yourit.va.gov
Open in
urlscan Pro
149.96.188.219
Public Scan
URL:
https://yourit.va.gov/csm?id=csm_anonymous_case_creation
Submission: On May 22 via manual from US — Scanned from DE
Submission: On May 22 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: case_creation —
<form id="case_formv3" name="case_creation" role="form" validate="" class="ng-pristine ng-invalid ng-invalid-required ng-valid-pattern ng-valid-maxlength">
<div class="form-group">
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error has-feedback' : case_creation.first_name.$invalid && c.submitted}">
<input type="text" name="first_name" id="first_name" placeholder="First Name" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" ng-model="c.data.first_name" ng-disabled="c.data.hasContactRecord"
ng-required="true" ng-class="{ 'input-has-error' : case_creation.first_name.$invalid && c.submitted}" role="textbox" required="required">
<p ng-show="case_creation.first_name.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Your First Name is required.</p>
<!--<span ng-show="case_creation.first_name.$invalid && c.submitted" id="errorIcon" class="glyphicon glyphicon-remove form-control-feedback" aria-hidden="true"></span>-->
</div>
<div class="col-md-6 contact-right-field" ng-class="{ 'has-error has-feedback' : case_creation.last_name.$invalid && c.submitted}">
<input type="text" name="last_name" id="last_name" placeholder="Last Name" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" ng-model="c.data.last_name" ng-disabled="c.data.hasContactRecord"
ng-required="true" ng-class="{ 'input-has-error' : case_creation.last_name.$invalid && c.submitted}" role="textbox" required="required">
<p ng-show="case_creation.last_name.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Your Last Name is required.</p>
</div>
</div>
<div class="form-two-col">
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error' : case_creation.email.$invalid && c.submitted}"> <label class="sr-only" for="contact-email">Email</label>
<input type="text" name="email" placeholder="Email" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-pattern" id="contact-email" ng-model="c.data.email" ng-disabled="c.data.hasContactRecord"
ng-change="c.hideAlert()" ng-required="true" ng-class="{ 'input-has-error' : case_creation.email.$invalid && c.submitted}" ng-pattern="/^[^\s@]+@[^\s@]+\.[^\s@]{2,}$/" role="textbox" required="required">
<p ng-show="case_creation.email.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid email.</p>
</div>
<div class="col-md-6 contact-right-field" ng-class="{ 'has-error has-feedback' : case_creation.phone.$invalid && c.submitted}">
<input type="text" name="phone" id="phone" placeholder="Phone Number" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-pattern" ng-model="c.data.phone" ng-disabled="c.data.hasContactRecord"
ng-required="!data.status" ng-class="{ 'input-has-error' : case_creation.phone.$invalid && c.submitted}"
ng-pattern="/^(?:\+?1\s*(?:[.-]\s*)?)?(?:\(\s*([2-9]1[02-9]|[2-9][02-8]1|[2-9][02-8][02-9])\s*\)|([2-9]1[02-9]|[2-9][02-8]1|[2-9][02-8][02-9]))\s*(?:[.-]\s*)?([2-9]1[02-9]|[2-9][02-9]1|[2-9][02-9]{2})\s*(?:[.-]\s*)?([0-9]{4})$/"
role="textbox" required="required"> <!-- ng-pattern="/^\+?\d{10,14}$/g" //pattern for the phone number, needs some more work -->
<p ng-show="case_creation.phone.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid phone number.</p>
</div>
</div> <!-- New LGY Fields -->
<div class="form-group" ng-class="{ 'has-error has-feedback' : case_creation.lgy_product.$invalid && c.submitted}">
<!--label for="VA_LGY_Product">Are you having trouble logging in or registering for a VA LGY Product (VALERI, LGYHub, FFPS)?</label--> <select name="lgy_product" id="lgy_product"
class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" ng-class="{ 'input-has-error' : case_creation.lgy_product.$invalid && c.submitted}" requried="" ng-model="c.data.lgyProductSelect" ng-required="true"
ng-disabled="c.data.submitted" ng-options="item as item.label for item in c.data.lgyProductIssue track by item.value" required="required">
<option disabled="" value="" class="" selected="selected">Are you having trouble logging in or registering for a VA LGY Product (VALERI, LGYHub, FFPS)?</option>
