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[SIMPLE_FORMS] feat: update form 21-10210 with new pdf form and expiration date #18379

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[SIMPLE_FORMS] feat: update form 21-10210 with new pdf form and expiration date #18379

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4eb5239
attempt at sorting out pdf changes
pennja Sep 10, 2024
7645946
updates and comments for clarity
pennja Oct 8, 2024
1f6d0eb
fix typos
pennja Oct 8, 2024
54658fa
stamp tweaks
pennja Oct 8, 2024
39a9777
remove commented code
pennja Oct 8, 2024
a1016bc
update form mapping checker to account for comments
pennja Oct 8, 2024
490328d
updates to json files
pennja Oct 8, 2024
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148 changes: 105 additions & 43 deletions modules/simple_forms_api/app/form_mappings/vba_21_10210.json.erb
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Original file line number Diff line number Diff line change
@@ -1,82 +1,144 @@
{
<%# Page 1 %>

<%# Section 1: Veteran's Identification Information %>

<%# 1. Veteran's Name %>
"vba210304[0].#subform[0].Veterans_First_Name[0]": "<%= form.data.dig('veteran_full_name', 'first') %>",
"vba210304[0].#subform[0].Middle_Initial1[0]": "<%= form.data.dig('veteran_full_name', 'middle') %>",
"vba210304[0].#subform[0].Last_Name[0]": "<%= form.data.dig('veteran_full_name', 'last') %>",
"vba210304[0].#subform[0].SocialSecurityNumber_FirstThreeNumbers[0]": "<%= form.data['veteran_ssn']&.[](0..2) %>",
"vba210304[0].#subform[0].SocialSecurityNumber_SecondTwoNumbers[0]": "<%= form.data['veteran_ssn']&.[](3..4) %>",
"vba210304[0].#subform[0].SocialSecurityNumber_LastFourNumbers[0]": "<%= form.data['veteran_ssn']&.[](5..8) %>",

<%# 2. Social Security Number %>
"vba210304[0].#subform[0].SSN1[0]": "<%= form.data['veteran_ssn']&.[](0..2) %>",
"vba210304[0].#subform[0].SSN2[0]": "<%= form.data['veteran_ssn']&.[](3..4) %>",
"vba210304[0].#subform[0].SSN3[0]": "<%= form.data['veteran_ssn']&.[](5..8) %>",

<%# 3. VA File Number %>
"vba210304[0].#subform[0].VA_File_Number_If_Applicable[0]": "<%= form.data['veteran_va_file_number'] %>",

<%# 4. Date of Birth %>
"vba210304[0].#subform[0].Month[1]": "<%= form.data['veteran_date_of_birth']&.[](5..6) %>",
"vba210304[0].#subform[0].Day[1]": "<%= form.data['veteran_date_of_birth']&.[](8..9) %>",
"vba210304[0].#subform[0].Year[1]": "<%= form.data['veteran_date_of_birth']&.[](0..3) %>",

<%# 5. VA Insurance File Number %>
"vba210304[0].#subform[0].VA_INSURANCE_FILE_NUMBER[0]": "<%= form.data['veteran_va_insurance_file_number'] %>",
"vba210304[0].#subform[0].DOByear[0]": "<%= form.data['veteran_date_of_birth']&.[](0..3) %>",
"vba210304[0].#subform[0].DOBmonth[0]": "<%= form.data['veteran_date_of_birth']&.[](5..6) %>",
"vba210304[0].#subform[0].DOBday[0]": "<%= form.data['veteran_date_of_birth']&.[](8..9) %>",
"vba210304[0].#subform[0].CurrentMailingAddress_Country[0]": "<%= form.data.dig('veteran_mailing_address', 'country') %>",

<%# 6. Current Mailing Address %>
"vba210304[0].#subform[0].CurrentMailingAddress_NumberAndStreet[0]": "<%= form.data.dig('veteran_mailing_address', 'street') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_ApartmentOrUnitNumber[0]": "<%= form.data.dig('veteran_mailing_address', 'street2')&.gsub(/\D/, '') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_City[0]": "<%= form.data.dig('veteran_mailing_address', 'city') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_StateOrProvince[0]": "<%= form.data.dig('veteran_mailing_address', 'state') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_Country[0]": "<%= form.data.dig('veteran_mailing_address', 'country') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_ZIPOrPostalCode_FirstFiveNumbers[0]": "<%= form.data.dig('veteran_mailing_address', 'postal_code')&.[](0..4) %>",
"vba210304[0].#subform[0].CurrentMailingAddress_ZIPOrPostalCode_LastFourNumbers[0]": "<%= form.data.dig('veteran_mailing_address', 'postal_code')&.[](5..8) %>",
"vba210304[0].#subform[0].TelephoneNumber_FirstThreeNumbers[0]": "<%= form.data['veteran_phone']&.gsub('-', '')&.[](0..2) %>",
"vba210304[0].#subform[0].TelephoneNumber_SecondThreeNumbers[0]": "<%= form.data['veteran_phone']&.gsub('-', '')&.[](3..5) %>",
"vba210304[0].#subform[0].TelephoneNumber_LastFourNumbers[0]": "<%= form.data['veteran_phone']&.gsub('-', '')&.[](6..9) %>",

