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| 1 | {
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| 2 | "email": "{{email}}",
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| 3 | "phone": "{{phone||phone:10}}",
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| 4 | "firstName": "{{first_name}}",
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| 5 | "lastName": "{{last_name}}",
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| 6 | "name": "{{first_name}} {{last_name}}",
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| 7 | "dateOfBirth": "{{date_of_birth}}",
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| 8 | "address1": "{{address}}",
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| 9 | "city": "{{city}}",
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| 10 | "state": "{{state}}",
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| 11 | "country": "US", | |
| 12 | "postalCode": "{{zip_code}}",
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| 13 | "tags": [ | |
| 14 | "lead prosper", | |
| 15 | - | "obamacare", |
| 15 | + | "obamacare" |
| 16 | - | "adswapper" |
| 16 | + | |
| 17 | "source": "public api", | |
| 18 | "customField": {
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| 19 | "annual_household_income": "{{annual_household_income}}",
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| 20 | "social_security_number": "{{ssn}}",
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| 21 | "gender": "{{gender}}",
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| 22 | "marital_status": "{{martial_status}}",
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| 23 | "tobacco_use": "{{tabaco_use}}",
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| 24 | "household_makeup": "{{household_makeup}}",
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| 25 | "how_many_tax_dependents_do_you_have": "{{number_of_dependents}}",
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| 26 | "are_you_selfemployed": "{{is_self_employed}}",
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| 27 | "employer_name": "{{employer_name}}",
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| 28 | "employer_address": "{{employer_address}}",
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| 29 | "employer_phone_number": "{{employer_phone_number}}",
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| 30 | "i_attest_that_i_qualify_for_one_of_the_following_special_enrollment_periods": "{{Special_enrollment_period_reason}}",
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| 31 | "has_health_insurance": "{{has_health_insurance}}",
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| 32 | "spouse_first_name": "{{Spouse_First_Name}}",
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| 33 | "spouse_last_name": "{{Spouse_Last_Name}}",
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| 34 | "spouse_date_of_birth": "{{Spouse_Date_of_Birth}}",
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| 35 | "spouse_social_security_number": "{{Spouse_Social_Security_Number}}",
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| 36 | "does_spouse_need_health_insurance": "{{Does_Spouse_need_health_insurance}}",
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| 37 | "is_spouse_selfemployed": "{{Is_Spouse_self-employed}}",
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| 38 | "spouses_employer_name": "{{spouse_employer_name}}",
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| 39 | "spouses_employer_address": "{{spouse_employer_address}}",
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| 40 | "spouse_employer_phone_number": "{{spouse_employer_phone_number}}",
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| 41 | "spouse_email": "{{Spouse_Email}}",
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| 42 | "spouse_phone": "{{Spouse_Phone}}",
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| 43 | "child_1_first_name": "{{Child_1_First_Name}}",
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| 44 | "child_1_last_name": "{{Child_1_Last_Name}}",
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| 45 | "child_1_date_of_birth": "{{Child_1_Date_of_Birth}}",
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| 46 | "child_1_social_security_number": "{{Child_1_Social_Security_Number}}",
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| 47 | "does_child_1_need_health_insurance": "{{Does_Child_1_need_health_insurance}}",
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| 48 | "child_2_first_name": "{{Child_2_First_Name}}",
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| 49 | "child_2_last_name": "{{Child_2_Last_Name}}",
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| 50 | "child_2_date_of_birth": "{{Child_2_Date_of_Birth}}",
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| 51 | "child_2_social_security_number": "{{Child_2_Social_Security_Number}}",
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| 52 | "does_child_2_need_health_insurance": "{{Does_Child_2_need_health_insurance}}",
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| 53 | "child_3_first_name": "{{Child_3_First_Name}}",
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| 54 | "child_3_last_name": "{{Child_3_Last_Name}}",
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| 55 | "child_3_date_of_birth": "{{Child_3_Date_of_Birth}}",
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| 56 | "child_3_social_security_number": "{{Child_3_Social_Security_Number}}",
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| 57 | "does_child_3_need_health_insurance": "{{Does_Child_3_need_health_insurance}}",
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| 58 | "child_4_first_name": "{{Child_4_First_Name}}",
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| 59 | "child_4_last_name": "{{Child_4_Last_Name}}",
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| 60 | "child_4_date_of_birth": "{{Child_4_Date_of_Birth}}",
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| 61 | "child_4_social_security_number": "{{Child_4_Social_Security_Number}}",
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| 62 | "does_child_4_need_health_insurance": "{{Does_Child_4_need_health_insurance}}",
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| 63 | "child_5_first_name": "{{Child_5_First_Name}}",
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| 64 | "child_5_last_name": "{{Child_5_Last_Name}}",
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| 65 | "child_5_date_of_birth": "{{Child_5_Date_of_Birth}}",
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| 66 | "child_5_social_security_number": "{{Child_5_Social_Security_Number}}",
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| 67 | "does_child_5_need_health_insurance": "{{Does_Child_5_need_health_insurance}}",
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| 68 | "multiline_field_for_the_rest_of_the_childrens_names_dobs_ssns_etc": "{{Rest_of_Children}}",
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| 69 | "signature": "{{Signature}}",
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| 70 | "limited_power_of_attorney": "{{Limited_power_of_attorney}}",
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| 71 | - | "agent_of_record_confirmation": "{{Agent_of_record_confirmation}}",
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| 71 | + | |
| 72 | "ip_address": "{{ip_address}}",
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| 73 | - | "agree_to_be_enrolled": "{{Agree_to_enroll}}",
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| 73 | + | |
| 74 | - | "right_to_cancel": "{{Right_to_cancel}}",
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| 74 | + | |
| 75 | - | "permission_to_access_hc_gov_account": "{{Permission_for_healthcare_account}}",
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| 75 | + | |
| 76 | - | "confirm_that_plan_options_vary": "{{Confirm_plan_options_vary}}",
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| 76 | + | |
| 77 | "click_id": "{{clickid}}",
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| 78 | "lead_Source": "source" | |
| 79 | } | |
| 80 | } |
