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Routine: EASEZPF2

Package: Enrollment Application System

Routine: EASEZPF2


Information

EASEZPF2 ;ALB/SCK - Print 1010EZ Enrollment Form Cont., Page 2 ; 10/19/2000

Source Information

Source file <EASEZPF2.m>

Entry Points

Name Comments DBIA/ICR reference
EN(EALNE,EAINFO) ; Main entry point
; Input
; EALNE - Array of line formats for output
; EAINFO - Application Data array, see SETUP^EASEZPF
DEP ; Print out VA 10-10EZ Section IIA, Dependent Information
FIN ; Print out VA 10-10EZ Section IIB, Financial Disclosure information
INC ; Print out VA 10-10EZ Section IIC, Gross Annual Income information
EXP ; Print out VA 10-10EZ Section IID, Deductible Expense Information
NET ; Print out VA 10-10EZ Section IIE, Net Worth Information

Interaction Calls

Name Line Occurrences
Function Call: WRITE
  • Prompt: !,?50,"SECTION II - FINANCIAL ASSESSMENT",!,EALNE("DD")
  • Line Location: EN+8
Function Call: WRITE
  • Prompt: !,?52,"IIA - DEPENDENT INFORMATION",!,EALNE("D")
  • Line Location: DEP+1
Function Call: WRITE
  • Prompt: !,"1. Spouse's Name ",@EASD@(1),?65,"|2. Child's Name ",@EASD@(2)
  • Line Location: DEP+2
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEP+3
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEP+3
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEP+3
Function Call: WRITE
  • Prompt: !,"3. Spouse's Social Security Number ",$P(@EASD@(3),U),?50,"|4. Spouse's Date Of Birth ",@EASD@(4),?90,"|5. Child's Date Of Birth ",@EASD@(5)
  • Line Location: DEP+5
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEP+6
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEP+6
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEP+6
Function Call: WRITE
  • Prompt: !,"6. Spouse's Address",?65,"|7. Child's Social Security Number"
  • Line Location: DEP+8
Function Call: WRITE
  • Prompt: !?1,$P(@EASD@(6),U),?65,"| ",@EASD@(7)
  • Line Location: DEP+9
Function Call: WRITE
  • Prompt: !?1,$P(@EASD@(6),U,2),?65,"|"
  • Line Location: DEP+10
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEP+11
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEP+11
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEP+11
Function Call: WRITE
  • Prompt: !,"8. Spouse's Telephone Number ",@EASD@(8),?65,"|9. Child's Relationship To You ",@EASD@(9)
  • Line Location: DEP+13
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEP+14
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEP+14
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEP+14
Function Call: WRITE
  • Prompt: !,"10. Date of Marriage ",@EASD@(10),?65,"|11. Date Child Became Your Dependent ",@EASD@(11)
  • Line Location: DEP+16
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEP+17
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEP+17
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEP+17
Function Call: WRITE
  • Prompt: !,"12. If Your Spouse or Dependent Child Did Not Live With You Last",?65,"|13. Expenses Paid By YOUR Dependent Child for College, Vocational"
  • Line Location: DEP+19
Function Call: WRITE
  • Prompt: !,"Year, Enter the Amount you Contributed To Their Support",?65,"|Rehabilitation or Training (tuition, books, materials, etc.)"
  • Line Location: DEP+20
Function Call: WRITE
  • Prompt: !?4,"Spouse $ ",$P(@EASD@(12),U),?26,"Child $ ",$P(@EASD@(12),U,2),?65,"| $ ",@EASD@(13)
  • Line Location: DEP+22
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: DEP+23
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: DEP+23
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: DEP+23
Function Call: WRITE
  • Prompt: !,"14. Was Child Permanently And Totally Disabled Before",?65,"|15. If Child is Between 18 and 23 Years Of Age, Did Child"