<%# 7. Telephone Number %>
"vba210304[0].#subform[0].AreaCode[0]": "<%= form.data['veteran_phone']&.gsub('-', '')&.[](0..2) %>",
"vba210304[0].#subform[0].FirstThreeNumbers[0]": "<%= form.data['veteran_phone']&.gsub('-', '')&.[](3..5) %>",
"vba210304[0].#subform[0].LastFourNumbers[0]": "<%= form.data['veteran_phone']&.gsub('-', '')&.[](6..9) %>",
"vba210304[0].#subform[0].International_Phone_Number[0]": "<%= %>",

<%# 8. E-Mail Address %>
"vba210304[0].#subform[0].CheckBox1[0]": "<%= (form.data['claimant_type'] == 'veteran' && form.data['claim_ownership'] == 'self') ? 1 : 0 %>",
"vba210304[0].#subform[0].EMAIL_ADDRESS[0]": "<%= form.data['veteran_email']&.[](0..19) %>",
"vba210304[0].#subform[0].EMAIL_ADDRESS[1]": "<%= form.data['veteran_email']&.[](20..39) %>",
"vba210304[0].#subform[0].CheckBox1[0]": "<%= (form.data['claimant_type'] == 'veteran' && form.data['claim_ownership'] == 'self') ? 1 : 0 %>",
"vba210304[0].#subform[0].International_Phone_Number[0]": "<%= %>",

"vba210304[0].#subform[0].Claimants_First_Name[0]": "<%= form.data.dig('claimant_full_name', 'first') %>",
<%# Section 2: Claimant's Identification Information %>

<%# 9. Claimant's Name %>
"vba210304[0].#subform[0].Veterans_First_Name[1]": "<%= form.data.dig('claimant_full_name', 'first') %>",
"vba210304[0].#subform[0].Middle_Initial1[1]": "<%= form.data.dig('claimant_full_name', 'middle') %>",
"vba210304[0].#subform[0].Last_Name[1]": "<%= form.data.dig('claimant_full_name', 'last') %>",
"vba210304[0].#subform[0].Claimants_SocialSecurityNumber_FirstThreeNumbers[0]": "<%= form.data['claimant_ssn']&.[](0..2) %>",
"vba210304[0].#subform[0].Claimants_SocialSecurityNumber_SecondTwoNumbers[0]": "<%= form.data['claimant_ssn']&.[](3..4) %>",
"vba210304[0].#subform[0].Claimants_SocialSecurityNumber_LastFourNumbers[0]": "<%= form.data['claimant_ssn']&.[](5..8) %>",

<%# 10. Social Security Number %>
"vba210304[0].#subform[0].FirstThreeNumbers[1]": "<%= form.data['claimant_ssn']&.[](0..2) %>",
"vba210304[0].#subform[0].SecondTwoNumbers[1]": "<%= form.data['claimant_ssn']&.[](3..4) %>",
"vba210304[0].#subform[0].LastFourNumbers[1]": "<%= form.data['claimant_ssn']&.[](5..8) %>",

<%# 11. VA File Number %>
"vba210304[0].#subform[0].VA_File_Number_If_Applicable[1]": "<%= form.data['claimant_va_file_number'] %>",

<%# 12. Date of Birth %>
"vba210304[0].#subform[0].Year[3]": "<%= form.data['claimant_date_of_birth']&.[](0..3) %>",
"vba210304[0].#subform[0].Month[3]": "<%= form.data['claimant_date_of_birth']&.[](5..6) %>",
"vba210304[0].#subform[0].Day[3]": "<%= form.data['claimant_date_of_birth']&.[](8..9) %>",

