver_s_license_or_alabama_non_driver_id_or_a_social_security_number_" ],
"options" : [ {
"id" : 1,
"adminName" : "i_do_not_have_an_alabama_driver_s_license_or_alabama_non_driver_id_or_a_social_security_number_",
"localizedOptionText" : {
"translations" : {
"en_US" : "I do not have an Alabama driver's license or Alabama non-driver ID or a social security number."
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "shooter_license_expiration",
"description" : "Expiration Date:",
"questionText" : {
"translations" : {
"en_US" : "Expiration Date:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2150,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_data_consent_statement",
"description" : "Consent to data collection and exchange",
"questionText" : {
"translations" : {
"en_US" : "Consent to data collection and exchange"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "I consent to DHR and its E&T partners collecting and exchanging confidential information and data about me to plan, provide, and coordinate services, payments, and benefits. This includes collecting participation and outcome data for State and Federal reporting. I grant permission to use and disclose my data for these purposes, shared verbally, by transfer, mail, or hand delivery. This consent is valid for 2 years beyond program participation. A copy of this form is valid."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2224,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_declaration_signature",
"description" : "Voter Declaration Signature",
"questionText" : {
"translations" : {
"en_US" : "Voter Declaration Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "I am a U.S. citizen, live in Alabama, and will be 18 by election day. I am not barred from voting by felony conviction or mental incompetence. I swear to support the constitutions. OPTIONAL: I decline to include the final four words of the oath. False signing can lead to conviction and imprisonment. Your decision to register will not affect services."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2246,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "shell_size",
"description" : "Size of Shells:",
"questionText" : {
"translations" : {
"en_US" : "Size of Shells:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2135,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "fraudulent_statement_member_name",
"description" : "Member's name",
"questionText" : {
"translations" : {
"en_US" : "Member's name"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If yes, member's name"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2194,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Household Members",
"description" : "Household Member",
"questionText" : {
"translations" : {
"en_US" : "Household Member"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "enumerator",
"minEntities" : null,
"maxEntities" : null
},
"id" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"entityType" : {
"translations" : {
"en_US" : "Household Member"
},
"isRequired" : true
}
}, {
"config" : {
"name" : "shooter_license_number",
"description" : "Shooter License #:",
"questionText" : {
"translations" : {
"en_US" : "Shooter License #:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2149,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "TestQue",
"description" : "",
"questionText" : {
"translations" : {
"en_US" : "Sample question to test"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "test question"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : 10,
"maxLength" : 20
},
"id" : 2173,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_signature",
"description" : "Household member signature or mark (X)",
"questionText" : {
"translations" : {
"en_US" : "Household member signature or mark (X)"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2248,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample File Upload Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "Upload the required documents listed"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Your driver's license and last month's paycheck "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "fileupload",
"maxFiles" : null
},
"id" : 2126,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "money_in_cash_bank",
"description" : "How much money do the members of your household have in cash or in a bank account?",
"questionText" : {
"translations" : {
"en_US" : "How much money do the members of your household have in cash or in a bank account?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2182,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "fire_department_contact",
"description" : "Contact Person:",
"questionText" : {
"translations" : {
"en_US" : "Contact Person:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2163,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Static Content Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "Hi I'm a block of static text.\n * Welcome to this __test program__.\n * It contains one of every question type.\n\n## What are the eligibility requirements?\nPlease go [here](https://www.example.com) for more information"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "static"
},
"id" : 2115,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household",
"description" : "",
"questionText" : {
"translations" : {
"en_US" : "How many people live in your household?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Please include all permanent residents in your household. "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "number",
"min" : null,
"max" : null
},
"id" : 2125,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "new_income_source_amount",
"description" : "If yes, how much?",
"questionText" : {
"translations" : {
"en_US" : "If yes, how much?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If yes, how much?"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2189,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample ID Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "What is your driver's license ID?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "id",
"minLength" : null,
"maxLength" : null
},
"id" : 2110,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_email",
"description" : "Email:",
"questionText" : {
"translations" : {
"en_US" : "Email:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "email"
},
"id" : 2139,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "expected_income_this_month",
"description" : "What is the total amount of income you expect your household to receive this month?",
"questionText" : {
"translations" : {
"en_US" : "What is the total amount of income you expect your household to receive this month?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2183,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "fire_department_date",
"description" : "Date",
"questionText" : {
"translations" : {
"en_US" : "Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2168,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_primary_telephone",
"description" : "Primary Telephone",
"questionText" : {
"translations" : {
"en_US" : "Primary Telephone"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2236,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Address Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "What is your address?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2101,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_witness_signature",
"description" : "Witness Signature",
"questionText" : {
"translations" : {
