EASEC10R ;ALB/LBD - Print 1010EC LTC Enrollment form ; 9/20/01 12:25pm
;;1.0;ENROLLMENT APPLICATION SYSTEM;**40**;Mar 15, 2001
;
; Called from ^EASEC10E to print pages 2 and 3 of the revised 1010EC
;
PAGE2(EALNE,EAINFO,EASDFN) ;Print page 2 of revised 1010EC
N X,EASROOT
S EASROOT="^TMP(""1010EC"",$J,"_EASDFN_","
D HDR^EASEC10E(.EALNE,.EAINFO)
D SIGN
D SEC4
D SEC5 ;SEC 6 is part of SEC 5
D SEC7
D FT^EASEC10E(.EALNE,.EAINFO)
Q
SIGN ;print disclaimer and signature block to refuse income data
;
W !,"I do not wish to provide my detailed financial information. "
W "I understand that I will be assessed the maximum copayment amount for"
W !,"extended care services and agree to pay the applicable VA copayment as required by law.",?131,$C(13) X EAINFO("L")
W !,"Signature",?97,"| Date",!?97,"|",?131,$C(13) X EAINFO("L")
Q
;
SEC4 ; print section 4 - Fixed Assets (Veteran and Spouse)
N EAS4
S EAS4=EASROOT_"4)"
W !?23,"SECTION IV - FIXED ASSETS (VETERAN AND SPOUSE)",?97,"|",?102,"VETERAN",?113,"|",?119,"SPOUSE",?131,$C(13) X EAINFO("L")
;
W !,"1. Primary Residence (Market value minus mortgages or liens. "
W "Exclude if veteran receiving only",?97,"| $",$J(@EAS4@(1),12,2),?113,"| $",$J(@EAS4@(1.5),12,2)
W !?3,"non-institutional extended care services or spouse or dependent residing in community. If the",?97,"|",?113,"|"
W !?3,"veteran and spouse maintain separate residences, and the veteran is receiving institutional",?97,"|",?113,"|"
W !?3,"(inpatient) extended care services, include value of the veteran's primary residence.)",?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
;
W !,"2. Other Residences/Land/Farm or Ranch (Market value minus mortgages or liens. "
W "This would",?97,"| $",$J(@EAS4@(2),12,2),?113,"| $",$J(@EAS4@(2.5),12,2)
W !?3,"include a second home, vacation home, rental property.)",?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
;
W !,"3. Vehicle(s) (Value minus outstanding lien. Exclude primary vehicle if veteran "
W "receiving only",?97,"| $",$J(@EAS4@(3),12,2),?113,"| $",$J(@EAS4@(3.5),12,2)
W !?3,"non-institutional extended care services or spouse or dependent residing in community. If the",?97,"|",?113,"|"
W !?3,"veteran and spouse maintain separate residences and vehicles, and the veteran is receiving",?97,"|",?113,"|"
W !?3,"institutional (inpatient) extended care services, include value of veteran's primary vehicle.)",?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
;
Q
SEC5 ; print section 5 - Liquid Assets (Veteran and Spouse)
N EAS5
S EAS5=EASROOT_"5)"
W !?23,"SECTION V - LIQUID ASSETS (VETERAN AND SPOUSE)",?97,"|",?113,"|",?131 X EAINFO("L")
;
W !,"1. Cash, Amount in Bank Accounts (e.g., checking and savings accounts, certificates "
W "of deposit",?97,"| $",$J(@EAS5@(1),12,2),?113,"| $",$J(@EAS5@(1.5),12,2)
W !?3,"individual retirement accounts, stocks and bonds.)"
