| (Individual) Work City (Individual) Work State (Individual) Work Street Address (Individual) Work Street Address (additional) (Individual) Work Zip A Number Access to a Car Active Directory GUID Additional City Additional Contact Notes Additional Contact Type Additional First Name Additional Last Name Additional Middle Name Additional Phone Additional Phone 2 Additional Phone 2 Note Additional Phone Note Additional State Additional Street Address Additional Street Address 2 Additional Suffix Additional Title Additional Zip Adjusted Monthly Income Adjusted Percentage of Poverty Adverse Party Conflict Status Age at Intake Annual Adjusted Income Approximate DOB ARDC Last Checked Date ARDC Licensed Attention/Care Of Attn line Availability to meet during the day Bar Number Best time to call? Bind Work Address to Non-Primary Organization Address ID Bind Work Address to Organization Case Contact Case Status Case Type Cell Phone # Safe? Chronically homeless? Citizenship City Citizenship Status Citizenship Verified City City Of Birth Client Conflict Status | Country Issuing Passport Country Issuing Passport (2) Country Of Birth Country of Citizenship Country of Origin Country Of Residence County County of Dispute Creating Process CUA Organization Current Living Situation Current Placement Status Current Placement Status of the Child Date File Opened Date Graduated Date of Birth Date of Current Removal / Re-entry Date of Enrollment Date of Initial Petition Date of Initial Removal Date Passport Expires Date Passport Expires (2) Date Passport Issued Date Passport Issued (2) Date Visa Issued DHS Number Disabled DOB Status Does Applicant pay child support payments? Does caller live in the service area? (Even though the dispute is outside the service area) Domestic Violence Present? Driver's License Drivers License Number Duplicate Status Elderly? Email Employer Employment Status Ethnicity (Non-HUD) Exclude from Search Results Exp Date Eye Color Family ID Number Family Size (Application) Fax # Safe? Fax Note Fax Number File Exists | Financial Eligibility Override Reason Financial Override Financial Override Advocate First Name Foster or Kinship Care Agency Gender General Person Note Globally Unique ID Grade Gross Monthly Income (Application) Hair Color Has Applicant been to DEMO before? Has the Intake Specialist printed and placed a copy of the Alien Determination Form in the Caller's File? Hearing Impaired? Height Highest Court of Practice Highest Education Highest Education Level HIV/AIDS Status Home Phone Home Phone # Safe? Home Phone Note Home/Hospital Visits Housing Stability Rating HUD 9902 Ethnicity HUD Destination HUD Disabling Condition HUD Ethnicity HUD Housing Relocation and Stabilization Services Provided HUD Housing Status (Entry) HUD Housing Status (Exit) HUD Last Permanent Zip HUD Length Of Stay In Previous Place HUD Race HUD Type of Housing Prior to Entry of Program HUD Veteran Status HUD Zip Code Type ID If yes, who is the attorney and for what matter is s/he representing the Applicant? IHPS Agency Immigration Status Impact Imported from Kemps DB Imported Id Income Eligible
| Income Note Income Provided? Indigenous Initial Visitation Status Institutionalized at Institutionalized?
Intake OfficeIntake Type Interpreter Needed Is another attorney helping Applicant in any Matter? Is applicant a student? Is applicant caring for relative's child? Is Applicant's Income expected to change in a manner which would change Applicant's Eligibility? Is Child Court Involved? Is Child Currently Removed? Is Group? Is it okay to send email? Is it okay to send mail? Is The Client Head Of Household? Is There a CUA? Is there a safety plan Is There Foster or Kinship Care? Is There Home Protective Services? Is this matter LSC Eligible Is this Needs Based Public Assistance J Number Jurisdiction Language Last Name Last or Current Employer Last Salary Last Sync With Active Directory/LDAP Latitude Legal Problem Code Lives With Client Longitude LSC Eligibility Override Date LSC Eligibility Override Reason Maiden Name Mailing Address Mailing Address 2 Mailing Apt#/Lot# Mailing City Mailing State
| Mailing Town Mailing Zip Marital Status Medical Insurance Type Member in Good Standing of Bar Mental Disability Description Mental Disability? Middle Name Migrant Military Service MLP system fields Mobile Phone Mobile Phone NoteMonthly food stamps received Monthly rent or mortgage Name of Current Care Giver Naturalization Cert # Naturalization Date Naturalization Place Nickname No Phone Number Note Number of People 18 and Over Number of People under 18 Organization Lacks Means for Other Representation Organization Name Organization Services Eligible Persons Other Contact Notes Other Phone Other Phone # Safe? Other Phone Note Other Relationships to Case Packet Passport # Passport # (2) Percentage of Median Income Percentage of Poverty Perm. Address Notes Perm. City Perm. State Perm. Zip Permanent Contact Address Permanent Contact Address 2 Person's Docket Number Phone Ref Physical Disability Description Physical Disability? Placement Status at Time of Intake Preferred Address Preferred Donation Name Preferred Phone # Prefix
| Prefix/Salutation Primary Source of Medical Care (HIV) Profile Program Quadrant (DC only) Race Referred By Referring Organization Retainer Agreement Salutation SchoolSchool Attended School Status Second Language Secretary Name Shelter Social Security # Special Characteristics SSN Information State State (Province) Of Birth State of Practice Street Address Street Address 2 Suffix Supported By Client Tax Identification Number Telephone System Login Total Annual Expenses Total Annual Income Total Assistance Total Liquid Asset Amount Total Monthly Expenses Total Monthly Income Total Non Liquid Asset Amount Town Transfer Unemployed? For how long? Veteran Visa Expiration Date Visa Issue Location Visa Number Website URL Weight Wife's Maiden Name OR Husband's Last Name Work Phone Work Phone # Safe? Work Phone Note Zero Income? Zip Code{FADE}~tc~
Refer to Quick Case Copy for admin setup of this feature |