"en_US" : "Witness Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(if signed with an X)"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2227,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "shooter_name",
"description" : "Shooter Name:",
"questionText" : {
"translations" : {
"en_US" : "Shooter Name:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2147,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_shooter_signature",
"description" : "Applicant / Shooter's Signature",
"questionText" : {
"translations" : {
"en_US" : "Applicant / Shooter's Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2152,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "inspection_agency",
"description" : "Agency:",
"questionText" : {
"translations" : {
"en_US" : "Agency:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2156,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_signature_date",
"description" : "Date",
"questionText" : {
"translations" : {
"en_US" : "Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2249,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "shooter_emergency_contact",
"description" : "24/7 Emergency Contact Number:",
"questionText" : {
"translations" : {
"en_US" : "24/7 Emergency Contact Number:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2148,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "insurance_provider",
"description" : "Company Providing Insurance for Display:",
"questionText" : {
"translations" : {
"en_US" : "Company Providing Insurance for Display:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2151,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "complying_with_sentence",
"description" : "Is the convicted member complying with the terms of the sentence?",
"questionText" : {
"translations" : {
"en_US" : "Is the convicted member complying with the terms of the sentence?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If yes, is the convicted member complying with the terms of the sentence?"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2197,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "shell_number",
"description" : "Number of Shells:",
"questionText" : {
"translations" : {
"en_US" : "Number of Shells:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "number",
"min" : null,
"max" : null
},
"id" : 2136,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "other_person_age",
"description" : "Age",
"questionText" : {
"translations" : {
"en_US" : "Age for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "number",
"min" : null,
"max" : null
},
"id" : 2212,
"enumeratorId" : 2210,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "inspection_phone",
"description" : "Phone:",
"questionText" : {
"translations" : {
"en_US" : "Phone:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2157,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "fire_dept_required",
"description" : "Fire Department Required to be on Scene?",
"questionText" : {
"translations" : {
"en_US" : "Fire Department Required to be on Scene?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate whether the fire department is required on scene."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2161,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "authorized_representative_name",
"description" : "If you want to appoint someone for this, write his/her name here:",
"questionText" : {
"translations" : {
"en_US" : "If you want to appoint someone for this, write his/her name here:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2216,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "received_lottery_gambling_winnings",
"description" : "Have you or anyone in your household received lottery or gambling winnings of $4,500 or more this month?",
"questionText" : {
"translations" : {
"en_US" : "Have you or anyone in your household received lottery or gambling winnings of $4,500 or more this month?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate if you or anyone in your household received lottery or gambling winnings of $4,500 or more this month."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2199,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "Sample Phone Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "What is your phone number"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "We will use this as a secondary method to contact you. We will never send text messages. "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2120,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ "APPLICANT_PHONE" ]
}
}, {
"config" : {
"name" : "Sample Name Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "What is your name?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Please enter your name as it appears on legal documents. "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2121,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ "APPLICANT_NAME" ]
}
}, {
"config" : {
"name" : "fire_department_email",
"description" : "Email Address:",
"questionText" : {
"translations" : {
"en_US" : "Email Address:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "email"
},
"id" : 2166,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "firework_emergency_contact",
"description" : "24/7 Emergency Contact Number:",
"questionText" : {
"translations" : {
"en_US" : "24/7 Emergency Contact Number:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2146,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "fire_department_signature",
"description" : "Fire Department Officer Signature",
"questionText" : {
"translations" : {
"en_US" : "Fire Department Officer Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2167,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "convicted_felony_drug_conviction",
"description" : "Have you or any member of your household been convicted of a felony under Federal or State law for possession, use or distribution of a controlled substance (felony drug conviction) after August 22, 1996?",
"questionText" : {
"translations" : {
"en_US" : "Have you or any member of your household been convicted of a felony under Federal or State law for possession, use or distribution of a controlled substance (felony drug conviction) after August 22, 1996?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if you or a household member have a felony drug conviction after August 22, 1996."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2195,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "Sample Checkbox Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "Which of the following kitchen instruments do you own?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : null,
"maxChoicesAllowed" : null
},
"id" : 2102,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "toaster",
"localizedOptionText" : {
"translations" : {
"en_US" : "Toaster"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "pepper_grinder",
"localizedOptionText" : {
"translations" : {
"en_US" : "Pepper Grinder"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "garlic_press",
"localizedOptionText" : {
"translations" : {
"en_US" : "Garlic Press"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "CHECKBOX",
"optionAdminNames" : [ "toaster", "pepper_grinder", "garlic_press" ],
"options" : [ {
"id" : 1,
"adminName" : "toaster",
"localizedOptionText" : {
"translations" : {
"en_US" : "Toaster"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "pepper_grinder",
"localizedOptionText" : {
"translations" : {
"en_US" : "Pepper Grinder"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "garlic_press",