W ?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
;
W !,"2. Value of Other Liquid Assets (e.g., art, rare coins, stamp collections, collectibles) Minus"
W ?97,"| $",$J(@EAS5@(3),12,2),?113,"| $",$J(@EAS5@(3.5),12,2)
W !?3,"the amount you owe on these items. Exclude household effects, clothing, jewelry, and personal",?97,"|",?113,"|"
W !?3,"items if veteran receiving only non-institutional extended care services or spouse or",?97,"|",?113,"|"
W !?3,"dependent residing in the community.",?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
;
W !," SUM OF ALL LINES FIXED AND LIQUID ASSETS"
W ?75,"| TOTAL ASSETS",?97,"| $",$J(@EAS5@(5),12,2),?113,"| $",$J(@EAS5@(5.5),12,2),?131,$C(13) X EAINFO("L")
;
; print section 6 - Current Gross Income
W !?23,"SECTION VI - CURRENT GROSS INCOME OF VETERAN AND SPOUSE",?97,"|",?113,"|",?131 X EAINFO("L")
W !?45,"CATEGORY",?97,"|",?102,"VETERAN",?113,"|",?119,"SPOUSE",?131,$C(13) X EAINFO("L")
;
W !,"1. Gross annual income from employment (e.g., wages, bonuses, tips, severance pay"
W ?97,"| $",$J(@EAS5@(6),10,2),?113,"| $",$J(@EAS5@(7),10,2)
W !,"accrued benefits)",?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
;
W !,"2. Net income from your farm/ranch, property or business.",?97,"| $",$J(@EAS5@(10),10,2),?113,"| $",$J(@EAS5@(11),10,2),?131,$C(13) X EAINFO("L")
;
W !,"3. List other income amounts (e.g., Social Security, retirement and pension, ",?97,"| $",$J(@EAS5@(32),10,2),?113,"| $",$J(@EAS5@(33),10,2)
W !?3,"interest, dividends) Refer to instructions.",?97,"|",?113,"|",?131,$C(13) X EAINFO("L")
Q
SEC7 ; print section 7 - Expenses
; Expenses are in section 7 on the new 10-10EC (section 6 on the old)
N EAS6
S EAS6=EASROOT_"6)"
;
W !?43,"SECTION VII - DEDUCTIBLE EXPENSES",!,EALNE("D")
W !?54,"ITEMS",?113,"|",?119,"AMOUNT",?131,$C(13) X EAINFO("L")
W !,"1. Educational expenses of veteran, spouse or dependent (e.g., tuition, books, fees, material, etc.)",?113,"| $",$J(@EAS6@(1),10,2),?131,$C(13) X EAINFO("L")
W !,"2. Funeral and Burial (spouse or child, amount you paid for funeral and burial expenses, including prepaid",?113,"| $",$J(@EAS6@(2),10,2)
W !?3,"arrangements)",?113,"|",?131,$C(13) X EAINFO("L")
W !,"3. Rent/Mortgage (monthly amount or annual amount)",?113,"| $",$J(@EAS6@(3),10,2),?131,$C(13) X EAINFO("L")
W !,"4. Utilities (calculate by average monthly amounts over the past 12 months)",?113,"| $",$J(@EAS6@(4),10,2),?131,$C(13) X EAINFO("L")
W !,"5. Car Payment for one vehicle only (exclude gas, automobile insurance, parking fees, repairs)",?113,"| $",$J(@EAS6@(5),10,2),?131,$C(13) X EAINFO("L")
W !,"6. Food (for veteran, spouse and dependent)",?113,"| $",$J(@EAS6@(6),10,2),?131,$C(13) X EAINFO("L")
W !,"7. Non-reimbursed medical expenses paid by you or spouse (e.g., copayments for physicians, dentists,",?113,"| $",$J(@EAS6@(7),10,2)
W !?3,"medications, Medicare, health insurance, hospital and nursing home expenses)",?113,"|",?131,$C(13) X EAINFO("L")
W !,"8. Court-ordered payments (e.g., alimony, child support)",?113,"| $",$J(@EAS6@(8),10,2),?131,$C(13) X EAINFO("L")
