[
{
"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."
},
{
"timestamp": "2026-05-07T22:48:45.887Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "cash-on-hand",
"groupId": "group-new-e5fd9e9d",
"label": "Total cash on hand (including money in checking and savings accounts)",
"fieldType": "currency",
"required": true,
"helpText": "Include cash, checking accounts, savings accounts, and any other liquid resources available to your household"
},
{
"kind": "addField",
"id": "investments",
"groupId": "group-new-e5fd9e9d",
"label": "Savings certificates, stocks, bonds, or other investments",
"fieldType": "currency",
"required": true,
"helpText": "Enter the current value of any savings certificates, stocks, bonds, or other investments"
},
{
"kind": "addField",
"id": "vehicle-value",
"groupId": "group-new-e5fd9e9d",
"label": "Value of vehicles owned (exclude one vehicle per adult household member)",
"fieldType": "currency",
"required": true,
"helpText": "Enter the fair market value minus any loans owed on vehicles that exceed the state exclusion limits"
},
{
"kind": "addField",
"id": "work-property",
"groupId": "group-new-e5fd9e9d",
"label": "Property used for work or self-employment",
"fieldType": "currency",
"required": true,
"helpText": "Enter the value of property, tools, or equipment essential to your employment or business"
},
{
"kind": "addField",
"id": "other-resources",
"groupId": "group-new-e5fd9e9d",
"label": "Other resources not listed above",
"fieldType": "currency",
"required": true,
"helpText": "Include any other countable resources such as land that is not your home, additional real estate, etc."
},
{
"kind": "addField",
"id": "owns-home",
"groupId": "group-new-e5fd9e9d",
"label": "Do you own your home?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "Your home and surrounding property are excluded from resource limits"
},
{
"kind": "addField",
"id": "lump-sum-received",
"groupId": "group-new-e5fd9e9d",
"label": "Have you received any lump-sum payments in the past 12 months?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "Include tax refunds, insurance settlements, retroactive Social Security or SSI payments, etc."
},
{
"kind": "addField",
"id": "lump-sum-details",
"groupId": "group-new-e5fd9e9d",
"label": "Describe the lump-sum payment(s) and amount(s)",
"fieldType": "longText",
"required": true,
"helpText": "Provide details about each lump-sum payment including source, amount, and date received"
},
{
"kind": "setFieldSensitivity",
"id": "cash-on-hand",
"level": "medium"
},
{
"kind": "setFieldSensitivity",
"id": "investments",
"level": "medium"
},
{
"kind": "setFieldSensitivity",
"id": "vehicle-value",
"level": "medium"
},
{
"kind": "setFieldSensitivity",
"id": "work-property",
"level": "medium"
},
{
"kind": "setFieldSensitivity",
"id": "other-resources",
"level": "medium"
},
{
"kind": "setFieldSensitivity",
"id": "lump-sum-details",
"level": "medium"
},
{
"kind": "setFieldCondition",
"id": "lump-sum-details",
"condition": {
"field": "lump-sum-received",
"operator": "equals",
"value": true
}
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:48:58.784Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "shelter-rent-mortgage",
"groupId": "group-new-cb66747f",
"label": "Monthly rent or mortgage payment",
"fieldType": "currency",
"required": true,
"helpText": "Enter the amount you pay each month for rent or mortgage payments. If you own your home free and clear, enter $0."
},
{
"kind": "addField",
"id": "shelter-property-taxes",
"groupId": "group-new-cb66747f",
"label": "Property taxes (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "If you pay property taxes, enter the monthly amount. If paid annually, divide by 12."
},
{
"kind": "addField",
"id": "shelter-insurance",
"groupId": "group-new-cb66747f",
"label": "Home insurance (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter monthly homeowner's or renter's insurance premium. If paid annually, divide by 12."