"localizedOptionText" : {
"translations" : {
"en_US" : "Garlic Press"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "fire_department_rank",
"description" : "Rank:",
"questionText" : {
"translations" : {
"en_US" : "Rank:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2164,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_signature",
"description" : "Signature",
"questionText" : {
"translations" : {
"en_US" : "Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2225,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_email_address",
"description" : "Email Address",
"questionText" : {
"translations" : {
"en_US" : "Email Address"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "email"
},
"id" : 2237,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_signature_date",
"description" : "Date",
"questionText" : {
"translations" : {
"en_US" : "Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2226,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_current_mailing_address",
"description" : "Current Address where you receive your mail",
"questionText" : {
"translations" : {
"en_US" : "Current Address where you receive your mail"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Mailing Address, if different from Home Address City, State, ZIP"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2239,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_dob",
"description" : "Birth date",
"questionText" : {
"translations" : {
"en_US" : "Birth date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(Month, Day, Year)"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2176,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "convicted_aggravated_sexual_abuse",
"description" : "Have you or any member of your household been convicted as an adult of aggravated sexual abuse, murder, sexual exploitation and other abuse of children, a Federal or State offense involving sexual assault, or an offense under State law determined by the Attorney General to be substantially similar to such an offense, after February 7, 2014?",
"questionText" : {
"translations" : {
"en_US" : "Have you or any member of your household been convicted as an adult of aggravated sexual abuse, murder, sexual exploitation and other abuse of children, a Federal or State offense involving sexual assault, or an offense under State law determined by the Attorney General to be substantially similar to such an offense, after February 7, 2014?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if you or a household member have a conviction for aggravated sexual abuse, murder, sexual exploitation, or similar offense after February 7, 2014."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2196,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "applicant_physical_address",
"description" : "Street Address, if different from Mailing Address",
"questionText" : {
"translations" : {
"en_US" : "Street Address, if different from Mailing Address"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Enter your physical street address if it is different from your mailing address, including Street, City, County, State, and Zip Code."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2178,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "income_stopped_recently",
"description" : "Did all of your household income stop recently?",
"questionText" : {
"translations" : {
"en_US" : "Did all of your household income stop recently?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if all household income stopped recently."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2187,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "rain_date",
"description" : "Rain Date:",
"questionText" : {
"translations" : {
"en_US" : "Rain Date:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2134,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "convicted_buying_selling_food_assistance",
"description" : "Have you or any member of your household been convicted of buying or selling food assistance benefits over $500?",
"questionText" : {
"translations" : {
"en_US" : "Have you or any member of your household been convicted of buying or selling food assistance benefits over $500?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if you or a household member have been convicted of buying or selling food assistance benefits over $500."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2198,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "household_member_in_school",
"description" : "In school",
"questionText" : {
"translations" : {
"en_US" : "In school for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate if this household member is currently in school."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2205,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "ahj_inspection_report_attachment",
"description" : "AHJ Inspection Report",
"questionText" : {
"translations" : {
"en_US" : "AHJ Inspection Report"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Attach the AHJ inspection report."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "fileupload",
"maxFiles" : 3
},
"id" : 2170,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Dropdown Question",
"description" : "select your favorite ice cream flavor",
"questionText" : {
"translations" : {
"en_US" : "Select your favorite ice cream flavor from the following"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "this is sample help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2106,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "chocolate",
"localizedOptionText" : {
"translations" : {
"en_US" : "Chocolate"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "strawberry",
"localizedOptionText" : {
"translations" : {
"en_US" : "Strawberry"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "vanilla",
"localizedOptionText" : {
"translations" : {
"en_US" : "Vanilla"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "coffee",
"localizedOptionText" : {
"translations" : {
"en_US" : "Coffee"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "DROPDOWN",
"optionAdminNames" : [ "chocolate", "strawberry", "vanilla", "coffee" ],
"options" : [ {
"id" : 1,
"adminName" : "chocolate",
"localizedOptionText" : {
"translations" : {
"en_US" : "Chocolate"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "strawberry",
"localizedOptionText" : {
"translations" : {
"en_US" : "Strawberry"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "vanilla",
"localizedOptionText" : {
"translations" : {
"en_US" : "Vanilla"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "coffee",
"localizedOptionText" : {
"translations" : {
"en_US" : "Coffee"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "voter_registration_options",
"description" : "Voter Registration Options",
"questionText" : {
"translations" : {
"en_US" : "Voter Registration Options"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If you do not check a box, you are considered to have decided not to register. Applying or declining to register will not affect your assistance. We can help you fill out the form privately. Information will remain confidential and used only for voter registration. Complaints can be filed with the Secretary of State at 600 Dexter Avenue Suite E-208, Montgomery, Al 36130 or by calling 334-242-7210 or 1-800-274-VOTE."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2217,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes_i_would_like_to_register_to_vote_",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes, I would like to register to vote."