<option label="No, I'm logged in but have another issue" value="b176cd671b33981812979796bc4bcbdc">No, I'm logged in but have another issue</option>
<option label="No, I'm logging in but trying to help another person with my company" value="9396c1a71b33981812979796bc4bcb82">No, I'm logging in but trying to help another person with my company</option>
<option label="Yes" value="17e50d271b33981812979796bc4bcb1f">Yes</option>
</select> <!-- <p ng-show="c.options.debug == 'true'">
Issue type: {{c.data.lgyProductSelect.label}} - {{c.data.lgyProductSelect.value}}
</p>-->
<p ng-show="case_creation.lgy_product.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">VA LGY Product is required.</p>
</div> <!-- Affected End User (opened for) -->
<div class="form-two-col"> <label for="first_name_ae" style="float:left" ng-show="c.data.lgyProductSelect.value == c.data.lgy_log_for_another_person" aria-hidden="true" class="ng-hide">Affected User</label>
<div ng-show="c.data.lgyProductSelect.value == c.data.lgy_log_for_another_person" class="col-md-10 form-box ng-hide" aria-hidden="true">
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error has-feedback' : case_creation.first_name_ae.$invalid && c.submitted}">
<!-- ngIf: c.data.lgyProductSelect.value == c.data.lgy_log_for_another_person -->
<p ng-show="case_creation.first_name_ae.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Affected End-User's First Name is required.</p>
<!--<span ng-show="case_creation.first_name.$invalid && c.submitted" id="errorIcon" class="glyphicon glyphicon-remove form-control-feedback" aria-hidden="true"></span>-->
</div>
<div class="col-md-6 contact-right-field" ng-class="{ 'has-error has-feedback' : case_creation.last_name_ae.$invalid && c.submitted}">
<!-- ngIf: c.data.lgyProductSelect.value == c.data.lgy_log_for_another_person -->
<p ng-show="case_creation.last_name_ae.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Affected End-User's Last Name is required.</p>
</div>
</div>
<div class="form-two-col-sub">
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error' : case_creation.email_ae.$invalid && c.submitted}"> <label class="sr-only" for="contact-email-ae">Email</label>
<!-- ngIf: c.data.lgyProductSelect.value == c.data.lgy_log_for_another_person -->
<p ng-show="case_creation.email_ae.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid email for the Affected End-User.</p>
</div>
<div class="col-md-6 contact-right-field" ng-class="{ 'has-error has-feedback' : case_creation.phone_ae.$invalid && c.submitted}">
<!-- ngIf: c.data.lgyProductSelect.value == c.data.lgy_log_for_another_person --> <!-- ng-pattern="/^\+?\d{10,14}$/g" //pattern for the phone number, needs some more work -->
<p ng-show="case_creation.phone_ae.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid phone number for the Affected End-User.</p>
</div>
</div>
</div> <!--div class="form-group">
<label for="VA_LGY_Product">Please select one role that is associated to the issue you are reporting. For any additional roles, please include that information in the detail description of your issue.</label>
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error has-feedback' : case_creation.role_affiliation.$invalid && c.submitted}">
<select type="text"
name="role_affiliation"
id="role_affiliation"
class="form-control"
ng-class="{ 'input-has-error' : case_creation.role_affiliation.$invalid && c.submitted}"
ng-model="c.data.roleSelect"
ng-required="true"
ng-disabled="c.data.submitted"
ng-options="item as item.label for item in c.data.lgyRole track by item.value">
<option disabled value="">What is your role/affiliation with VA Loan Guaranty Systems?</option>
</select>
<!-- <script ng-if="c.data.roleSelect.value=='other_role'" ng-init="document.getElementById('role-div').className = 'col-md-6';"></script> --> <!-- <p ng-show="c.options.debug == 'true'">
Role: {{c.data.roleSelect.value}}
</p>--> <!--p ng-show="case_creation.role_affiliation.$invalid && c.submitted" class="help-block">Your Role/Affiliation is required.</p>
</div>
