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Routine: EASEZRP3

Package: Enrollment Application System

Routine: EASEZRP3


Information

EASEZRP3 ;ALB/AMA,TDM - Print 1010EZR, Cont. ; 1/19/13 5:10pm

Source Information

Source file <EASEZRP3.m>

Entry Points

Name Comments DBIA/ICR reference
EN(EALNE,EAINFO,EASDG) ; Entry point to print Page 3, called from EN^EASEZRPF
; Input
; EALNE - Array of line formats for output
; EAINFO - Application Data array, see SETUP^EASEZRPF
; EASDG - Flag variable to signify request to print from DG options
NET ; Print SECTION VIII - PREVIOUS CALENDAR YEAR NET WORTH
CON ; Print SECTION X - CONSENT TO COPAYMENTS
AOB ; Print SECTION XI - ASSIGNMENT OF BENEFITS

Interaction Calls

Name Line Occurrences
Function Call: WRITE
  • Prompt: !!?2,"SECTION VIII - PREVIOUS CALENDAR YEAR NET WORTH (INCOME YEAR: ",@EASD@(999),") (Use a separate sheet for additional dependents)"
  • Line Location: NET+2
Function Call: WRITE
  • Prompt: !!?38,"SECTION VIII - PREVIOUS CALENDAR YEAR NET WORTH (Use a separate sheet for additional dependents)"
  • Line Location: NET+3
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+4
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+4
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+4
Function Call: WRITE
  • Prompt: !?78,"|",?84,"VETERAN",?96,"|",?102,"SPOUSE",?114,"|",?120,"CHILD 1"
  • Line Location: NET+6
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+7
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+7
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+7
Function Call: WRITE
  • Prompt: !,"1. CASH, AMOUNT IN BANK ACCOUNTS (e.g., checking and savings accounts,",?78,"| $ ",$P(@EASD@("2E1"),U),?96,"| $ ",$P(@EASD@("2E1"),U,2),?114,"| $ ",$P(@EASD@("2E1"),U,3)
  • Line Location: NET+9
Function Call: WRITE
  • Prompt: !,"certificates of deposit, individual retirement accounts, stocks and bonds)",?78,"|",?96,"|",?114,"|"
  • Line Location: NET+10
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+11
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+11
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+11
Function Call: WRITE
  • Prompt: !,"2. MARKET VALUE OF LAND AND BUILDINGS MINUS MORTGAGES AND LIENS (e.g., second",?78,"| $ ",$P(@EASD@("2E2"),U),?96,"| $ ",$P(@EASD@("2E2"),U,2),?114,"| $ ",$P(@EASD@("2E2"),U,3)
  • Line Location: NET+13
Function Call: WRITE
  • Prompt: !,"homes and non-income-producing property. Do not include your primary home.)",?78,"|",?96,"|",?114,"|"
  • Line Location: NET+14
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+15
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+15
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+15
Function Call: WRITE
  • Prompt: !,"3. VALUE OF OTHER PROPERTY OR ASSETS (e.g., art, rare coins, collectibles)",?78,"| $ ",$P(@EASD@("2E3"),U),?96,"| $ ",$P(@EASD@("2E3"),U,2),?114,"| $ ",$P(@EASD@("2E3"),U,3)
  • Line Location: NET+17
Function Call: WRITE
  • Prompt: !,"MINUS THE AMOUNT YOU OWE ON THESE ITEMS. INCLUDE VALUE OF FARM, RANCH, OR",?78,"|",?96,"|",?114,"|"
  • Line Location: NET+18
Function Call: WRITE
  • Prompt: !,"BUSINESS ASSETS. Exclude household effects and family vehicles.",?78,"|",?96,"|",?114,"|"
  • Line Location: NET+19
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: NET+20
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: NET+20
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: NET+20
Function Call: WRITE
  • Prompt: !?49,"SECTION X - CONSENT TO COPAYMENTS"
  • Line Location: CON+2
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: CON+3
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: CON+3
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: CON+3
Function Call: WRITE
  • Prompt: !,"By signing this application you are agreeing to pay the applicable VA copays for treatment or services for your NSC conditions as"
  • Line Location: CON+5
Function Call: WRITE
  • Prompt: !,"required by law."
  • Line Location: CON+6
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: CON+7
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: CON+7