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "yes_i_am_registered_but_would_like_to_change_my_address_for_voting_purposes_",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes, I am registered but would like to change my address for voting purposes."
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "no_i_do_not_want_to_apply_to_register_to_vote_",
"localizedOptionText" : {
"translations" : {
"en_US" : "No, I do not want to apply to register to vote."
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes_i_would_like_to_register_to_vote_", "yes_i_am_registered_but_would_like_to_change_my_address_for_voting_purposes_", "no_i_do_not_want_to_apply_to_register_to_vote_" ],
"options" : [ {
"id" : 1,
"adminName" : "yes_i_would_like_to_register_to_vote_",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes, I would like to register to vote."
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "yes_i_am_registered_but_would_like_to_change_my_address_for_voting_purposes_",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes, I am registered but would like to change my address for voting purposes."
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "no_i_do_not_want_to_apply_to_register_to_vote_",
"localizedOptionText" : {
"translations" : {
"en_US" : "No, I do not want to apply to register to vote."
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "received_food_assistance_last_month",
"description" : "Did anyone in your household receive food assistance last month?",
"questionText" : {
"translations" : {
"en_US" : "Did anyone in your household receive food assistance last month?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if anyone in your household received food assistance last month."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2192,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "insurance_certificate_attachment",
"description" : "Attach Insurance Certificate",
"questionText" : {
"translations" : {
"en_US" : "Attach Insurance Certificate"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Attach Insurance Certificate - Non Deductible Form, State of Maryland must be named as an additional insured, thirty day cancellation clause."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "fileupload",
"maxFiles" : 3
},
"id" : 2169,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Currency Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "How much should a scoop of ice cream cost?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2103,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "monthly_rent_mortgage",
"description" : "What is your current monthly rent/mortgage payment?",
"questionText" : {
"translations" : {
"en_US" : "What is your current monthly rent/mortgage payment?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2184,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "site_phone",
"description" : "Site Phone Number:",
"questionText" : {
"translations" : {
"en_US" : "Site Phone Number:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2143,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "interview_preference_face_to_face",
"description" : "Face-to-Face Interview",
"questionText" : {
"translations" : {
"en_US" : "Face-to-Face Interview"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Check if you prefer a face-to-face interview."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2175,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "CHECKBOX",
"optionAdminNames" : [ "yes" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "other_county_food_assistance_where",
"description" : "Where",
"questionText" : {
"translations" : {
"en_US" : "Where"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If yes, where?"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2191,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "display_address_all",
"description" : "Display Address:",
"questionText" : {
"translations" : {
"en_US" : "Display Address:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2144,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_declaration_date",
"description" : "Voter Declaration Date",
"questionText" : {
"translations" : {
"en_US" : "Voter Declaration Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(mm/dd/yyyy)"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2247,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Enumerated Date Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "When is $this's birthday?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text for $this's birthday"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2117,
"enumeratorId" : 2108,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_phone",
"description" : "Phone Number",
"questionText" : {
"translations" : {
"en_US" : "Phone Number"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2220,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_race",
"description" : "Race",
"questionText" : {
"translations" : {
"en_US" : "Race"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(Optional) Check all races that apply. This information is voluntary and will not affect your registration."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 6
},
"id" : 2243,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "white",
"localizedOptionText" : {
"translations" : {
"en_US" : "White"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "black",
"localizedOptionText" : {
"translations" : {
"en_US" : "Black"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "asian",
"localizedOptionText" : {
"translations" : {
"en_US" : "Asian"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "american_indian",
"localizedOptionText" : {
"translations" : {
"en_US" : "American Indian"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
}, {
"id" : 5,
"adminName" : "hispanic",
"localizedOptionText" : {
"translations" : {
"en_US" : "Hispanic"
},
"isRequired" : true
},
"displayOrder" : 5,
"displayInAnswerOptions" : null
}, {
"id" : 6,
"adminName" : "other",
"localizedOptionText" : {
"translations" : {
"en_US" : "Other"
},