  • Line Location: DEP+25
Function Call: WRITE
  • Prompt: !,"The Age Of 18? ",@EASD@(14),?65,"| Attend School Last Calendar Year? ",@EASD@(15)
  • Line Location: DEP+26
Function Call: WRITE
  • Prompt: !,EALNE("DD")
  • Line Location: FIN+1
Function Call: WRITE
  • Prompt: !,?50,"IIB - FINANCIAL DISCLOSURE"
  • Line Location: FIN+2
Function Call: WRITE
  • Prompt: !,"You are not required to provide the financial information in this Section. However, current law may require VA to consider your"
  • Line Location: FIN+3
Function Call: WRITE
  • Prompt: !,"household financial situation to determine your eligibility for enrollment and/or cost-free care of your nonservice-connected"
  • Line Location: FIN+4
Function Call: WRITE
  • Prompt: !,"(NSC) conditions. If you are 0% SC noncompensable or NSC (and are not an Ex-POW, WWI veteran or VA pensioner) and your"
  • Line Location: FIN+5
Function Call: WRITE
  • Prompt: !,"annual household income (or combined income net worth) exceeds the established threshold, you must agree to pay VA co-payments"
  • Line Location: FIN+6
Function Call: WRITE
  • Prompt: !,"for care of your NSC conditions to be eligible for enrollment. See Section III - Consent and Signature"
  • Line Location: FIN+7
Function Call: WRITE
  • Prompt: !!?4,EAY," YES, I WILL PROVIDE SPECIFIC INCOME AND/OR ASSET INFORMATION TO HAVE ELIGIBILITY FOR CARE DETERMINED. Complete all"
  • Line Location: FIN+13
Function Call: WRITE
  • Prompt: !?8,"sections below that apply to you with last calendar year's information. Sign and date the application."
  • Line Location: FIN+14
Function Call: WRITE
  • Prompt: !?4,EAN," NO, I DO NOT WISH TO PROVIDE MY DETAILED FINANCIAL INFORMATION. I understand I will be assigned the appropriate enrollment"
  • Line Location: FIN+15
Function Call: WRITE
  • Prompt: !?8,"priority based on nondisclosure of my financial information. By checking NO and signing below, I am agreeing to pay the"
  • Line Location: FIN+16
Function Call: WRITE
  • Prompt: !?8,"applicable VA co-payment. Sign and date the application."
  • Line Location: FIN+17
Function Call: WRITE
  • Prompt: !,EALNE("DD")
  • Line Location: INC+1
Function Call: WRITE
  • Prompt: !?17,"IIC - PREVIOUS CALENDAR YEAR GROSS ANNUAL INCOME OF VETERAN, SPOUSE AND DEPENDENT CHILDREN"
  • Line Location: INC+2
Function Call: WRITE
  • Prompt: !?73,"| VETERAN",?90,"| SPOUSE",?110,"| CHILDREN"
  • Line Location: INC+4
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: INC+5
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: INC+5
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: INC+5
Function Call: WRITE
  • Prompt: !,"1. What Was Your Gross Annual Income From Employment (wages, bonuses,"
  • Line Location: INC+7
Function Call: WRITE
  • Prompt: !,"tips, etc), As Well as Income From Your Farm, Ranch, Property or Business",?73,"| $ "
  • Line Location: INC+8
Function Call: WRITE
  • Prompt: $P(@EASD@("2C1"),U),?90,"| $ ",$P(@EASD@("2C1"),U,2),?110,"| $ ",$P(@EASD@("2C1"),U,3)
  • Line Location: INC+9
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: INC+10
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: INC+10
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: INC+10
Function Call: WRITE
  • Prompt: !,"2. List Other Income Amounts (Social Security, compensation, pension,"
  • Line Location: INC+12
Function Call: WRITE
  • Prompt: !,"interest, dividends) Exclude Welfare.",?73,"| $ "
  • Line Location: INC+13
Function Call: WRITE
  • Prompt: $P(@EASD@("2C2"),U),?90,"| $ ",$P(@EASD@("2C2"),U,2),?110,"| $ ",$P(@EASD@("2C2"),U,3)
  • Line Location: INC+14