<!-- <div class="form-group" ng-if="c.data.roleSelect.value=='other_role'" ng-class="{ 'has-error has-feedback' : case_creation.other_role.$invalid && c.submitted}"> --> <!-- <div class="col-md-6 contact-right-field" ng-if="c.data.roleSelect.label=='Other Role'" ng-class="{ 'has-error has-feedback' : case_creation.other_role.$invalid && c.submitted}">
<textarea name="other_role"
ng-model="c.data.otherRole"
id="otherRole"
ng-required="true"
class="form-control noresize"
ng-class="{ 'input-has-error' : case_creation.other_role.$invalid && c.submitted}"
placeholder="Please Provide Other Role(s)"
ng-model-options="{ debounce: 2000 }">Please Provide Other Role(s)</textarea>
<p ng-show="case_creation.other_role.$invalid && c.submitted" class="help-block">Other role is required.</p>
</div>
</div>--> <!-- gap--> <!--*********************************************************-->
<div class="form-group"> <label>Please select up to three (3) roles that is associated to the issue you are reporting.</label>
<option disabled="" value="">What is your role/affiliation with VA Loan Guaranty Systems?</option>
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error has-feedback' : case_creation.role.$invalid && c.submitted}">
<div>
<div class="va-selected-items-container">
<div class="va-selected-items" aria-label="What is your role/affiliation with VA Loan Guaranty Systems?" ng-click="c.toggleDisplayOpts()" ng-blur="c.toggleDisplayOpts( false )" tabindex="0"
data-placeholder="What is your role/affiliation with VA Loan Guaranty Systems?" id="va-selected-items" role="button">
<!-- ngRepeat: item in c.selected -->
</div> <!--
<i class="fa fa-lg va-toggle-icon"
ng-class="{ 'fa-caret-down': !c.displayOpts, 'fa-caret-up': c.displayOpts }"
ng-click="c.toggleDisplayOpts()"></i>
-->
</div> <select type="text" multiple="" name="role_TEST" id="role_TEST" class="va-select form-control ng-pristine ng-untouched ng-valid ng-empty ng-valid-maxlength ng-hide" ng-hide="!c.displayOpts" maxlength="3" ng-model="c.data.roleTEST"
aria-hidden="true"> <!-- ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="Appraiser">Appraiser</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="Inspector">Inspector</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="Lender">Lender</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="Other requestor">Other requestor</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="SAPP SAR">SAPP SAR</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="SAR">SAR</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="Servicer">Servicer</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="VA Central Office">VA Central Office</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="VA RLC">VA RLC</option><!-- end ngRepeat: opt in c.option -->
<option ng-repeat="opt in c.option" ng-selected="c.selected.indexOf( opt.name ) > -1" class="ng-binding ng-scope" value="Other Role">Other Role</option><!-- end ngRepeat: opt in c.option -->
</select>
</div>
</div>
<!-- ngIf: c.data.otherrole=='Other Role' -->
</div> <!--**********************************************************-->
<div class="form-two-col">
<div class="col-md-6 contact-left-field" ng-class="{ 'has-error' : case_creation.organization.$invalid && c.submitted}"> <!-- <div class="form-group" ng-class="{ 'has-error' : case_creation.organization.$invalid && c.submitted}"> -->
<label class="sr-only" for="organization">Organization</label>
<input type="text" name="organization" placeholder="Organization" class="form-control ng-pristine ng-untouched ng-empty ng-valid ng-valid-required" id="organization" ng-model="c.data.organization" ng-required="false"
ng-disabled="c.data.submitted" ng-class="{ 'input-has-error' : case_creation.organization.$invalid && c.submitted}" role="textbox">
<p ng-show="case_creation.organization.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid Organization name.</p>
</div>
<div class="col-md-6 contact-right-field" ng-class="{ 'has-error' : case_creation.affiliate_id.$invalid && c.submitted}"> <!-- <div class="form-group" ng-class="{ 'has-error' : case_creation.affiliate_id.$invalid && c.submitted}"> -->
<label class="sr-only" for="affiliate_id">Affiliate ID</label>