"isRequired" : true
},
"displayOrder" : 6,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "CHECKBOX",
"optionAdminNames" : [ "white", "black", "asian", "american_indian", "hispanic", "other" ],
"options" : [ {
"id" : 1,
"adminName" : "white",
"localizedOptionText" : {
"translations" : {
"en_US" : "White"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "black",
"localizedOptionText" : {
"translations" : {
"en_US" : "Black"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "asian",
"localizedOptionText" : {
"translations" : {
"en_US" : "Asian"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "american_indian",
"localizedOptionText" : {
"translations" : {
"en_US" : "American Indian"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
}, {
"id" : 5,
"adminName" : "hispanic",
"localizedOptionText" : {
"translations" : {
"en_US" : "Hispanic"
},
"isRequired" : true
},
"displayOrder" : 5,
"displayInAnswerOptions" : null
}, {
"id" : 6,
"adminName" : "other",
"localizedOptionText" : {
"translations" : {
"en_US" : "Other"
},
"isRequired" : true
},
"displayOrder" : 6,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "food_assistance_case_number",
"description" : "Food Assistance Case Number",
"questionText" : {
"translations" : {
"en_US" : "Food Assistance Case Number"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2180,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "office_phone",
"description" : "",
"questionText" : {
"translations" : {
"en_US" : "Office Phone"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Don't use mobile"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2171,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_address",
"description" : "Address",
"questionText" : {
"translations" : {
"en_US" : "Address"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2219,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Radio Button Question",
"description" : "favorite season in the year",
"questionText" : {
"translations" : {
"en_US" : "What is your favorite season?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "this is sample help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2114,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "winter",
"localizedOptionText" : {
"translations" : {
"en_US" : "Winter (will hide next block)"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "spring",
"localizedOptionText" : {
"translations" : {
"en_US" : "Spring"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "summer",
"localizedOptionText" : {
"translations" : {
"en_US" : "Summer"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "fall",
"localizedOptionText" : {
"translations" : {
"en_US" : "Fall (will hide next block)"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "winter", "spring", "summer", "fall" ],
"options" : [ {
"id" : 1,
"adminName" : "winter",
"localizedOptionText" : {
"translations" : {
"en_US" : "Winter (will hide next block)"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "spring",
"localizedOptionText" : {
"translations" : {
"en_US" : "Spring"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
}, {
"id" : 3,
"adminName" : "summer",
"localizedOptionText" : {
"translations" : {
"en_US" : "Summer"
},
"isRequired" : true
},
"displayOrder" : 3,
"displayInAnswerOptions" : null
}, {
"id" : 4,
"adminName" : "fall",
"localizedOptionText" : {
"translations" : {
"en_US" : "Fall (will hide next block)"
},
"isRequired" : true
},
"displayOrder" : 4,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "income-month",
"description" : "",
"questionText" : {
"translations" : {
"en_US" : "What is your monthly income?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Please enter the your total income across all sources. If your income varies month to month, please share your income last month. "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2124,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_cellular",
"description" : "Cellular:",
"questionText" : {
"translations" : {
"en_US" : "Cellular:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2140,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_working",
"description" : "Working",
"questionText" : {
"translations" : {
"en_US" : "Working for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate if this household member is currently working."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2204,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "other_person_name",
"description" : "Name",
"questionText" : {
"translations" : {
"en_US" : "Name for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2211,
"enumeratorId" : 2210,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_address",
"description" : "Address:",
"questionText" : {
"translations" : {
"en_US" : "Address:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2138,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "receive_snap_benefits",
"description" : "Do you currently receive SNAP benefits?",
"questionText" : {
"translations" : {
"en_US" : "Do you currently receive SNAP benefits?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if you currently receive SNAP benefits. If yes, please provide your 9-digit case number."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2222,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "site_compliance_status",
"description" : "Site was found to be in compliance",
"questionText" : {
"translations" : {
"en_US" : "Site was found to be in compliance"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select whether the site complies with NFPA regulations"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2158,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "compliance",
"localizedOptionText" : {
"translations" : {
"en_US" : "compliance"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "noncompliance",
"localizedOptionText" : {
"translations" : {
"en_US" : "noncompliance"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "compliance", "noncompliance" ],
"options" : [ {
"id" : 1,
"adminName" : "compliance",
"localizedOptionText" : {
