{
'personalIdentification' => {
'ssn' => {
key: 'vaco5655[0].#subform[0].Field1[0]',
limit: 9,
question_num: 1
},
'fileNumber' => {
key: 'vaco5655[0].#subform[0].Field2[0]',
question_num: 2
},
'fsrReason' => {
key: 'vaco5655[0].#subform[0].Field3[0]',
question_num: 3
}
},
'personalData' => {
'veteranFullName' => {
key: 'vaco5655[0].#subform[0].Field4[0]',
question_num: 4
},
'address' => {
key: 'vaco5655[0].#subform[0].Field5[0]',
question_num: 5
},
'telephoneNumber' => {
key: 'vaco5655[0].#subform[0].Field6[0]',
question_num: 6
},
'dateOfBirth' => {
key: 'vaco5655[0].#subform[0].Field7[0]',
question_num: 7
},
'married' => {
key: 'vaco5655[0].#subform[0].RadioButtonList[0]',
question_num: 8
},
'spouseFullName' => {
key: 'vaco5655[0].#subform[0].Field10[0]',
question_num: 9
},
'agesOfOtherDependents' => {
key: 'vaco5655[0].#subform[0].Field11[0]',
question_num: 10
},
'veteranCurrentEmployment' => {
'kindOfJob' => {
key: 'vaco5655[0].#subform[0].Field12[0]'
},
'fromDate' => {
key: 'vaco5655[0].#subform[0].Field13[0]'
},
'employerName' => {
key: 'vaco5655[0].#subform[0].Field14[0]'
}
},
'veteranPastEmployment' => {
'kindOfJob' => {
key: 'vaco5655[0].#subform[0].Field15[0]'
},
'fromDate' => {
key: 'vaco5655[0].#subform[0].Field16[0]'
},
'toDate' => {
key: 'vaco5655[0].#subform[0].Field17[0]'
},
'employerName' => {
key: 'vaco5655[0].#subform[0].Field18[0]'
}
},
'spouseCurrentEmployment' => {
'kindOfJob' => {
key: 'vaco5655[0].#subform[0].Field19[0]'
},
'fromDate' => {
key: 'vaco5655[0].#subform[0].Field20[0]'
},
'employerName' => {
key: 'vaco5655[0].#subform[0].Field21[0]'
}
},
'spousePastEmployment' => {
'kindOfJob' => {
key: 'vaco5655[0].#subform[0].Field22[0]'
},
'fromDate' => {
key: 'vaco5655[0].#subform[0].Field23[0]'
},
'toDate' => {
key: 'vaco5655[0].#subform[0].Field24[0]'
},
'employerName' => {
key: 'vaco5655[0].#subform[0].Field25[0]'
}
}
},
'veteranIncome' => {
'monthlyGrossSalary' => {
key: 'vaco5655[0].#subform[0].Field26[0]',
question_num: 13
},
'deductions' => {
'taxes' => {
key: 'vaco5655[0].#subform[0].Field28[0]',
question_num: 14,
question_suffix: 'A'
},
'retirement' => {
key: 'vaco5655[0].#subform[0].Field30[0]',
question_num: 14,
question_suffix: 'B'
},
'socialSecurity' => {
key: 'vaco5655[0].#subform[0].Field32[0]',
question_num: 14,
question_suffix: 'C'
},
'otherDeductions' => {
'name' => {
key: 'vaco5655[0].#subform[0].Field34[0]'
},
'amount' => {
key: 'vaco5655[0].#subform[0].Field35[0]',
question_num: 14,
question_suffix: 'D'
}
}
},
'totalDeductions' => {
key: 'vaco5655[0].#subform[0].Field37[0]',
question_num: 14,
question_suffix: 'E'
},
'netTakeHomePay' => {
key: 'vaco5655[0].#subform[0].Field39[0]',
question_num: 15
},
'otherIncome' => {
'name' => {
key: 'vaco5655[0].#subform[0].Field41[0]'
},
'amount' => {
key: 'vaco5655[0].#subform[0].Field42[0]',
question_num: 16
}
},
'totalMonthlyNetIncome' => {
key: 'vaco5655[0].#subform[0].Field44[0]',
question_num: 17
}
},
'spouseIncome' => {
'monthlyGrossSalary' => {
key: 'vaco5655[0].#subform[0].Field27[0]',
question_num: 13
},
'deductions' => {
'taxes' => {
key: 'vaco5655[0].#subform[0].Field29[0]',
question_num: 14,
question_suffix: 'A'
},
'retirement' => {
key: 'vaco5655[0].#subform[0].Field31[0]',
question_num: 14,
question_suffix: 'B'
},
'socialSecurity' => {
key: 'vaco5655[0].#subform[0].Field33[0]',
question_num: 14,
question_suffix: 'C'
},
'otherDeductions' => {
'amount' => {
key: 'vaco5655[0].#subform[0].Field36[0]',
question_num: 14,
question_suffix: 'D'
}
}
},
'totalDeductions' => {
key: 'vaco5655[0].#subform[0].Field38[0]',
question_num: 14,
question_suffix: 'E'
},
'netTakeHomePay' => {
key: 'vaco5655[0].#subform[0].Field40[0]',
question_num: 15
},
'otherIncome' => {
'amount' => {
key: 'vaco5655[0].#subform[0].Field43[0]',
question_num: 16
}
},
'totalMonthlyNetIncome' => {