W !,"9. Insurance (e.g., automobile insurance, homeowners insurance) Exclude life insurance",?113,"| $",$J(@EAS6@(9),10,2),?131,$C(13) X EAINFO("L")
W !,"10. Taxes (e.g., personal property for home, automobile) Include average monthly expense for taxes paid on",?113,"| $",$J(@EAS6@(10),10,2)
W !?3,"income over the past 12 months.",?113,"|",?131,$C(13) X EAINFO("L")
W !,?95,"| TOTAL",?113,"| $",$J(@EAS6@(11),10,2),?131
Q
;
PAGE3(EALNE,EAINFO,EASDFN) ;Print page 3
N X,EASROOT
S EASROOT="^TMP(""1010EC"",$J,"_EASDFN_","
D HDR^EASEC10E(.EALNE,.EAINFO)
D SEC8
D SEC9
D SEC10
D FT^EASEC10E(.EALNE,.EAINFO)
Q
;
SEC8 ; print section 8 - Consent for Assignment of Benefits
; (section 7 on old 10-10EC form)
D SEC7^EASEC103
Q
;
SEC9 ;print section 9 - Consent to Agreement to Make Copayments
; (section 8 on old 10-10EC form)
D SEC8^EASEC103
Q
;
SEC10 ; print section 10 - Paperwork Privacy Act Information
N I,WPLINE,EAS8,WPCNT
S EAS8=EASROOT_"8)",WPLINE=0,WPCNT=1
W !?43,"SECTION X - PAPERWORK PRIVACY ACT INFORMATION",!,EALNE("D")
W !,"The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance"
W !,"requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to"
W !,"respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all"
W !,"individuals who must complete this form will average 90 minutes. This includes the time it will take to read instructions, gather"
W !,"the necessary facts and fill out the form. If you have comments regarding this burden estimate or any other aspect of this"
W !,"collection, call 202.273.8247 for mailing information on where to send your comments.",!
W !,"Privacy Act Information: The VA is asking you to provide the information on this form under Title 38, United States Code,"
W !,"sections 1710, 1712, 1722 and 1729 in order for VA to determine your eligibility for extended care benefits and to establish"
W !,"financial eligibility, if applicable, when placed in extended care services. The information you supply may be verified through a"
W !,"computer-matching program. VA may disclose the information that you put on the form as permitted by law. VA may make a"
W !,"""routine use"" disclosure of the information as outlined in the Privacy Act systems of records notices and in accordance with the"
W !,"VHA Notice of Privacy Practices. You do not have to provide the information to VA, but if you don't, VA will be unable to process"
W !,"your request and serve your medical needs. Failure to furnish the information will not have any affect on any other benefits to"
W !,"which you may be entitled. If you provide VA your Social Security Number, VA will use it to administer your VA benefits. VA may"
W !,"also use this information to identify veterans and persons claiming or receiving VA benefits and their records, and for other"
W !,"purposes authorized or required by law.",?131,$C(13) X EAINFO("L")
W !,"Additional Comments:"
D:$D(EAS8)
.F S WPLINE=$O(@EAS8@(WPLINE)) Q:'WPLINE S WPCNT=WPCNT+1 W !,@EAS8@(WPLINE)
F I=WPCNT:1:14 W !