},
{
"kind": "addField",
"id": "shelter-condo-fees",
"groupId": "group-new-cb66747f",
"label": "Condominium or cooperative fees (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter monthly condo fees or cooperative housing fees, if applicable."
},
{
"kind": "addField",
"id": "utility-choice-method",
"groupId": "group-new-cb66747f",
"label": "Do you want to claim actual utility costs or use the standard utility allowance?",
"fieldType": "choice",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "utility-electricity",
"groupId": "group-new-cb66747f",
"label": "Electricity costs (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter your average monthly electricity bill. Only complete if claiming actual utility costs."
},
{
"kind": "addField",
"id": "utility-gas-heating",
"groupId": "group-new-cb66747f",
"label": "Gas/heating costs (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter your average monthly gas or heating bill. Only complete if claiming actual utility costs."
},
{
"kind": "addField",
"id": "utility-water-sewer",
"groupId": "group-new-cb66747f",
"label": "Water and sewer costs (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter your average monthly water and sewer bill. Only complete if claiming actual utility costs."
},
{
"kind": "addField",
"id": "utility-telephone",
"groupId": "group-new-cb66747f",
"label": "Telephone costs (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter your average monthly telephone bill (landline and/or cell phone). Only complete if claiming actual utility costs."
},
{
"kind": "addField",
"id": "utility-other",
"groupId": "group-new-cb66747f",
"label": "Other utility costs (monthly amount)",
"fieldType": "currency",
"required": false,
"helpText": "Enter any other utility costs such as trash collection, internet, or cable. Only complete if claiming actual utility costs."
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:49:10.223Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "has-medical-expenses",
"groupId": "group-new-a56f8163",
"label": "Do you or any household member have medical expenses that exceed $35 per month?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "Medical expenses include prescription drugs, medical supplies, health insurance premiums, and transportation to medical appointments. Only expenses for elderly (60+) or disabled members can be deducted."
},
{
"kind": "addField",
"id": "medical-expenses-amount",
"groupId": "group-new-a56f8163",
"label": "Monthly medical expenses amount (only amount over $35)",
"fieldType": "currency",
"required": false,
"helpText": "Enter only the portion of medical expenses that exceeds $35 per month. Include prescription drugs, medical supplies, health insurance premiums, and transportation to medical appointments for elderly or disabled members."
},
{
"kind": "addField",
"id": "has-dependent-care",
"groupId": "group-new-a56f8163",
"label": "Do you or any household member have dependent care costs?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "Dependent care costs include expenses for child care or care for disabled adults when necessary for a household member to work, seek employment, or attend training or education."
},
{
"kind": "addField",
"id": "dependent-care-amount",
"groupId": "group-new-a56f8163",
"label": "Monthly dependent care costs",
"fieldType": "currency",
"required": false,
"helpText": "Enter the actual monthly cost for dependent care when necessary for work, job training, or education. Include care for children or disabled adults."
},
{
"kind": "addField",
"id": "dependent-care-provider",
"groupId": "group-new-a56f8163",
"label": "Name of dependent care provider",
"fieldType": "text",
"required": false
},
{
"kind": "addField",
"id": "dependent-care-address",
"groupId": "group-new-a56f8163",
"label": "Dependent care provider address",
"fieldType": "text",
"required": false
},
{
"kind": "addField",
"id": "dependent-care-recipient",
"groupId": "group-new-a56f8163",
"label": "Who receives the dependent care?",
"fieldType": "text",
"required": false,
"helpText": "Name of the household member(s) who receive dependent care services."
