2025 VA APPLICATION FOR HEALTH BENEFITS

{
  "id": "atm_form_dd87d638b369f8467051",
  "kind": "Form",
  "name": "2025 VA APPLICATION FOR HEALTH BENEFITS",
  "parent_id": null,
  "depth": null,
  "facts": {
    "url": "https://marincounty.jotform.com/submit/250144699612965",
    "host": "marincounty.jotform.com",
    "fields": [
      "formID",
      "jsExecutionTracker",
      "submitSource",
      "submitDate",
      "buildDate",
      "uploadServerUrl",
      "eventObserver",
      "q213_typeOf[]",
      "q145_contactEmail",
      "q7_veteransName7",
      "q8_preferredName",
      "q9_mothersMaiden",
      "q101_birthSex",
      "q193_selfidentifiedGender",
      "q103_areYou",
      "q105_name105[]",
      "q12_socialSecurity12",
      "q232_dateOf232[month]",
      "q232_dateOf232[day]",
      "q232_dateOf232[year]",
      "q14_dateOf[month]",
      "q14_dateOf[day]",
      "q14_dateOf[year]",
      "q15_placeOf",
      "q233_preferredLanguage",
      "q16_religion",
      "q111_mailingAddress",
      "q112_city112",
      "q113_state113",
      "q114_zipCode",
      "q115_county",
      "q210_homeTelephone210[full]",
      "q211_mobileTelephone211[full]",
      "q20_eMail",
      "q212_isHome",
      "q106_homeAddress",
      "q107_city",
      "q108_state",
      "q109_zipCode109",
      "q110_county110",
      "q118_currentMarital",
      "q24_nextOf",
      "q25_nextOf25",
      "q26_nextOf26",
      "q214_nextOf214[full]",
      "q234_emergencyContact",
      "q215_emergencyContact215[full]",
      "q33_designeeIndividual",
      "q35_whichVa",
      "q122_wouldYou",
      "q38_lastBranch",
      "q238_lastEntry238[month]",
      "q238_lastEntry238[day]",
      "q238_lastEntry238[year]",
      "q39_lastEntry[month]",
      "q39_lastEntry[day]",
      "q39_lastEntry[year]",
      "q239_futureDischarge239[month]",
      "q239_futureDischarge239[day]",
      "q239_futureDischarge239[year]",
      "q40_futureDischarge[month]",
      "q40_futureDischarge[day]",
      "q40_futureDischarge[year]",
      "q240_lastDischarge240[month]",
      "q240_lastDischarge240[day]",
      "q240_lastDischarge240[year]",
      "q41_lastDischarge[month]",
      "q41_lastDischarge[day]",
      "q41_lastDischarge[year]",
      "q42_dischargeType",
      "q43_militaryService",
      "q123_areYou123",
      "q124_areYou124",
      "q125_didYou",
      "q126_wereYou",
      "q128_didYou128",
      "q129_doYou129",
      "q217_whatIs",
      "q131_didYou131",
      "q259_didYou259"
    ],
    "on_page": "https://marincounty.jotform.com/250144699612965",
    "form_kind": "web form"
  },
  "source_id": "src_5ad3cc6df1d1e72a55ad",
  "updated_at": "2026-10-14T01:42:18.475Z",
  "type": "Feature",
  "geometry": null,
  "links": {
    "self": "https://miscsubjects.com/atlas/atoms/atm_form_dd87d638b369f8467051",
    "children": "https://miscsubjects.com/atlas/atoms/atm_form_dd87d638b369f8467051/children",
    "descendants": "https://miscsubjects.com/atlas/atoms/atm_form_dd87d638b369f8467051/descendants",
    "inside": "https://miscsubjects.com/atlas/atoms/atm_form_dd87d638b369f8467051/inside",
    "graph": "https://miscsubjects.com/atlas/graph?start=atm_form_dd87d638b369f8467051"
  },
  "ancestors": [],
  "children_by_kind": [],
  "edges_out": [],
  "edges_in": [
    {
      "rel": "publishes",
      "id": "atm_site_aba32fd1beb400a959b2",
      "kind": "Website",
      "name": "MCFL-Sr-Exemptions-Application-2026-2027",
      "share": null
    }
  ],
  "edges_in_total": 1,
  "external_ids": [],
  "source": {
    "id": "src_5ad3cc6df1d1e72a55ad",
    "url": null,
    "license": "public web pages, robots.txt honoured",
    "read_at": "2026-10-13T23:21:09.844Z",
    "sha256": "208b3244e04e88f503da63917fd963b3f4f5a70528be355db4d5f625a8a28164"
  },
  "observations": [],
  "edges_out_total": 0
}