"translations" : {
"en_US" : "compliance"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "noncompliance",
"localizedOptionText" : {
"translations" : {
"en_US" : "noncompliance"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "voter_map_diagram",
"description" : "Map / Diagram of home location",
"questionText" : {
"translations" : {
"en_US" : "Map / Diagram of home location"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If your home has no street number or name, please draw a map of where your house is located. Please include roads and landmarks."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2244,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_witness_date",
"description" : "Witness Date",
"questionText" : {
"translations" : {
"en_US" : "Witness Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2228,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_applicant_name",
"description" : "Print Your Name",
"questionText" : {
"translations" : {
"en_US" : "Print Your Name"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "First, Middle, Last, Suffix"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2231,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_driver_id_number",
"description" : "Alabama Driver's License or Non-Driver ID Number",
"questionText" : {
"translations" : {
"en_US" : "Alabama Driver's License or Non-Driver ID Number"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "STATE, NUMBER"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2232,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "other_utilities",
"description" : "Utilities other than phone?",
"questionText" : {
"translations" : {
"en_US" : "Utilities other than phone?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "currency"
},
"id" : 2185,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "interview_preference_telephone",
"description" : "Telephone Interview",
"questionText" : {
"translations" : {
"en_US" : "Telephone Interview"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Check if you prefer a telephone interview."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2174,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "CHECKBOX",
"optionAdminNames" : [ "yes" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "received_food_assistance_other_county",
"description" : "Have you or anyone in your household received or do you expect to receive Food Assistance benefits from any other county in Alabama or any other state this month?",
"questionText" : {
"translations" : {
"en_US" : "Have you or anyone in your household received or do you expect to receive Food Assistance benefits from any other county in Alabama or any other state this month?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if you or anyone in your household received or expects food assistance from another county or state this month."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2190,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "other_person_gives_money",
"description" : "Does this person give you or anyone listed above any money?",
"questionText" : {
"translations" : {
"en_US" : "Does this person give you or anyone listed above any money? for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if this person provides money to anyone in your food assistance household. If yes, explain the reason."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2214,
"enumeratorId" : 2210,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "daytime_phone",
"description" : "Daytime Phone",
"questionText" : {
"translations" : {
"en_US" : "Daytime Phone"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2179,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_phone_other",
"description" : "Phone (Other):",
"questionText" : {
"translations" : {
"en_US" : "Phone (Other):"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2141,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "other_person_relation",
"description" : "Relation to you",
"questionText" : {
"translations" : {
"en_US" : "Relation to you for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2213,
"enumeratorId" : 2210,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "display_date",
"description" : "Date of Display:",
"questionText" : {
"translations" : {
"en_US" : "Date of Display:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2132,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "other_person_pays_bills",
"description" : "Does this person pay any part of the household bills?",
"questionText" : {
"translations" : {
"en_US" : "Does this person pay any part of the household bills? for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select Yes if this person pays any part of the household bills. If yes, explain the reason."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2215,
"enumeratorId" : 2210,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "inspection_date",
"description" : "Date",
"questionText" : {
"translations" : {
"en_US" : "Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2160,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_case_number",
"description" : "9 digit Case number",
"questionText" : {
"translations" : {
"en_US" : "9 digit Case number"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "number",
"min" : null,
"max" : null
},
"id" : 2223,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "fire_department_name",
"description" : "Fire Department Name:",
"questionText" : {
"translations" : {
"en_US" : "Fire Department Name:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2162,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Applicant Date of Birth",
"description" : "Applicant's date of birth",
"questionText" : {
"translations" : {
"en_US" : "Please enter your date of birth "
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Please use the format mm/dd/yyyy"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2123,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Enumerator Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "List all members of your household."