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:49:30.922Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "student-status",
"groupId": "group-new-f5847b49",
"label": "Are you currently enrolled at least half-time in a college, university, trade school, or vocational school?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "This includes any institution that normally requires a high school diploma for enrollment"
},
{
"kind": "addField",
"id": "school-name",
"groupId": "group-new-f5847b49",
"label": "Name of school or institution",
"fieldType": "text",
"required": false
},
{
"kind": "addField",
"id": "student-age-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you under 18 or over 50 years old?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "student-work-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you employed at least 20 hours per week or self-employed with weekly earnings equal to 20 times the federal minimum wage?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "student-disability-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you physically or mentally unfit for employment?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "student-parent-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you a single parent enrolled full-time and caring for a dependent child under 12?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "abawd-status",
"groupId": "group-new-f5847b49",
"label": "Are you between 18 and 50 years old without dependents?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "Able-bodied adults without dependents (ABAWD) have special work requirements"
},
{
"kind": "addField",
"id": "work-hours-weekly",
"groupId": "group-new-f5847b49",
"label": "How many hours per week do you currently work?",
"fieldType": "number",
"required": false
},
{
"kind": "addField",
"id": "work-program-participation",
"groupId": "group-new-f5847b49",
"label": "Are you participating in a qualifying work or training program?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "program-hours-weekly",
"groupId": "group-new-f5847b49",
"label": "How many hours per week do you participate in work or training programs?",
"fieldType": "number",
"required": false
},
{
"kind": "addField",
"id": "work-disability-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you physically or mentally unfit for employment?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "caregiver-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you caring for a dependent child under 6 or an incapacitated person?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "addField",
"id": "unemployment-exempt",
"groupId": "group-new-f5847b49",
"label": "Are you receiving unemployment compensation?",
"fieldType": "boolean",
"required": false,
"control": "radio"
},
{
"kind": "setFieldCondition",
"id": "school-name",
"condition": {
"field": "student-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "student-age-exempt",
"condition": {
"field": "student-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "student-work-exempt",
"condition": {
"field": "student-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "student-disability-exempt",
"condition": {
"field": "student-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "student-parent-exempt",
"condition": {
"field": "student-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "work-hours-weekly",
"condition": {
"field": "abawd-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "work-program-participation",
"condition": {
"field": "abawd-status",
"operator": "equals",
"value": true
}
},
{
"kind": "setFieldCondition",
"id": "program-hours-weekly",
"condition": {
"field": "work-program-participation",
"operator": "equals",
"value": true
}
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:49:44.437Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "has-authorized-rep",
"groupId": "group-new-fd543e9e",
"label": "Do you want to designate someone to act on your behalf for this application?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "An authorized representative can help you complete this application, attend interviews, and receive benefits on your behalf."
},
{
"kind": "addField",
"id": "auth-rep-name",
"groupId": "group-new-fd543e9e",
"label": "Full name of authorized representative",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "auth-rep-relationship",
"groupId": "group-new-fd543e9e",
"label": "Relationship to household",
"fieldType": "text",
"required": true,
"helpText": "For example: spouse, adult child, social worker, legal guardian, etc."
},
{
"kind": "addField",
"id": "auth-rep-address",
"groupId": "group-new-fd543e9e",
"label": "Street address",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "auth-rep-city",
"groupId": "group-new-fd543e9e",
"label": "City",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "auth-rep-state",
"groupId": "group-new-fd543e9e",
"label": "State",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "auth-rep-zip",
"groupId": "group-new-fd543e9e",
"label": "ZIP code",
"fieldType": "text",
"required": true
},
{
"kind": "addField",
"id": "auth-rep-phone",
"groupId": "group-new-fd543e9e",
"label": "Phone number",
"fieldType": "phone",
"required": true
},
{
"kind": "addField",
"id": "auth-rep-email",
"groupId": "group-new-fd543e9e",
"label": "Email address (optional)",
"fieldType": "email",
"required": false
},
{
"kind": "addField",
"id": "auth-rep-authority",
"groupId": "group-new-fd543e9e",
"label": "What authority does this person have to act on your behalf?",
"fieldType": "choice",
"required": true,
"control": "radio"
},
{
"kind": "addField",
"id": "auth-rep-only-contact",
"groupId": "group-new-fd543e9e",
"label": "Send all communications to authorized representative only",
"fieldType": "boolean",
"required": false,
"control": "checkbox",
"helpText": "By default, we will send notices to both you and your authorized representative. Check this box if you want us to communicate only with your representative."
