Submission Page Fields - MVP_d511a81ed8754ada8acf0a48683c0a71-100821-1955-282

Family Reunification Task Force Travel Questionnaire and Website Application

Submission Page Fields - MVP_d511a81ed8754ada8acf0a48683c0a71-100821-1955-282

OMB: 1601-0031

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Submission Page Fields - MVP
Epic - SDDFRTF1

#

1

Field Name

Preparer First,
Middle, Last Name

Type

Text
Input

Required

no

Completed
By

Validation
Required

Preparer

Trigger
For
Manual
Review
no

Field Discussion Notes

Additional Checkbox for N/A?
Only English alphabet allowed (no accents)
Legal Name

2

Preparer Email

Text
Input

no

Preparer

Valid Email
address

no

Email or Phone Required

3

Preparer Phone
Number

Text
Input

no

Preparer

Valid Phone
Number

no

Email or Phone Required | US or International phone numbers allowed

4

Preparer
Relationship to
Applicant

Dropdown conditional

Preparer

Pre-approved list no

5

Preparer Legal
Agreement

Checkbox conditional

Preparer

Required

N/A

6

Applicant First,
Middle, Last

Text
Input

Applicant
/Preparer
/Attorney
/Advocate

Required

no

yes

Only English alphabet allowed (no accents)
Legal Name

7

Applicant AKA
/Nickname

Text
Input

no

Applicant
/Preparer
/Attorney
/Advocate

Optional

no

8

Applicant preferred
language

Dropdown no

Applicant
/Preparer
/Attorney
/Advocate

No

no

English/Spanish/Portuguese/K'iche/M'ame

9

Applicant A#

Text
Input

conditional

Applicant
/Preparer
/Attorney
/Advocate

A# Format
Requirements
(CIS to provide)

yes

Site language to instruct users on importance of including A#

10

Applicant Date of
Birth

Date
Input

yes

Applicant
/Preparer
/Attorney
/Advocate

Date Mask

no

11

Applicant
Relationship to Child

Dropdown yes

Applicant
/Preparer
/Attorney
/Advocate

Pre-approved list no

12

Applicant in Contact
with Child

Boolean
Input

no

Applicant
/Preparer
/Attorney
/Advocate

if relationship =
Parent

13

Applicant knows
Child Location

Boolean
Input

no

14

Applicant Physical
Address

Text
Input

15

no

Assistance Locating Child

Applicant
/Preparer
/Attorney
/Advocate

no

Assistance Locating Child

yes

Applicant
/Preparer
/Attorney
/Advocate

no

Full address?

Applicant Country of
Citizenship

Dropdown yes

Applicant
/Preparer
/Attorney
/Advocate

Pre-approved list no

16

Applicant County of
Birth

Dropdown yes

Applicant
/Preparer
/Attorney
/Advocate

Pre-approved list no

17

Applicant Email
Address

Text
Input

conditional

Applicant
/Preparer
/Attorney
/Advocate

Valid Email
address

no

Email or Phone Required

18

Applicant Phone
Number

Text
Input

conditional

Applicant
/Preparer
/Attorney
/Advocate

Valid Phone
Number

no

Email or Phone Required | US or International phone numbers allowed

19

Applicant SMS
consent

Checkbox no

N/A

Active agreement?

Applicant
/Preparer
/Attorney
/Advocate

20

Applicant Question
Date Range

Date
Range

yes

Applicant
/Preparer
/Attorney
/Advocate

Automated
validation based
on known range

yes

When the Separation happened - Qualifying questions?

21

Applicant Parent
/Guardian Question

Y/N

conditional

Applicant
/Preparer
/Attorney
/Advocate

depends on #11

yes

When the Separation happened - Qualifying questions

22

Applicant Last
Known Location of
Child - Country

Dropdown no

Applicant
/Preparer
/Attorney
/Advocate

no

Assistance Locating Child

23

Child A#

Text
Input

conditional

Applicant
/Preparer
/Attorney
/Advocate

A# Format
Requirements
(CIS to provide)

yes

24

Child Date of Birth

Date
Input

yes

Applicant
/Preparer
/Attorney
/Advocate

Date Mask

no

25

Child First, Middle,
Last Name

Text
Input

yes

Applicant
/Preparer
/Attorney
/Advocate

26

Child AKA/Nickname Text
Input

no

Applicant
/Preparer
/Attorney
/Advocate

Optional

27

Child Country of
Birth

Dropdown yes

Applicant
/Preparer
/Attorney
/Advocate

Pre-approved list no

28

Child Country of
Citizenship

Dropdown yes

Applicant
/Preparer
/Attorney
/Advocate

Pre-approved list no

29

Ability to Add
Another Child

Add
Form
Button

Applicant
/Preparer
/Attorney
/Advocate

No

no

Legal Name

no

yes

Ask the question "is there another child from whom you are separated?"
first or just have a section for "Add Another Child" with a way to add
another child's name (First, Last, MI), A#, DOB, etc. ?
Do we need to ask the "Assistance in locating separated child" questions
for each child on the form?

30

Attorney/Advocate
First, Middle, Last

Text
Input

no

Preparer
/Attorney
/Advocate

no

Additional Checkbox for N/A?

31

Attorney/Advocate
Company

Text
Input

no

Preparer
/Attorney
/Advocate

no

32

Attorney/Advocate
Address

Text
Input

no

Preparer
/Attorney
/Advocate

no

33

Attorney/Advocate
State/Province

Dropdown no

Preparer
/Attorney
/Advocate

no

34

Attorney/Advocate
City/Town

Text
Input

no

Preparer
/Attorney
/Advocate

no

35

Attorney/Advocate
Country

Dropdown no

Preparer
/Attorney
/Advocate

Pre-approved list no

36

Attorney/Advocate
Email

Text
Input

conditional

Preparer
/Attorney
/Advocate

Valid Email
address

no

Email or Phone Required

37

Attorney/Advocate
Phone

Text
Input

conditional

Preparer
/Attorney
/Advocate

Valid Phone
Number

no

Email or Phone Required | US or International phone numbers allowed

38

Attorney/Advocate
Legal Disclaimer

Checkbox conditional

Preparer
/Attorney
/Advocate

Required If
Attorney present

N/A

39

Attorney/Advocate
G-28 on File

Checkbox conditional

Preparer
/Attorney
/Advocate

Required If
Attorney present

yes?

Add Link to Filing your G-28

40

Who Best to
Contact

Form

yes

Applicant
/Preparer
/Attorney
/Advocate

no

Main contact who IOM will reach out to

41

Best to Contact
Legal Agreement

Checkbox yes

Applicant
/Preparer
/Attorney
/Advocate

N/A

42

Privacy Disclaimer

Checkbox yes

Applicant
/Preparer
/Attorney
/Advocate

Required

N/A


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