<%# 13. VA Insurance File Number %>
"vba210304[0].#subform[0].VA_INSURANCE_FILE_NUMBER[1]": "<%= form.data['claimant_va_insurance_file_number'] %>",
"vba210304[0].#subform[0].DOByear[1]": "<%= form.data['claimant_date_of_birth']&.[](0..3) %>",
"vba210304[0].#subform[0].DOBmonth[1]": "<%= form.data['claimant_date_of_birth']&.[](5..6) %>",
"vba210304[0].#subform[0].DOBday[1]": "<%= form.data['claimant_date_of_birth']&.[](8..9) %>",
"vba210304[0].#subform[0].CurrentMailingAddress_Country[1]": "<%= form.data.dig('claimant_mailing_address', 'country') %>",

<%# 14. Current Mailing Address %>
"vba210304[0].#subform[0].CurrentMailingAddress_NumberAndStreet[1]": "<%= form.data.dig('claimant_mailing_address', 'street') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_ApartmentOrUnitNumber[1]": "<%= form.data.dig('claimant_mailing_address', 'street2')&.gsub(/\D/, '') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_City[1]": "<%= form.data.dig('claimant_mailing_address', 'city') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_StateOrProvince[1]": "<%= form.data.dig('claimant_mailing_address', 'state') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_Country[1]": "<%= form.data.dig('claimant_mailing_address', 'country') %>",
"vba210304[0].#subform[0].CurrentMailingAddress_ZIPOrPostalCode_FirstFiveNumbers[1]": "<%= form.data.dig('claimant_mailing_address', 'postal_code')&.[](0..4) %>",
"vba210304[0].#subform[0].CurrentMailingAddress_ZIPOrPostalCode_LastFourNumbers[1]": "<%= form.data.dig('claimant_mailing_address', 'postal_code')&.[](5..8) %>",
"vba210304[0].#subform[0].TelephoneNumber_FirstThreeNumbers[1]": "<%= form.data['claimant_phone']&.gsub('-', '')&.[](0..2) %>",
"vba210304[0].#subform[0].TelephoneNumber_SecondThreeNumbers[1]": "<%= form.data['claimant_phone']&.gsub('-', '')&.[](3..5) %>",
"vba210304[0].#subform[0].TelephoneNumber_LastFourNumbers[1]": "<%= form.data['claimant_phone']&.gsub('-', '')&.[](6..9) %>",
"vba210304[0].#subform[0].EMAIL_ADDRESS[3]": "<%= form.data['claimant_email']&.[](0..19) %>",
"vba210304[0].#subform[0].EMAIL_ADDRESS[2]": "<%= form.data['claimant_email']&.[](20..39) %>",
"vba210304[0].#subform[0].I_AGREE_TO_RECEIVE_ELECTRONIC_CORRESPONDENCE_FROM_VA_IN_REGARDS_TO_MY_CLAIM[0]": "<%= (form.data['claimant_type'] == 'non-veteran' && form.data['claim_ownership'] == 'self') ? 1 : 0 %>",

<%# 15. Telephone Number %>
"vba210304[0].#subform[0].AreaCode[1]": "<%= form.data['claimant_phone']&.gsub('-', '')&.[](0..2) %>",
"vba210304[0].#subform[0].FirstThreeNumbers[2]": "<%= form.data['claimant_phone']&.gsub('-', '')&.[](3..5) %>",
"vba210304[0].#subform[0].LastFourNumbers[2]": "<%= form.data['claimant_phone']&.gsub('-', '')&.[](6..9) %>",
"vba210304[0].#subform[0].International_Phone_Number[1]": "<%= %>",

<%# 16. E-Mail Address %>
"vba210304[0].#subform[0].CheckBox1[1]": "<%= (form.data['claimant_type'] == 'non-veteran' && form.data['claim_ownership'] == 'self') ? 1 : 0 %>",
"vba210304[0].#subform[0].EMAIL_ADDRESS[2]": "<%= form.data['claimant_email']&.[](0..19) %>",
"vba210304[0].#subform[0].EMAIL_ADDRESS[3]": "<%= form.data['claimant_email']&.[](20..39) %>",

<%# Page 2 %>

<%# HEADER: Social Security Number %>
"vba210304[0].#subform[1].SSN1[1]": "<%= form.data['veteran_ssn']&.[](0..2) %>",
"vba210304[0].#subform[1].SSN2[1]": "<%= form.data['veteran_ssn']&.[](3..4) %>",
"vba210304[0].#subform[1].SSN3[1]": "<%= form.data['veteran_ssn']&.[](5..8) %>",

<%# Section 3: Statement %>

<%# 17. Statement %>
"vba210304[0].#subform[1].TextField1[0]": "<%= form.data['statement']&.[](0..5554) %>",