}
],
"explanation": "Applied changes."
},
{
"timestamp": "2026-05-07T22:50:03.120Z",
"authorCommit": "",
"source": "llm",
"commands": [
{
"kind": "addField",
"id": "field-rights-acknowledgment",
"groupId": "group-new-dd5d95ee",
"label": "I understand my rights and responsibilities under the SNAP program",
"fieldType": "boolean",
"required": true,
"control": "checkbox",
"helpText": "By checking this box, you acknowledge that you have received and understand the written notice of your rights and responsibilities under the SNAP program, including your right to apply for benefits, receive expedited service if eligible, request a fair hearing, and your responsibilities to provide accurate information and report changes."
},
{
"kind": "addField",
"id": "field-perjury-certification",
"groupId": "group-new-dd5d95ee",
"label": "I certify under penalty of perjury that the information provided in this application is true and complete to the best of my knowledge",
"fieldType": "boolean",
"required": true,
"control": "checkbox",
"helpText": "This certification is required by federal law. Providing false information may result in prosecution under state and federal law."
},
{
"kind": "addField",
"id": "field-benefit-use-understanding",
"groupId": "group-new-dd5d95ee",
"label": "I understand that I will use SNAP benefits only to purchase eligible food items for my household",
"fieldType": "boolean",
"required": true,
"control": "checkbox",
"helpText": "SNAP benefits can only be used to purchase eligible food items. Misuse of benefits may result in disqualification and prosecution."
},
{
"kind": "addField",
"id": "field-verification-authorization",
"groupId": "group-new-dd5d95ee",
"label": "I authorize the state agency to verify the information I have provided through computer matches, contacts with employers, and other verification methods allowed by law",
"fieldType": "boolean",
"required": true,
"control": "checkbox",
"helpText": "The state agency is required to verify eligibility information through various means including computer matching and collateral contacts."
},
{
"kind": "addField",
"id": "field-authorized-rep-designation",
"groupId": "group-new-dd5d95ee",
"label": "Do you want to designate an authorized representative to act on your behalf for this SNAP application?",
"fieldType": "boolean",
"required": true,
"control": "radio",
"helpText": "An authorized representative can complete your application, participate in interviews, and receive communications on your behalf."
},
{
"kind": "addField",
"id": "field-auth-rep-name",
"groupId": "group-new-dd5d95ee",
"label": "Authorized Representative's Full Name",
"fieldType": "text",
"required": false
},
{
"kind": "addField",
"id": "field-auth-rep-address",
"groupId": "group-new-dd5d95ee",
"label": "Authorized Representative's Address",
"fieldType": "longText",
"required": false
},
{
"kind": "addField",
"id": "field-auth-rep-phone",
"groupId": "group-new-dd5d95ee",
"label": "Authorized Representative's Phone Number",
"fieldType": "phone",
"required": false
},
{
"kind": "addField",
"id": "field-auth-rep-relationship",
"groupId": "group-new-dd5d95ee",
"label": "Relationship of Authorized Representative to Household",
"fieldType": "text",
"required": false,
"helpText": "Describe how the authorized representative is related to you or your household (e.g., family member, friend, organization, etc.)"
},
{
"kind": "addField",
"id": "field-applicant-signature",
"groupId": "group-new-dd5d95ee",
"label": "Applicant/Household Member Signature",
"fieldType": "text",
"required": true,
"helpText": "Type your full name to serve as your electronic signature. By signing, you attest under penalty of perjury that all information provided is true and complete."
},
{
"kind": "addField",
"id": "field-signature-date",
"groupId": "group-new-dd5d95ee",
"label": "Date of Signature",
"fieldType": "date",
"required": true
}
],
"explanation": "Applied changes."
}
]
A digital services project by Flexion