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "enumerator",
"minEntities" : null,
"maxEntities" : null
},
"id" : 2108,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"entityType" : {
"translations" : {
"en_US" : "household member"
},
"isRequired" : true
}
}, {
"config" : {
"name" : "Sample Predicate Date Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "When is your birthday?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2104,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_name",
"description" : "Name",
"questionText" : {
"translations" : {
"en_US" : "Name for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "First, Middle, Last"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2201,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_citizen_usa",
"description" : "Are you a citizen of the United States of America?",
"questionText" : {
"translations" : {
"en_US" : "Are you a citizen of the United States of America?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "You must be a U.S. citizen to register to vote. If No, do not complete this application."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2229,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "Sample Date Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "When is your birthday?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "help text"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2105,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ "APPLICANT_DOB" ]
}
}, {
"config" : {
"name" : "fire_department_phone",
"description" : "Phone:",
"questionText" : {
"translations" : {
"en_US" : "Phone:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "phone"
},
"id" : 2165,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_assistance_details",
"description" : "Did you receive assistance?",
"questionText" : {
"translations" : {
"en_US" : "Did you receive assistance?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "If you are unable to sign your name, who helped you fill out this application? Give name, address, and phone number (phone number is optional)."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2245,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_dob",
"description" : "Date of Birth",
"questionText" : {
"translations" : {
"en_US" : "Date of Birth for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Month Day Year"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2202,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_sex",
"description" : "Sex",
"questionText" : {
"translations" : {
"en_US" : "Sex for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Select M for Male or F for Female."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2206,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "m",
"localizedOptionText" : {
"translations" : {
"en_US" : "M"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "f",
"localizedOptionText" : {
"translations" : {
"en_US" : "F"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "m", "f" ],
"options" : [ {
"id" : 1,
"adminName" : "m",
"localizedOptionText" : {
"translations" : {
"en_US" : "M"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "f",
"localizedOptionText" : {
"translations" : {
"en_US" : "F"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "convicted_fraudulent_statement",
"description" : "Have you or anyone in your household been convicted by a state or federal court of making a fraudulent statement about your identity or residency in order to receive food assistance in more than one state at the same time?",
"questionText" : {
"translations" : {
"en_US" : "Have you or anyone in your household been convicted by a state or federal court of making a fraudulent statement about your identity or residency in order to receive food assistance in more than one state at the same time?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate if you or a household member have been convicted of making a fraudulent statement about identity or residency for food assistance."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2193,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "Sample Number Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "How many pets do you have?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Dogs and cats"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "number",
"min" : null,
"max" : null
},
"id" : 2130,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_current_home_address",
"description" : "Current Address where you live",
"questionText" : {
"translations" : {
"en_US" : "Current Address where you live"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(Do not use post office box) Home Address (include apartment or other unit number if applicable) City, State, ZIP"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2238,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "firework_company_name",
"description" : "Firework Co. Name:",
"questionText" : {
"translations" : {
"en_US" : "Firework Co. Name:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2145,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "applicant_signature",
"description" : "Signature",
"questionText" : {
"translations" : {
"en_US" : "Signature"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2181,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_place_of_birth",
"description" : "Place of Birth",
"questionText" : {
"translations" : {
"en_US" : "Place of Birth"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "City, County, State, Country"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2242,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "voter_age_r_by_election",
"description" : "Will you be 18 years of age on or before election day?",
"questionText" : {
"translations" : {
"en_US" : "Will you be 18 years of age on or before election day?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "You must be 18 years of age on or before election day to register to vote. If No, do not complete this application."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2230,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "Name",
"description" : "The applicant's name",
"questionText" : {
"translations" : {