<input type="text" name="affiliate_id" placeholder="Affiliate ID" class="form-control ng-pristine ng-untouched ng-empty ng-valid ng-valid-required" id="affiliate_id" ng-model="c.data.affiliate_id" ng-required="false"
ng-disabled="c.data.submitted" ng-class="{ 'input-has-error' : case_creation.affiliate_id.$invalid && c.submitted}" role="textbox">
<p ng-show="case_creation.affiliate_id.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid Affiliate ID.</p>
</div>
</div> <!-- Application field (Product Access/Issue) -->
<div class="form-group" ng-class="{ 'has-error has-feedback' : case_creation.lgy_access.$invalid && c.submitted}"> <!--label for="lgy_access">What Product are you trying to access or have experienced a problem with?</label--> <select
name="lgy_access" id="lgy_access" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" ng-class="{ 'input-has-error' : case_creation.lgy_access.$invalid && c.submitted}" required="required"
ng-model="c.data.accessSelect" ng-change="c.data.categoryOptions = c.data['selectoption_'+c.data.accessSelect.value]" ng-required="true" ng-disabled="c.data.submitted"
ng-options="item as item.label for item in c.data.lgyApplicationOptions track by item.value">
<option disabled="" value="" class="" selected="selected">What product are you trying to access or have experienced a problem with?</option>
<option label="FFPS (Funding Fee Payment System)" value="954358a81b80e054a25d0d08ec4bcba0">FFPS (Funding Fee Payment System)</option>
<option label="LGYHub/WebLGY" value="b280146c1bc0ec5812979796bc4bcb10">LGYHub/WebLGY</option>
<option label="SAH (Special Adaptive Housing)" value="6bb210281b80e054a25d0d08ec4bcb89">SAH (Special Adaptive Housing)</option>
<option label="VALERI" value="548354681b80e054a25d0d08ec4bcb8a">VALERI</option>
<option label="API Support" value="4daefaad1b827410a25d0d08ec4bcbce">API Support</option>
<option label="LGY Transformation" value="ce36fe611bce3410a25d0d08ec4bcbf2">LGY Transformation</option>
<option label="ServiceNow" value="587e43671bab2c10a25d0d08ec4bcbf9">ServiceNow</option>
<option label="Data Analytics" value="2d3da0cc1b3a85d8d24020a5624bcb75">Data Analytics</option>
<option label="PPM (Program Participant Management)" value="240ef0f897028e90a66619900153affb">PPM (Program Participant Management)</option>
</select> <!-- <p ng-show="c.options.debug == 'true'">
Application Value: {{c.data.accessSelect.value}}
</p>-->
<p ng-show="case_creation.lgy_access.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Product access/issue is required.</p>
</div> <!-- Product Category field --> <!-- <div class="form-group" ng-class="{ 'has-error has-feedback' : case_creation.lgy_category.$invalid && c.submitted}"> -->
<div class="form-group" ng-class="{ 'has-error has-feedback' : case_creation.lgy_category.$invalid && c.submitted}"> <select name="lgy_category" id="lgy_category"
class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-hide" ng-class="{ 'input-has-error' : case_creation.lgy_category.$invalid && c.submitted}" required="required" ng-model="c.data.categorySelect"
ng-required="true" ng-show="c.data.accessSelect" ng-disabled="c.data.submitted" ng-options="item as item.label for item in c.data.categoryOptions track by item.value" aria-hidden="true">
<option disabled="" value="" class="" selected="selected">Please select the appropriate product category.</option>
<option label="Access to existing report, dashboard, or dataset " value="cf80f0801bba85d8d24020a5624bcb5d">Access to existing report, dashboard, or dataset </option>
<option label="Access Issue" value="b37d47241bbf5094a25d0d08ec4bcbb3">Access Issue</option>
<option label="Account Help – One-time Lender/Organization Setup for Payments" value="f77dc7241bbf5094a25d0d08ec4bcb92">Account Help – One-time Lender/Organization Setup for Payments</option>
<option label="Account Help – Password/Pin/Admin Issues" value="b37dc7241bbf5094a25d0d08ec4bcb92">Account Help – Password/Pin/Admin Issues</option>
<option label="Admin (Lender/Servicer) Needs Own Account Activated" value="b37d47241bbf5094a25d0d08ec4bcbb5">Admin (Lender/Servicer) Needs Own Account Activated</option>
<option label="Admin (Lender/Servicer) Validation/Activation of User Issues" value="f77d47241bbf5094a25d0d08ec4bcbb5">Admin (Lender/Servicer) Validation/Activation of User Issues</option>