key: 'vaco5655[0].#subform[0].Field45[0]',
question_num: 17
}
},
'expenses' => {
'rentOrMortgage' => {
key: 'vaco5655[0].#subform[0].Field46[0]',
question_num: 18
},
'food' => {
key: 'vaco5655[0].#subform[0].Field47[0]',
question_num: 19
},
'utilities' => {
key: 'vaco5655[0].#subform[0].Field48[0]',
question_num: 20
},
'otherLivingExpenses' => {
'name' => {
key: 'vaco5655[0].#subform[0].Field35[1]'
},
'amount' => {
key: 'vaco5655[0].#subform[0].Field49[0]',
question_num: 21
}
},
'expensesInstallmentContractsAndOtherDebts' => {
key: 'vaco5655[0].#subform[0].Field50[0]',
question_num: 22
},
'totalMonthlyExpenses' => {
key: 'vaco5655[0].#subform[0].Field51[0]',
question_num: 23
}
},
'discretionaryIncome' => {
'netMonthlyIncomeLessExpenses' => {
key: 'vaco5655[0].#subform[0].Field52[0]',
question_num: 24,
question_suffix: 'A'
},
'amountCanBePaidTowardDebt' => {
key: 'vaco5655[0].#subform[0].Field53[0]',
question_num: 24,
question_suffix: 'B'
}
},
'assets' => {
'cashInBank' => {
key: 'vaco5655[0].#subform[1].Field54[0]',
question_num: 25
},
'cashOnHand' => {
key: 'vaco5655[0].#subform[1].Field55[0]',
question_num: 26
},
'automobiles' => {
limit: 3,
question_num: 27,
'make' => {
key: "automobiles.make[#{ITERATOR}]",
question_num: 27,
question_text: 'Car make'
},
'year' => {
key: "automobiles.year[#{ITERATOR}]",
question_num: 27,
question_text: 'Car year'
},
'model' => {
key: "automobiles.model[#{ITERATOR}]",
question_num: 27,
question_text: 'Car model'
},
'resaleValue' => {
key: "automobiles.value[#{ITERATOR}]",
question_num: 27,
question_text: 'Car value'
}
},
'trailersBoatsCampers' => {
key: 'vaco5655[0].#subform[1].Field68[0]',
question_num: 28
},
'usSavingsBonds' => {
key: 'vaco5655[0].#subform[1].Field69[0]',
question_num: 29
},
'stocksAndOtherBonds' => {
key: 'vaco5655[0].#subform[1].Field70[0]',
question_num: 30
},
'realEstateOwned' => {
key: 'vaco5655[0].#subform[1].Field71[0]',
question_num: 31
},
'otherAssets' => {
limit: 3,
question_num: 32,
'name' => {
key: "otherAssets.name[#{ITERATOR}]"
},
'amount' => {
key: "otherAssets.value[#{ITERATOR}]"
}
},
'totalAssets' => {
key: 'vaco5655[0].#subform[1].Field78[0]'
}
},
'installmentContractsAndOtherDebts' => {
limit: 8,
'nameAndAddress' => {
key: "debts.name[#{ITERATOR}]",
question_suffix: 'A'
},
'dateAndPurpose' => {
key: "debts.date[#{ITERATOR}]",
question_suffix: 'B'
},
'originalAmount' => {
key: "debts.originalAmount[#{ITERATOR}]",
question_suffix: 'C'
},
'unpaidBalance' => {
key: "debts.unpaidBalance[#{ITERATOR}]",
question_suffix: 'D'
},
'amountDueMonthly' => {
key: "debts.monthlyDue[#{ITERATOR}]",
question_suffix: 'E'
},
'amountPastDue' => {
key: "debts.pastDue[#{ITERATOR}]",
question_suffix: 'F'
}
},
'totalOfInstallmentContractsAndOtherDebts' => {
'originalAmount' => {
key: 'vaco5655[0].#subform[1].Field127[0]'
},
'unpaidBalance' => {
key: 'vaco5655[0].#subform[1].Field128[0]'
},
'amountDueMonthly' => {
key: 'vaco5655[0].#subform[1].Field129[0]'
},
'amountPastDue' => {
key: 'vaco5655[0].#subform[1].Field130[0]'
}
},
'additionalData' => {
'bankruptcy' => {
'hasBeenAdjudicatedBankrupt' => {
key: 'vaco5655[0].#subform[1].RadioButtonList[1]',
question_num: 35,
question_suffix: 'A'
},
'dateDischarged' => {
key: 'vaco5655[0].#subform[1].Field133[0]',
question_num: 35,
question_suffix: 'B'
},
'courtLocation' => {
key: 'vaco5655[0].#subform[1].Field134[0]',
question_num: 35,
question_suffix: 'C'
},
'docketNumber' => {
key: 'vaco5655[0].#subform[1].Field135[0]',
question_num: 35,
question_suffix: 'D'
}
},
'additionalComments' => {
key: 'vaco5655[0].#subform[1].Field136[0]',
question_num: 36,
question_text: 'Additional Comments',
limit: 450
}
},
'applicantCertifications' => {
'veteranSignature' => {
key: 'Text1',
question_num: 37,
question_suffix: 'A'
},
'veteranDateSigned' => {
key: 'Text3',
question_num: 37,
question_suffix: 'B'
}
}
}.freeze