"am" : "ስም (የመጀመሪያ ስም እና የመጨረሻ ስም አህጽሮት ይሆናል)",
"ko" : "성함 (이름 및 성의 경우 이니셜도 괜찮음)",
"lo" : "ຊື່ (ນາມສະກຸນ ແລະ ຕົວອັກສອນທຳອິດຂອງນາມສະກຸນແມ່ນຖືກຕ້ອງ)",
"so" : "Magaca (magaca koowaad iyo kan dambe okay)",
"tl" : "Pangalan (unang pangalan at ang unang titik ng apilyedo ay okay)",
"vi" : "Tên (tên và họ viết tắt đều được)",
"en_US" : "Please enter your first and last name",
"es_US" : "Nombre (nombre y la inicial del apellido está bien)",
"zh_TW" : "姓名（名字和姓氏第一個字母便可）"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : { },
"isRequired" : false
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2118,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "new_income_source_expected",
"description" : "Does anyone in your household expect to receive income from a new source this month?",
"questionText" : {
"translations" : {
"en_US" : "Does anyone in your household expect to receive income from a new source this month?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Indicate if anyone in your household expects new income this month."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2188,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "household_member_us_citizen",
"description" : "U.S. Citizen",
"questionText" : {
"translations" : {
"en_US" : "U.S. Citizen for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(Applicants Only) ***Providing citizenship/immigration information is voluntary. Failure to provide this information for each household member will result in disqualification of that member."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "multioption",
"minChoicesRequired" : 1,
"maxChoicesAllowed" : 1
},
"id" : 2209,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
},
"questionOptions" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ],
"multiOptionQuestionType" : "RADIO_BUTTON",
"optionAdminNames" : [ "yes", "no" ],
"options" : [ {
"id" : 1,
"adminName" : "yes",
"localizedOptionText" : {
"translations" : {
"en_US" : "Yes"
},
"isRequired" : true
},
"displayOrder" : 1,
"displayInAnswerOptions" : null
}, {
"id" : 2,
"adminName" : "no",
"localizedOptionText" : {
"translations" : {
"en_US" : "No"
},
"isRequired" : true
},
"displayOrder" : 2,
"displayInAnswerOptions" : null
} ]
}, {
"config" : {
"name" : "voter_old_address",
"description" : "Old Address where you were last registered to vote",
"questionText" : {
"translations" : {
"en_US" : "Old Address where you were last registered to vote"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "(Do not use post office box) Former Address City, County, State, ZIP"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "address",
"disallowPoBox" : false
},
"id" : 2240,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_relation",
"description" : "Relation to you",
"questionText" : {
"translations" : {
"en_US" : "Relation to you for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2203,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "account-number",
"description" : "",
"questionText" : {
"translations" : {
"en_US" : "Please enter your utilities account number"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "This it the number on the top right of your monthly utilities bill. "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2127,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "witness_signature_date",
"description" : "Date",
"questionText" : {
"translations" : {
"en_US" : "Date"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2251,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "Sample Email Question",
"description" : "description",
"questionText" : {
"translations" : {
"en_US" : "What is your email address?"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "We'll use this as the primary way to contact you with updates on your application. "
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "email"
},
"id" : 2122,
"displayMode" : "VISIBLE",
"universal" : true,
"primaryApplicantInfoTags" : [ "APPLICANT_EMAIL" ]
}
}, {
"config" : {
"name" : "applicant_name",
"description" : "Applicant Name:",
"questionText" : {
"translations" : {
"en_US" : "Applicant Name:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "name"
},
"id" : 2137,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "site_name",
"description" : "Display Site Name:",
"questionText" : {
"translations" : {
"en_US" : "Display Site Name:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2142,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "snap_consent_dob",
"description" : "Date of Birth",
"questionText" : {
"translations" : {
"en_US" : "Date of Birth"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "DOB"
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "date",
"minDate" : null,
"maxDate" : null
},
"id" : 2221,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "household_member_ethnicity",
"description" : "Ethnicity",
"questionText" : {
"translations" : {
"en_US" : "Ethnicity for $this"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : "Hispanic/Latino or Non-HISP NON (Optional) *This information is voluntary. List all races that apply only if the person is asking for benefits. Your benefits will not be affected if you don't answer the ethnicity or race items (the agency will choose for you if you do not answer). Giving us this information will help ensure program benefits are distributed without regard to race, color, or national origin."
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2207,
"enumeratorId" : 2200,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "witness_signature",
"description" : "Witness if signed by mark",
"questionText" : {
"translations" : {
"en_US" : "Witness if signed by mark"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2250,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
}, {
"config" : {
"name" : "inspection_performer",
"description" : "Inspection Performed By:",
"questionText" : {
"translations" : {
"en_US" : "Inspection Performed By:"
},
"isRequired" : true
},
"questionHelpText" : {
"translations" : {
"en_US" : ""
},
"isRequired" : true
},
"validationPredicates" : {
"type" : "text",
"minLength" : null,
"maxLength" : null
},
"id" : 2154,
"displayMode" : "VISIBLE",
"universal" : false,
"primaryApplicantInfoTags" : [ ]
}
} ]