{
    "personalIdentification": {
      "ssn": "4437",
      "fileNumber": "4437",
      "fsrReason": ""
    },
    "personalData": {
      "veteranFullName": {
        "first": "Mark",
        "middle": "",
        "last": "Webb"
      },
      "address": {
        "addresslineOne": "1200 Park Ave",
        "addresslineTwo": "c/o Pixar",
        "addresslineThree": "",
        "city": "Emeryville",
        "stateOrProvince": "CA",
        "zipOrPostalCode": "94608",
        "countryName": "US"
      },
      "telephoneNumber": "(510) 922-4444",
      "dateOfBirth": "10/04/1950",
      "married": false,
      "spouseFullName": {
        "first": "",
        "middle": "",
        "last": ""
      },
      "agesOfOtherDependents": [
        "12"
      ],
      "employmentHistory": [
        {
          "veteranOrSpouse": "VETERAN",
          "occupationName": "Full time",
          "from": "03/2020",
          "to": "",
          "present": true,
          "employerName": "Dan's Wizard Hole",
          "employerAddress": {
            "addresslineOne": "",
            "addresslineTwo": "",
            "addresslineThree": "",
            "city": "",
            "stateOrProvince": "",
            "zipOrPostalCode": "",
            "countryName": ""
          }
        }
      ]
    },
    "income": [
      {
        "veteranOrSpouse": "VETERAN",
        "monthlyGrossSalary": "3313.00",
        "deductions": {
          "taxes": "853.50",
          "retirement": "0.00",
          "socialSecurity": "0.00",
          "otherDeductions": {
            "name": "",
            "amount": "0.00"
          }
        },
        "totalDeductions": "853.50",
        "netTakeHomePay": "2459.50",
        "otherIncome": {
          "name": "",
          "amount": "0.00"
        },
        "totalMonthlyNetIncome": "2459.50"
      },
      {
        "veteranOrSpouse": "SPOUSE",
        "monthlyGrossSalary": "0.00",
        "deductions": {
          "taxes": "0.00",
          "retirement": "0.00",
          "socialSecurity": "0.00",
          "otherDeductions": {
            "name": "",
            "amount": "0.00"
          }
        },
        "totalDeductions": "0.00",
        "netTakeHomePay": "0.00",
        "otherIncome": {
          "name": "",
          "amount": "0.00"
        },
        "totalMonthlyNetIncome": "0.00"
      }
    ],
    "expenses": {
      "rentOrMortgage": "0.00",
      "food": "0.00",
      "utilities": "0.00",
      "otherLivingExpenses": {
        "name": "",
        "amount": "0.00"
      },
      "expensesInstallmentContractsAndOtherDebts": "0.00",
      "totalMonthlyExpenses": "0.00"
    },
    "discretionaryIncome": {
      "netMonthlyIncomeLessExpenses": "2459.50",
      "amountCanBePaidTowardDebt": "0.00"
    },
    "assets": {
      "cashInBank": "500.00",
      "cashOnHand": "0.00",
      "usSavingsBonds": "0.00",
      "stocksAndOtherBonds": "0.00",
      "realEstateOwned": "0.00",
      "totalAssets": "500.00"
    },
    "installmentContractsAndOtherDebts": [],
    "totalOfInstallmentContractsAndOtherDebts": {
      "originalAmount": "0.00",
      "unpaidBalance": "0.00",
      "amountDueMonthly": "0.00",
      "amountPastDue": "0.00"
    },
    "additionalData": {
      "bankruptcy": {}
    },
    "applicantCertifications": {
      "veteranSignature": "Mark  Webb",
      "veteranDateSigned": "07/25/2023"
    },
    "selectedDebtsAndCopays": [
      {
        "id": "3fa85f64-5717-4562-b3fc-2c963f66afa6",