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HEASEC10R 9341 printed Apr 09, 2024@20:58:12 Page 2
EASEC10R ;ALB/LBD - Print 1010EC LTC Enrollment form ; 9/20/01 12:25pm
+1 ;;1.0;ENROLLMENT APPLICATION SYSTEM;**40**;Mar 15, 2001
+2 ;
+3 ; Called from ^EASEC10E to print pages 2 and 3 of the revised 1010EC
+4 ;
PAGE2(EALNE,EAINFO,EASDFN) ;Print page 2 of revised 1010EC
+1 NEW X,EASROOT
+2 SET EASROOT="^TMP(""1010EC"",$J,"_EASDFN_","
+3 DO HDR^EASEC10E(.EALNE,.EAINFO)
+4 DO SIGN
+5 DO SEC4
+6 ;SEC 6 is part of SEC 5
DO SEC5
+7 DO SEC7
+8 DO FT^EASEC10E(.EALNE,.EAINFO)
+9 QUIT
SIGN ;print disclaimer and signature block to refuse income data
+1 ;
+2 WRITE !,"I do not wish to provide my detailed financial information. "
+3 WRITE "I understand that I will be assessed the maximum copayment amount for"
+4 WRITE !,"extended care services and agree to pay the applicable VA copayment as required by law.",?131,$CHAR(13)
XECUTE EAINFO("L")
+5 WRITE !,"Signature",?97,"| Date",!?97,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+6 QUIT
+7 ;
SEC4 ; print section 4 - Fixed Assets (Veteran and Spouse)
+1 NEW EAS4
+2 SET EAS4=EASROOT_"4)"
+3 WRITE !?23,"SECTION IV - FIXED ASSETS (VETERAN AND SPOUSE)",?97,"|",?102,"VETERAN",?113,"|",?119,"SPOUSE",?131,$CHAR(13)
XECUTE EAINFO("L")
+4 ;
+5 WRITE !,"1. Primary Residence (Market value minus mortgages or liens. "
+6 WRITE "Exclude if veteran receiving only",?97,"| $",$JUSTIFY(@EAS4@(1),12,2),?113,"| $",$JUSTIFY(@EAS4@(1.5),12,2)
+7 WRITE !?3,"non-institutional extended care services or spouse or dependent residing in community. If the",?97,"|",?113,"|"
+8 WRITE !?3,"veteran and spouse maintain separate residences, and the veteran is receiving institutional",?97,"|",?113,"|"
+9 WRITE !?3,"(inpatient) extended care services, include value of the veteran's primary residence.)",?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+10 ;
+11 WRITE !,"2. Other Residences/Land/Farm or Ranch (Market value minus mortgages or liens. "
+12 WRITE "This would",?97,"| $",$JUSTIFY(@EAS4@(2),12,2),?113,"| $",$JUSTIFY(@EAS4@(2.5),12,2)
+13 WRITE !?3,"include a second home, vacation home, rental property.)",?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+14 ;
+15 WRITE !,"3. Vehicle(s) (Value minus outstanding lien. Exclude primary vehicle if veteran "
+16 WRITE "receiving only",?97,"| $",$JUSTIFY(@EAS4@(3),12,2),?113,"| $",$JUSTIFY(@EAS4@(3.5),12,2)
+17 WRITE !?3,"non-institutional extended care services or spouse or dependent residing in community. If the",?97,"|",?113,"|"
+18 WRITE !?3,"veteran and spouse maintain separate residences and vehicles, and the veteran is receiving",?97,"|",?113,"|"
+19 WRITE !?3,"institutional (inpatient) extended care services, include value of veteran's primary vehicle.)",?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+20 ;
+21 QUIT
SEC5 ; print section 5 - Liquid Assets (Veteran and Spouse)
+1 NEW EAS5
+2 SET EAS5=EASROOT_"5)"
+3 WRITE !?23,"SECTION V - LIQUID ASSETS (VETERAN AND SPOUSE)",?97,"|",?113,"|",?131
XECUTE EAINFO("L")
+4 ;
+5 WRITE !,"1. Cash, Amount in Bank Accounts (e.g., checking and savings accounts, certificates "
+6 WRITE "of deposit",?97,"| $",$JUSTIFY(@EAS5@(1),12,2),?113,"| $",$JUSTIFY(@EAS5@(1.5),12,2)
+7 WRITE !?3,"individual retirement accounts, stocks and bonds.)"