<%# Page 3 %>

<%# HEADER: Social Security Number %>
"vba210304[0].#subform[2].SSN1[2]": "<%= form.data['veteran_ssn']&.[](0..2) %>",
"vba210304[0].#subform[2].SSN2[2]": "<%= form.data['veteran_ssn']&.[](3..4) %>",
"vba210304[0].#subform[2].SSN3[2]": "<%= form.data['veteran_ssn']&.[](5..8) %>",

<%# Section 3: Statement (Continued) %>

<%# 17. Statement %>
"vba210304[0].#subform[2].TextField1[1]": "<%= form.data['statement']&.[](5555..) %>",

"vba210304[0].#subform[1].SocialSecurityNumber_FirstThreeNumbers[1]": "<%= form.data['veteran_ssn']&.[](0..2) %>",
"vba210304[0].#subform[1].SocialSecurityNumber_SecondTwoNumbers[1]": "<%= form.data['veteran_ssn']&.[](3..4) %>",
"vba210304[0].#subform[1].SocialSecurityNumber_LastFourNumbers[1]": "<%= form.data['veteran_ssn']&.[](5..8) %>",
"vba210304[0].#subform[2].SocialSecurityNumber_FirstThreeNumbers[2]": "<%= form.data['veteran_ssn']&.[](0..2) %>",
"vba210304[0].#subform[2].SocialSecurityNumber_SecondTwoNumbers[2]": "<%= form.data['veteran_ssn']&.[](3..4) %>",
"vba210304[0].#subform[2].SocialSecurityNumber_LastFourNumbers[2]": "<%= form.data['veteran_ssn']&.[](5..8) %>",
"vba210304[0].#subform[1].STATEMENT[0]": "<%= form.data['statement']&.[](0..5554) %>",
"vba210304[0].#subform[2].STATEMENT[1]": "<%= form.data['statement']&.[](5555..) %>",
<%# Section 4: Witness Contact Information %>

<%# 18. Witness Name %>
"vba210304[0].#subform[2].WITNESS_FIRST_NAME[0]": "<%= form.data.dig('witness_full_name', 'first') %>",
"vba210304[0].#subform[2].Middle_Initial1[2]": "<%= form.data.dig('witness_full_name', 'middle') %>",
"vba210304[0].#subform[2].Last_Name[2]": "<%= form.data.dig('witness_full_name', 'last') %>",
"vba210304[0].#subform[2].TelephoneNumber_FirstThreeNumbers[2]": "<%= form.data['witness_phone']&.gsub('-', '')&.[](0..2) %>",
"vba210304[0].#subform[2].TelephoneNumber_SecondThreeNumbers[2]": "<%= form.data['witness_phone']&.gsub('-', '')&.[](3..5) %>",
"vba210304[0].#subform[2].TelephoneNumber_LastFourNumbers[2]": "<%= form.data['witness_phone']&.gsub('-', '')&.[](6..9) %>",
"vba210304[0].#subform[2].EMAIL_ADDRESS[4]": "<%= form.data['witness_email']&.[](0..19) %>",
"vba210304[0].#subform[2].EMAIL_ADDRESS[5]": "<%= form.data['witness_email']&.[](20..39) %>",
"vba210304[0].#subform[2].International_Phone_Number[2]": "<%= %>",

<%# 19. Relationship to Veteran/Claimant %>
"vba210304[0].#subform[2].SERVED_WITH_CLAIMANT[0]": "<%= form.data.dig('witness_relationship_to_claimant', 'served_with') ? 1 : 0 %>",
"vba210304[0].#subform[2].FAMILY_OR_FRIEND_OF_CLAIMANT[0]": "<%= form.data.dig('witness_relationship_to_claimant', 'family_or_friend') ? 1 : 0 %>",
"vba210304[0].#subform[2].COWORKER_OR_SUPERVISOR_OF_CLAIMANT[0]": "<%= form.data.dig('witness_relationship_to_claimant', 'coworker_or_supervisor') ? 1 : 0 %>",
"vba210304[0].#subform[2].OTHER_Specify[1]": "<%= form.data['witness_other_relationship_to_claimant'] ? 1 : 0 %>",
"vba210304[0].#subform[2].OTHER_Specify[0]": "<%= form.data['witness_other_relationship_to_claimant'] %>",

"vba210304[0].#subform[2].Date_Signed_Year[0]": "<%= Time.current.in_time_zone('America/Chicago').strftime('%Y') %>",
"vba210304[0].#subform[2].Date_Signed_Month[0]": "<%= Time.current.in_time_zone('America/Chicago').strftime('%m') %>",
"vba210304[0].#subform[2].Date_Signed_Day[0]": "<%= Time.current.in_time_zone('America/Chicago').strftime('%d') %>"
<%# 20. Telephone Number %>
"vba210304[0].#subform[2].AreaCode[2]": "<%= form.data['witness_phone']&.gsub('-', '')&.[](0..2) %>",
"vba210304[0].#subform[2].FirstThreeNumbers[3]": "<%= form.data['witness_phone']&.gsub('-', '')&.[](3..5) %>",
"vba210304[0].#subform[2].LastFourNumbers[3]": "<%= form.data['witness_phone']&.gsub('-', '')&.[](6..9) %>",
"vba210304[0].#subform[2].International_Phone_Number[2]": "<%= %>",