        "pSSeqNum": "1.00",
        "pSTotSeqNum": "1.00",
        "pSFacilityNum": "757",
        "pSFacPhoneNum": null,
        "pSTotStatement": "3.00",
        "pSStatementVal": "0000037953E",
        "pSStatementDate": "05242023",
        "pSStatementDateOutput": "05/24/2023",
        "pSProcessDate": "12102020",
        "pSProcessDateOutput": "12/10/2020",
        "pHPatientLstNme": "HHUFHYULSEHU",
        "pHPatientFstNme": "CDAA",
        "pHPatientMidNme": "A",
        "pHAddress1": "7780 RED MAPLE CT",
        "pHAddress2": null,
        "pHAddress3": null,
        "pHCity": "HUBER HEIGHTS",
        "pHState": "OH",
        "pHZipCde": "45424",
        "pHZipCdeOutput": "45424",
        "pHCtryNme": null,
        "pHAmtDue": "105.24",
        "pHAmtDueOutput": "105.24  ",
        "pHPrevBal": "103.21",
        "pHPrevBalOutput": "103.21  ",
        "pHTotCharges": "2.03",
        "pHTotChargesOutput": "2.03  ",
        "pHTotCredits": "0.00",
        "pHTotCreditsOutput": ".00  ",
        "pHNewBalance": "105.24",
        "pHNewBalanceOutput": "105.24  ",
        "pHSpecialNotes": null,
        "pHroParaCdes": "0125304050556065708085",
        "pHNumOfLines": "2.00",
        "pHDfnNumber": "197750.00",
        "pHCernerStatementNumber": "0.00",
        "pHCernerPatientId": "                ",
        "pHCernerAccountNumber": "                ",
        "pHIcnNumber": "                 ",
        "pHAccountNumber": "7570000000197750.00",
        "pHLargeFontIndcator": "0.00",
        "details": [
          {
            "pDDatePosted": null,
            "pDDatePostedOutput": "",
            "pDTransDesc": "INTEREST/ADM. CHARGE (Int:0.10 Adm:1.93 Other:0.00",
            "pDTransDescOutput": "INTEREST/ADM. CHARGE (Int:0.10 Adm:1.93 Other:0.00",
            "pDTransAmt": "2.03",
            "pDTransAmtOutput": "2.03  ",
            "pDRefNo": null
          },
          {
            "pDDatePosted": null,
            "pDDatePostedOutput": "",
            "pDTransDesc": "Please refer to previous statement of rights.",
            "pDTransDescOutput": "   Please refer to previous statement of rights.",
            "pDTransAmt": "0.00",
            "pDTransAmtOutput": ".00  ",
            "pDRefNo": null
          }
        ],
        "station": {
          "facilitYNum": "757",
          "visNNum": "10",
          "facilitYDesc": "CHALMERS P WYLIE VA ACC (757)",
          "cyclENum": "004",
          "remiTToFlag": "L",
          "maiLInsertFlag": "0",
          "staTAddress1": "420 N JAMES RD",
          "staTAddress2": null,
          "staTAddress3": null,
          "city": "Columbus",
          "state": "OH",
          "ziPCde": "432191834",
          "ziPCdeOutput": "43219-1834",
          "baRCde": "*432191834203*",
          "teLNumFlag": "S",
          "teLNum": "1-866-812-0318",
          "teLNum2": null,
          "contacTInfo": null,
          "dM2TelNum": null,
          "contacTInfo2": null,
          "toPTelNum": null,
          "lbXFedexAddress1": null,
          "lbXFedexAddress2": null,
          "lbXFedexAddress3": null,
          "lbXFedexCity": null,
          "lbXFedexState": null,
          "lbXFedexZipCde": null,
          "lbXFedexBarCde": null,
          "lbXFedexContact": null,
          "lbXFedexContactTelNum": null,
          "facilityName": "Chalmers P. Wylie Veterans Outpatient Clinic"
        },
        "debtType": "COPAY"
      }
    ],
    "streamlined": {
      "value": true,
      "type": "short"
    }
  }