[
{
"timestamp": "2026-05-07T22:47:27.423Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addPage",
"id": "page-application-signature",
"title": "Application Information and Signature"
},
{
"kind": "addPage",
"id": "page-household-info",
"title": "Household Information"
},
{
"kind": "addPage",
"id": "page-employment-income",
"title": "Employment and Income"
},
{
"kind": "addPage",
"id": "page-resources-assets",
"title": "Resources and Assets"
},
{
"kind": "addPage",
"id": "page-housing-shelter",
"title": "Housing and Shelter Costs"
},
{
"kind": "addPage",
"id": "page-medical-expenses",
"title": "Medical and Dependent Care Expenses"
},
{
"kind": "addPage",
"id": "page-student-work",
"title": "Student and Work Requirements"
},
{
"kind": "addPage",
"id": "page-authorized-rep",
"title": "Authorized Representative"
},
{
"kind": "addPage",
"id": "page-rights-responsibilities",
"title": "Rights and Responsibilities"
}
],
"explanation": "Add pages"
},
{
"timestamp": "2026-05-07T22:47:27.465Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addGroup",
"pageId": "page-application-signature",
"title": "Application Information and Signature"
},
{
"kind": "addGroup",
"pageId": "page-household-info",
"title": "Household Information"
},
{
"kind": "addGroup",
"pageId": "page-employment-income",
"title": "Employment and Income"
},
{
"kind": "addGroup",
"pageId": "page-resources-assets",
"title": "Resources and Assets"
},
{
"kind": "addGroup",
"pageId": "page-housing-shelter",
"title": "Housing and Shelter Costs"
},
{
"kind": "addGroup",
"pageId": "page-medical-expenses",
"title": "Medical and Dependent Care Expenses"
},
{
"kind": "addGroup",
"pageId": "page-student-work",
"title": "Student and Work Requirements"
},
{
"kind": "addGroup",
"pageId": "page-authorized-rep",
"title": "Authorized Representative"
},
{
"kind": "addGroup",
"pageId": "page-rights-responsibilities",
"title": "Rights and Responsibilities"
}
],
"explanation": "Add groups"
},
{
"timestamp": "2026-05-07T22:47:44.354Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "application-date",
"groupId": "group-new-192f8be6",
"label": "Application Date",
"fieldType": "date",
"required": true,
"helpText": "The date this application is being submitted"
},
{
"kind": "addField",
"id": "perjury-certification",
"groupId": "group-new-192f8be6",
"label": "I certify under penalty of perjury that all information provided in this application is true and complete to the best of my knowledge",
"fieldType": "boolean",
"required": true,
"control": "checkbox"
},
{
"kind": "addField",
"id": "benefit-use-understanding",
"groupId": "group-new-192f8be6",
"label": "I understand that I must use FoodShare benefits only to purchase eligible food for my household",
"fieldType": "boolean",
"required": true,
"control": "checkbox"
},
{
"kind": "addField",
"id": "false-info-understanding",
"groupId": "group-new-192f8be6",
"label": "I understand that providing false information is subject to prosecution under state and federal law",
"fieldType": "boolean",
"required": true,
"control": "checkbox"
},
{
"kind": "addField",
"id": "rights-responsibilities-ack",
"groupId": "group-new-192f8be6",
"label": "I acknowledge that I have received and understand my rights and responsibilities under the FoodShare program",
"fieldType": "boolean",
"required": true,
"control": "checkbox"
},
{
"kind": "addField",
"id": "verification-authorization",
"groupId": "group-new-192f8be6",
"label": "I authorize the State agency to verify the information I have provided through collateral contacts, computer matches, and other means permitted by law",
"fieldType": "boolean",
"required": true,
"control": "checkbox"
},
{
"kind": "addField",
"id": "applicant-printed-name",
"groupId": "group-new-192f8be6",
"label": "Applicant Full Name (Print)",
"fieldType": "text",
"required": true,
"helpText": "Print the full name of the person signing this application"
},
{
"kind": "addField",
"id": "applicant-signature",
"groupId": "group-new-192f8be6",
"label": "Applicant Signature",
"fieldType": "text",
"required": true,
"helpText": "Digital signature of the applicant or authorized representative. By typing your name here, you are providing your electronic signature."