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: INC+15
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: INC+15
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: INC+15
Function Call: WRITE
  • Prompt: !,"3. Was Income From Your Farm, Ranch, Property or Business (if yes, refer to page 2, Section IIC of the instructions.) ",@EASD@("2C3")
  • Line Location: INC+17
Function Call: WRITE
  • Prompt: !,EALNE("DD")
  • Line Location: EXP+1
Function Call: WRITE
  • Prompt: !?50,"IID - DEDUCTIBLE EXPENSES"
  • Line Location: EXP+2
Function Call: WRITE
  • Prompt: !,"1. Non-Reimbursed Medical Expenses Paid By You or Your Spouse (payments for doctors, dentists, drugs,"
  • Line Location: EXP+3
Function Call: WRITE
  • Prompt: !,"Medicare, health insurance, hospital and nursing home)",?110,"| $ ",@EASD@("2D1")
  • Line Location: EXP+4
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: EXP+5
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: EXP+5
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: EXP+5
Function Call: WRITE
  • Prompt: !,"2. Amount You Paid Last Calendar Year For Funeral And Burial Expenses For Deceased Spouse or Dependent"
  • Line Location: EXP+7
Function Call: WRITE
  • Prompt: !,"Child (also enter spouse or child's information in Section IIA)",?110,"| $ ",@EASD@("2D2")
  • Line Location: EXP+8
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: EXP+9
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: EXP+9
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: EXP+9
Function Call: WRITE
  • Prompt: !,"3. Amount You Paid Last Calendar Year For YOUR College or Vocational Educational Expenses (tutition, books,"
  • Line Location: EXP+11
Function Call: WRITE
  • Prompt: !,"fees, materials, etc.) Do Not List Your Dependent's Educational Expenses.",?110,"| $ ",@EASD@("2D3")
  • Line Location: EXP+12
Function Call: WRITE
  • Prompt: !,EALNE("DD")
  • Line Location: NET+1
Function Call: WRITE
  • Prompt: !?50,"IIE - NET WORTH"
  • Line Location: NET+2
Function Call: WRITE
  • Prompt: !?91,"| VETERAN",?110,"| SPOUSE"
  • Line Location: NET+3
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+4
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+4
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+4
Function Call: WRITE
  • Prompt: !,"1. Cash, Amount In Bank Accounts (checking and savings accounts, certificates of deposit,"
  • Line Location: NET+6
Function Call: WRITE
  • Prompt: !,"individual retirement accounts, etc.)",?91,"| $ ",$P(@EASD@("2E1"),U),?110,"| $ ",$P(@EASD@("2E1"),U,2)
  • Line Location: NET+7
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+8
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+8
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+8
Function Call: WRITE
  • Prompt: !,"2. Market Value Of Land And Buildings MINUS Mortgages And Liens. Do NOT COUNT YOUR"
  • Line Location: NET+10
Function Call: WRITE
  • Prompt: !,"PRIMARY HOME. Include value of farm, ranch, or business assets.",?91,"| $ ",$P(@EASD@("2E2"),U),?110,"| $ ",$P(@EASD@("2E2"),U,2)
  • Line Location: NET+11
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+12
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+12
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+12
Function Call: WRITE
  • Prompt: !,"3. Stocks And Bonds AND Value Of Other Property or Assets (art, rare coins, etc.) MINUS"
  • Line Location: NET+14
Function Call: WRITE
  • Prompt: !,"The Amount You Owe On These Items. Exclude household effects and family vehicles.",?91,"| $ ",$P(@EASD@("2E3"),U),?110,"| $ ",$P(@EASD@("2E3"),U,2)
  • Line Location: NET+15
Info |  Source |  Entry Points |  Interaction Calls