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: CON+7
Function Call: WRITE
  • Prompt: !?48,"SECTION XI - ASSIGNMENT OF BENEFITS"
  • Line Location: AOB+2
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: AOB+3
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: AOB+3
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: AOB+3
Function Call: WRITE
  • Prompt: !,"I understand that pursuant to 38 U.S.C. Section 1729 and 42 U.S.C. 2651, the Department of Veterans Affairs (VA) is authorized to"
  • Line Location: AOB+5
Function Call: WRITE
  • Prompt: !,"recover or collect from my health plan (HP) or any other legally responsible third party for the reasonable charges of nonservice-"
  • Line Location: AOB+6
Function Call: WRITE
  • Prompt: !,"connected VA medical care or services furnished or provided to me. I hereby authorize payment directly to VA from any HP under"
  • Line Location: AOB+7
Function Call: WRITE
  • Prompt: !,"which I am covered (including coverage provided under my spouse's HP) that is responsible for payment of the charges for my medical"
  • Line Location: AOB+8
Function Call: WRITE
  • Prompt: !,"care, including benefits otherwise payable to me or my spouse. Furthermore, I hereby assign to the VA any claim I may have against"
  • Line Location: AOB+9
Function Call: WRITE
  • Prompt: !,"any person or entity who is or may be legally responsible for the payment of the cost of medical services provided to me by the VA."
  • Line Location: AOB+10
Function Call: WRITE
  • Prompt: !,"I understand that this assignment shall not limit or prejudice my right to recover for my own benefit any amount in excess of the"
  • Line Location: AOB+11
Function Call: WRITE
  • Prompt: !,"cost of medical services provided to me by the VA or any other amount to which I may be entitled. I hereby appoint the Attorney"
  • Line Location: AOB+12
Function Call: WRITE
  • Prompt: !,"General of the United States and the Secretary of Veterans' Affairs and their designees as my Attorneys-in-fact to take all"
  • Line Location: AOB+13
Function Call: WRITE
  • Prompt: !,"necessary and appropriate actions in order to recover and receive all or part of the amount herein assigned. I hereby authorize"
  • Line Location: AOB+14
Function Call: WRITE
  • Prompt: !,"the VA to disclose to my attorney and to any third party or administrative agency who may be responsible for payment of the cost of"
  • Line Location: AOB+15
Function Call: WRITE
  • Prompt: !,"medical services provided to me, information from my medical records as necessary to verify my claim. Further, I hereby authorize"
  • Line Location: AOB+16
Function Call: WRITE
  • Prompt: !,"any such third party or administrative agency to disclose to the VA any information regarding my claim."
  • Line Location: AOB+17
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: AOB+18
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: AOB+18
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: AOB+18
Function Call: WRITE
  • Prompt: !?11,"ALL APPLICANTS MUST SIGN AND DATE THIS FORM. REFER TO INSTRUCTIONS ON WHO CAN SIGN ON BEHALF OF THE VETERAN.",!
  • Line Location: AOB+20
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: AOB+21
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: AOB+21
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: AOB+21
Function Call: WRITE
  • Prompt: !,"SIGNATURE OF APPLICANT",?90,"| DATE (mm/dd/yyyy)"
  • Line Location: AOB+23
Function Call: WRITE
  • Prompt: !,"SIGNATURE OF APPLICANT OR APPLICANT'S REPRESENTATIVE HAS BEEN VERIFIED",?90,"| ",EASIGN,!?90,"|"
  • Line Location: AOB+24
Function Call: WRITE
  • Prompt: !?90,"|",!?90,"|"
  • Line Location: AOB+25
Function Call: WRITE
  • Prompt: ?131,$C(13)
  • Line Location: AOB+26
Function Call: WRITE
  • Prompt: !
  • Condition for execution: EALNE("ULC")="-"
  • Line Location: AOB+26
Function Call: WRITE
  • Prompt: EALNE("UL")
  • Line Location: AOB+26

FileMan Files Accessed Via FileMan Db Call

FileNo Call Tags
^EAS(712 - [#712] GET1^DIQ
Info |  Source |  Entry Points |  Interaction Calls |  FileMan Files Accessed Via FileMan Db Call