},
{
"kind": "addField",
"id": "signature-date",
"groupId": "group-new-192f8be6",
"label": "Signature Date",
"fieldType": "date",
"required": true,
"helpText": "Date the application was signed"
},
{
"kind": "addField",
"id": "is-authorized-rep",
"groupId": "group-new-192f8be6",
"label": "Is this application being signed by an authorized representative on behalf of the household?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "auth-rep-name",
"groupId": "group-new-192f8be6",
"label": "Authorized Representative Name",
"fieldType": "text",
"required": false,
"helpText": "Full name of the authorized representative if different from applicant"
},
{
"kind": "addField",
"id": "auth-rep-relationship",
"groupId": "group-new-192f8be6",
"label": "Relationship to Household",
"fieldType": "text",
"required": false,
"helpText": "How is the authorized representative related to or connected to the household?"
},
{
"kind": "addField",
"id": "auth-documentation",
"groupId": "group-new-192f8be6",
"label": "Authorization Documentation",
"fieldType": "longText",
"required": false,
"helpText": "Describe the documentation provided establishing authority to act for the household (signed statement, power of attorney, court documentation, etc.)"
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:48:06.277Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "household-name",
"groupId": "group-new-d2a399b5",
"label": "Household Name",
"fieldType": "text",
"required": true,
"helpText": "Primary name for this household application"
},
{
"kind": "addField",
"id": "street-address",
"groupId": "group-new-d2a399b5",
"label": "Street Address",
"fieldType": "text",
"required": true,
"helpText": "Street address where the household resides"
},
{
"kind": "addField",
"id": "city",
"groupId": "group-new-d2a399b5",
"label": "City",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "state",
"groupId": "group-new-d2a399b5",
"label": "State",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "zip-code",
"groupId": "group-new-d2a399b5",
"label": "ZIP Code",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "county",
"groupId": "group-new-d2a399b5",
"label": "County",
"fieldType": "text",
"required": true,
"helpText": "County where the household resides"
},
{
"kind": "addField",
"id": "phone-number",
"groupId": "group-new-d2a399b5",
"label": "Phone Number",
"fieldType": "phone",
"required": false,
"helpText": "Primary contact phone number for the household"
},
{
"kind": "addField",
"id": "email-address",
"groupId": "group-new-d2a399b5",
"label": "Email Address",
"fieldType": "email",
"required": false,
"helpText": "Email address for household communications"
},
{
"kind": "addField",
"id": "household-size",
"groupId": "group-new-d2a399b5",
"label": "Total Number of People in Household",
"fieldType": "number",
"required": true,
"helpText": "Total number of people who live together and purchase and prepare meals together"
},
{
"kind": "addField",
"id": "has-elderly",
"groupId": "group-new-d2a399b5",
"label": "Is anyone in the household 60 years of age or older?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "has-disabled",
"groupId": "group-new-d2a399b5",
"label": "Is anyone in the household disabled?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "Includes anyone receiving disability benefits or unable to work due to disability"
},
{
"kind": "addField",
"id": "has-different-mailing",
"groupId": "group-new-d2a399b5",
"label": "Does the household have a current mailing address different from the home address?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "mailing-address",
"groupId": "group-new-d2a399b5",
"label": "Mailing Address (if different)",
"fieldType": "longText",
"required": false,
"helpText": "Complete mailing address if different from home address"
},
{
"kind": "addField",
"id": "monthly-gross-income",
"groupId": "group-new-d2a399b5",
"label": "Monthly Gross Income (before taxes and deductions)",
"fieldType": "currency",
"required": true,
"helpText": "Total monthly gross income for all household members from all sources"
},
{
"kind": "addField",
"id": "liquid-resources",
"groupId": "group-new-d2a399b5",
"label": "Cash on hand, checking and savings accounts",
"fieldType": "currency",
"required": true,
"helpText": "Total liquid resources available to the household"
},
{
"kind": "setFieldSensitivity",
"id": "household-name",
"level": "pii"
},
{
"kind": "setFieldSensitivity",