+8 WRITE ?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+9 ;
+10 WRITE !,"2. Value of Other Liquid Assets (e.g., art, rare coins, stamp collections, collectibles) Minus"
+11 WRITE ?97,"| $",$JUSTIFY(@EAS5@(3),12,2),?113,"| $",$JUSTIFY(@EAS5@(3.5),12,2)
+12 WRITE !?3,"the amount you owe on these items. Exclude household effects, clothing, jewelry, and personal",?97,"|",?113,"|"
+13 WRITE !?3,"items if veteran receiving only non-institutional extended care services or spouse or",?97,"|",?113,"|"
+14 WRITE !?3,"dependent residing in the community.",?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+15 ;
+16 WRITE !," SUM OF ALL LINES FIXED AND LIQUID ASSETS"
+17 WRITE ?75,"| TOTAL ASSETS",?97,"| $",$JUSTIFY(@EAS5@(5),12,2),?113,"| $",$JUSTIFY(@EAS5@(5.5),12,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+18 ;
+19 ; print section 6 - Current Gross Income
+20 WRITE !?23,"SECTION VI - CURRENT GROSS INCOME OF VETERAN AND SPOUSE",?97,"|",?113,"|",?131
XECUTE EAINFO("L")
+21 WRITE !?45,"CATEGORY",?97,"|",?102,"VETERAN",?113,"|",?119,"SPOUSE",?131,$CHAR(13)
XECUTE EAINFO("L")
+22 ;
+23 WRITE !,"1. Gross annual income from employment (e.g., wages, bonuses, tips, severance pay"
+24 WRITE ?97,"| $",$JUSTIFY(@EAS5@(6),10,2),?113,"| $",$JUSTIFY(@EAS5@(7),10,2)
+25 WRITE !,"accrued benefits)",?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+26 ;
+27 WRITE !,"2. Net income from your farm/ranch, property or business.",?97,"| $",$JUSTIFY(@EAS5@(10),10,2),?113,"| $",$JUSTIFY(@EAS5@(11),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+28 ;
+29 WRITE !,"3. List other income amounts (e.g., Social Security, retirement and pension, ",?97,"| $",$JUSTIFY(@EAS5@(32),10,2),?113,"| $",$JUSTIFY(@EAS5@(33),10,2)
+30 WRITE !?3,"interest, dividends) Refer to instructions.",?97,"|",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+31 QUIT
SEC7 ; print section 7 - Expenses
+1 ; Expenses are in section 7 on the new 10-10EC (section 6 on the old)
+2 NEW EAS6
+3 SET EAS6=EASROOT_"6)"
+4 ;
+5 WRITE !?43,"SECTION VII - DEDUCTIBLE EXPENSES",!,EALNE("D")
+6 WRITE !?54,"ITEMS",?113,"|",?119,"AMOUNT",?131,$CHAR(13)
XECUTE EAINFO("L")
+7 WRITE !,"1. Educational expenses of veteran, spouse or dependent (e.g., tuition, books, fees, material, etc.)",?113,"| $",$JUSTIFY(@EAS6@(1),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+8 WRITE !,"2. Funeral and Burial (spouse or child, amount you paid for funeral and burial expenses, including prepaid",?113,"| $",$JUSTIFY(@EAS6@(2),10,2)
+9 WRITE !?3,"arrangements)",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+10 WRITE !,"3. Rent/Mortgage (monthly amount or annual amount)",?113,"| $",$JUSTIFY(@EAS6@(3),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+11 WRITE !,"4. Utilities (calculate by average monthly amounts over the past 12 months)",?113,"| $",$JUSTIFY(@EAS6@(4),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+12 WRITE !,"5. Car Payment for one vehicle only (exclude gas, automobile insurance, parking fees, repairs)",?113,"| $",$JUSTIFY(@EAS6@(5),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+13 WRITE !,"6. Food (for veteran, spouse and dependent)",?113,"| $",$JUSTIFY(@EAS6@(6),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+14 WRITE !,"7. Non-reimbursed medical expenses paid by you or spouse (e.g., copayments for physicians, dentists,",?113,"| $",$JUSTIFY(@EAS6@(7),10,2)