<%# 21. E-Mail Address %>
"vba210304[0].#subform[2].EMAIL_ADDRESS[4]": "<%= form.data['witness_email']&.[](0..19) %>",
"vba210304[0].#subform[2].EMAIL_ADDRESS[5]": "<%= form.data['witness_email']&.[](20..39) %>",

<%# Section 5: Certification of Statement and Signature %>

<%# 22B. Date Signed %>
"vba210304[0].#subform[2].Year[5]": "<%= Time.current.in_time_zone('America/Chicago').strftime('%Y') %>",
"vba210304[0].#subform[2].Month[5]": "<%= Time.current.in_time_zone('America/Chicago').strftime('%m') %>",
"vba210304[0].#subform[2].Day[5]": "<%= Time.current.in_time_zone('America/Chicago').strftime('%d') %>"
}
6 changes: 3 additions & 3 deletions modules/simple_forms_api/app/models/simple_forms_api/vba_21_10210.rb
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Expand Up @@ -34,19 +34,19 @@ def words_to_remove
end

def desired_stamps
[{ coords: [50, 160], text: data['statement_of_truth_signature'], page: 2 }]
[{ coords: [50, 195], text: data['statement_of_truth_signature'], page: 2 }]
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end

def submission_date_stamps(timestamp = Time.current)
[
{
coords: [460, 710],
coords: [452, 690],
text: 'Application Submitted:',
page: 0,
font_size: 12
},
{
coords: [460, 690],
coords: [452, 670],
text: timestamp.in_time_zone('UTC').strftime('%H:%M %Z %D'),
page: 0,
font_size: 12
Expand Down
5 changes: 3 additions & 2 deletions modules/simple_forms_api/spec/fixtures/form_json/vba_26_4555-min.json
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Expand Up @@ -24,5 +24,6 @@
},
"living_situation": {
"is_in_care_facility": false
}
}
},
"statement_of_truth_signature": "Veteran Surname"
}
3 changes: 2 additions & 1 deletion modules/simple_forms_api/spec/fixtures/form_json/vba_26_4555.json
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Expand Up @@ -59,5 +59,6 @@
"postal_code": "54890"
}
},
"remarks": "Lengthy remarks here \nabout what is needed\tand such"
"remarks": "Lengthy remarks here about what is needed and such",
"statement_of_truth_signature": "Veteran Surname"
}
25 changes: 21 additions & 4 deletions modules/simple_forms_api/spec/services/pdf_filler_spec.rb
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Expand Up @@ -5,8 +5,21 @@

describe SimpleFormsApi::PdfFiller do
forms = %w[
vba_26_4555 vba_26_4555-min vba_21_4138 vba_21_4138-min vba_21_4142 vba_21_4142-min vba_21_10210 vba_21_10210-min
vba_21p_0847 vba_21p_0847-min vba_21_0972 vba_21_0972-min vba_21_0966 vba_21_0966-min vba_40_0247 vba_40_0247
vba_21_0966
vba_21_0966-min
vba_21_0972
vba_21_0972-min
vba_21_10210
vba_21_10210-min
vba_21_4138
vba_21_4138-min
vba_21_4142
vba_21_4142-min
vba_21p_0847
vba_21p_0847-min
vba_26_4555
vba_26_4555-min
vba_40_0247
vba_40_0247-min
]

Expand Down Expand Up @@ -76,8 +89,12 @@
end

def read_form_mapping(form_number)
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test_file = File.read("modules/simple_forms_api/app/form_mappings/#{form_number}.json.erb")
JSON.parse(test_file)
form_name = form_number.gsub('-min', '')
data = JSON.parse(File.read("modules/simple_forms_api/spec/fixtures/form_json/#{form_name}.json"))
form = "SimpleFormsApi::#{form_number.titleize.gsub(' ', '')}".constantize.new(data) # Used in ERB binding
erb_content = File.read("modules/simple_forms_api/app/form_mappings/#{form_number}.json.erb")
rendered_erb = ERB.new(erb_content).result(binding) # Rendering as ERB strips out comments
JSON.parse(rendered_erb)
end
end
end
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