"id": "street-address",
"level": "pii"
},
{
"kind": "setFieldSensitivity",
"id": "phone-number",
"level": "pii"
},
{
"kind": "setFieldSensitivity",
"id": "email-address",
"level": "pii"
},
{
"kind": "setFieldSensitivity",
"id": "mailing-address",
"level": "pii"
},
{
"kind": "setFieldSensitivity",
"id": "monthly-gross-income",
"level": "high"
},
{
"kind": "setFieldSensitivity",
"id": "liquid-resources",
"level": "high"
},
{
"kind": "setFieldCondition",
"id": "mailing-address",
"condition": {
"field": "has-different-mailing",
"operator": "equals",
"value": true
}
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:48:28.534Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "currently-employed",
"groupId": "group-new-1c3a17f7",
"label": "Are you currently employed?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "job-title",
"groupId": "group-new-1c3a17f7",
"label": "What is your job title or type of work?",
"fieldType": "text",
"required": false
},
{
"kind": "addField",
"id": "employer-name",
"groupId": "group-new-1c3a17f7",
"label": "Employer name",
"fieldType": "text",
"required": false
},
{
"kind": "addField",
"id": "hours-per-week",
"groupId": "group-new-1c3a17f7",
"label": "How many hours per week do you work?",
"fieldType": "number",
"required": false,
"helpText": "Enter the average number of hours you work per week"
},
{
"kind": "addField",
"id": "gross-monthly-earned-income",
"groupId": "group-new-1c3a17f7",
"label": "What is your gross monthly income from employment? (before taxes and deductions)",
"fieldType": "currency",
"required": true,
"helpText": "Include wages, salaries, tips, and commissions before any deductions"
},
{
"kind": "addField",
"id": "self-employed",
"groupId": "group-new-1c3a17f7",
"label": "Are you self-employed?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "net-self-employment-income",
"groupId": "group-new-1c3a17f7",
"label": "What is your net monthly income from self-employment? (after allowable business expenses)",
"fieldType": "currency",
"required": false,
"helpText": "Enter your self-employment income after deducting allowable business expenses"
},
{
"kind": "addField",
"id": "receives-unemployment",
"groupId": "group-new-1c3a17f7",
"label": "Do you receive unemployment compensation?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "unemployment-amount",
"groupId": "group-new-1c3a17f7",
"label": "Monthly unemployment compensation amount",
"fieldType": "currency",
"required": false
},
{
"kind": "addField",
"id": "receives-social-security",
"groupId": "group-new-1c3a17f7",
"label": "Do you receive Social Security benefits?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "social-security-amount",
"groupId": "group-new-1c3a17f7",
"label": "Monthly Social Security benefits amount",
"fieldType": "currency",
"required": false
},
{
"kind": "addField",
"id": "receives-ssi",
"groupId": "group-new-1c3a17f7",
"label": "Do you receive SSI (Supplemental Security Income)?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "ssi-amount",
"groupId": "group-new-1c3a17f7",
"label": "Monthly SSI amount",
"fieldType": "currency",
"required": false
},
{
"kind": "addField",
"id": "receives-veterans-benefits",
"groupId": "group-new-1c3a17f7",
"label": "Do you receive veterans' benefits?",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "veterans-benefits-amount",
"groupId": "group-new-1c3a17f7",
"label": "Monthly veterans' benefits amount",
"fieldType": "currency",
"required": false
},
{
"kind": "addField",
"id": "receives-other-income",
"groupId": "group-new-1c3a17f7",
"label": "Do you receive any other income? (TANF, General Assistance, pensions, rental income, interest, dividends, child support, etc.)",
"fieldType": "boolean",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "other-income-details",
"groupId": "group-new-1c3a17f7",
"label": "List all other sources of income and monthly amounts",
"fieldType": "longText",
"required": false,
"helpText": "Please list each source of income and the monthly amount (e.g., TANF $200, Rental income $500, etc.)"
},
{
"kind": "addField",
"id": "total-monthly-gross-income",
"groupId": "group-new-1c3a17f7",
"label": "What is your total monthly gross income from all sources?",
"fieldType": "currency",
"required": true,
"helpText": "This is used for expedited service screening and benefit calculation"
}
],
"explanation": "Applied changes."
}
]
A digital services project by Flexion