+15 WRITE !?3,"medications, Medicare, health insurance, hospital and nursing home expenses)",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+16 WRITE !,"8. Court-ordered payments (e.g., alimony, child support)",?113,"| $",$JUSTIFY(@EAS6@(8),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+17 WRITE !,"9. Insurance (e.g., automobile insurance, homeowners insurance) Exclude life insurance",?113,"| $",$JUSTIFY(@EAS6@(9),10,2),?131,$CHAR(13)
XECUTE EAINFO("L")
+18 WRITE !,"10. Taxes (e.g., personal property for home, automobile) Include average monthly expense for taxes paid on",?113,"| $",$JUSTIFY(@EAS6@(10),10,2)
+19 WRITE !?3,"income over the past 12 months.",?113,"|",?131,$CHAR(13)
XECUTE EAINFO("L")
+20 WRITE !,?95,"| TOTAL",?113,"| $",$JUSTIFY(@EAS6@(11),10,2),?131
+21 QUIT
+22 ;
PAGE3(EALNE,EAINFO,EASDFN) ;Print page 3
+1 NEW X,EASROOT
+2 SET EASROOT="^TMP(""1010EC"",$J,"_EASDFN_","
+3 DO HDR^EASEC10E(.EALNE,.EAINFO)
+4 DO SEC8
+5 DO SEC9
+6 DO SEC10
+7 DO FT^EASEC10E(.EALNE,.EAINFO)
+8 QUIT
+9 ;
SEC8 ; print section 8 - Consent for Assignment of Benefits
+1 ; (section 7 on old 10-10EC form)
+2 DO SEC7^EASEC103
+3 QUIT
+4 ;
SEC9 ;print section 9 - Consent to Agreement to Make Copayments
+1 ; (section 8 on old 10-10EC form)
+2 DO SEC8^EASEC103
+3 QUIT
+4 ;
SEC10 ; print section 10 - Paperwork Privacy Act Information
+1 NEW I,WPLINE,EAS8,WPCNT
+2 SET EAS8=EASROOT_"8)"
SET WPLINE=0
SET WPCNT=1
+3 WRITE !?43,"SECTION X - PAPERWORK PRIVACY ACT INFORMATION",!,EALNE("D")
+4 WRITE !,"The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance"
+5 WRITE !,"requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to"
+6 WRITE !,"respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all"
+7 WRITE !,"individuals who must complete this form will average 90 minutes. This includes the time it will take to read instructions, gather"
+8 WRITE !,"the necessary facts and fill out the form. If you have comments regarding this burden estimate or any other aspect of this"
+9 WRITE !,"collection, call 202.273.8247 for mailing information on where to send your comments.",!
+10 WRITE !,"Privacy Act Information: The VA is asking you to provide the information on this form under Title 38, United States Code,"
+11 WRITE !,"sections 1710, 1712, 1722 and 1729 in order for VA to determine your eligibility for extended care benefits and to establish"
+12 WRITE !,"financial eligibility, if applicable, when placed in extended care services. The information you supply may be verified through a"
+13 WRITE !,"computer-matching program. VA may disclose the information that you put on the form as permitted by law. VA may make a"
+14 WRITE !,"""routine use"" disclosure of the information as outlined in the Privacy Act systems of records notices and in accordance with the"
+15 WRITE !,"VHA Notice of Privacy Practices. You do not have to provide the information to VA, but if you don't, VA will be unable to process"
+16 WRITE !,"your request and serve your medical needs. Failure to furnish the information will not have any affect on any other benefits to"
+17 WRITE !,"which you may be entitled. If you provide VA your Social Security Number, VA will use it to administer your VA benefits. VA may"
+18 WRITE !,"also use this information to identify veterans and persons claiming or receiving VA benefits and their records, and for other"
+19 WRITE !,"purposes authorized or required by law.",?131,$CHAR(13)
XECUTE EAINFO("L")
+20 WRITE !,"Additional Comments:"
+21 if $DATA(EAS8)
Begin DoDot:1
+22 FOR
SET WPLINE=$ORDER(@EAS8@(WPLINE))
if 'WPLINE
QUIT
SET WPCNT=WPCNT+1
WRITE !,@EAS8@(WPLINE)
End DoDot:1
+23 FOR I=WPCNT:1:14
WRITE !
+24 QUIT