<option label="Ad Hoc Data request – One Time" value="6e2c885b1bd38918a58ca798624bcbf7">Ad Hoc Data request – One Time</option>
<option label="Ad Hoc Data request – Recurring" value="c87c0c5b1bd38918a58ca798624bcb8f">Ad Hoc Data request – Recurring</option>
<option label="Appeal" value="e6c06c301b49c1100ef2cbf7624bcbf0">Appeal</option>
<option label="Need help with Appraisal or NOV" value="bb7dc7241bbf5094a25d0d08ec4bcb8f">Need help with Appraisal or NOV</option>
<option label="Basic Claim" value="efd064341b49c1100ef2cbf7624bcba6">Basic Claim</option>
<option label="Bill Of Collection" value="9e7e89261bfacdd0f76287f4604bcb40">Bill Of Collection</option>
<option label="Bulk Load events" value="9bbe81e61bfacdd0f76287f4604bcbb2">Bulk Load events</option>
<option label="Change of Employment" value="3f7d47241bbf5094a25d0d08ec4bcbb5">Change of Employment</option>
<option label="Need help with COE" value="777dc7241bbf5094a25d0d08ec4bcb8f">Need help with COE</option>
<option label="Defect" value="9eef8faf1bab2c10a25d0d08ec4bcb24">Defect</option>
<option label="Enhancement" value="3acf47af1bab2c10a25d0d08ec4bcb38">Enhancement</option>
<option label="Page Gives Error or Blank Page" value="337dc7241bbf5094a25d0d08ec4bcb8f">Page Gives Error or Blank Page</option>
<option label="Event Reporting" value="0d71a0781b49c1100ef2cbf7624bcbd9">Event Reporting</option>
<option label="Feedback" value="3b7dc7241bbf5094a25d0d08ec4bcb91">Feedback</option>
<option label="Funding Fee + Loan Guaranty General Question" value="5858fead1bce3410a25d0d08ec4bcbc9">Funding Fee + Loan Guaranty General Question</option>
<option label="Guaranty API General Question" value="37304f691bc27410a25d0d08ec4bcbfe">Guaranty API General Question</option>
<option label="Guaranty API Testing Issue" value="edd083e91bc27410a25d0d08ec4bcb43">Guaranty API Testing Issue</option>
<option label="Need help with Issue Guaranty" value="ff7dc7241bbf5094a25d0d08ec4bcb8f">Need help with Issue Guaranty</option>
<option label="Help analyzing a report, dashboard, dataset, or external data source " value="0a70b0801bba85d8d24020a5624bcbfa">Help analyzing a report, dashboard, dataset, or external data source </option>
<option label="Loan Review API Production Support" value="a0c380ca1b184290d24020a5624bcb36">Loan Review API Production Support</option>
<option label="Missing Access" value="337dc7241bbf5094a25d0d08ec4bcb94">Missing Access</option>
<option label="OBIEE Reports (PA&I) – New Report " value="f4dc009b1bd38918a58ca798624bcb2c">OBIEE Reports (PA&I) – New Report </option>
<option label="OBIEE Reports (PA&I) – Report Defect" value="a2ec089b1bd38918a58ca798624bcb35">OBIEE Reports (PA&I) – Report Defect</option>
<option label="OBIEE Reports (PA&I) – Report Enhancement" value="f021d8df1bd38918a58ca798624bcbff">OBIEE Reports (PA&I) – Report Enhancement</option>
<option label="Other" value="411f690e1b88601c12979796bc4bcbc9">Other</option>
<option label="Other" value="fb7dc7241bbf5094a25d0d08ec4bcb93">Other</option>
<option label="Outage - Entire Site Not Working" value="bb7dc7241bbf5094a25d0d08ec4bcb94">Outage - Entire Site Not Working</option>
<option label="Outage – Entire site not working" value="737dc7241bbf5094a25d0d08ec4bcb93">Outage – Entire site not working</option>
<option label="Outage – Entire site not working" value="737d47241bbf5094a25d0d08ec4bcbb6">Outage – Entire site not working</option>
<option label="Page Not Working" value="9b5fe9ce1b88601c12979796bc4bcbf4">Page Not Working</option>
<option label="Page Not Working" value="b77dc7241bbf5094a25d0d08ec4bcb93">Page Not Working</option>
<option label="Partial Claim" value="6011a8741b49c1100ef2cbf7624bcbb4">Partial Claim</option>
<option label="Payment or Refund problem" value="3f7dc7241bbf5094a25d0d08ec4bcb92">Payment or Refund problem</option>
<option label="Policy" value="bf7d47241bbf5094a25d0d08ec4bcbb3">Policy</option>
<option label="PowerBI Dashboard – Dashboard enhancement" value="fb9c809b1bd38918a58ca798624bcbe1">PowerBI Dashboard – Dashboard enhancement</option>
<option label="PowerBI Dashboard – Defect" value="80bc809b1bd38918a58ca798624bcbe5">PowerBI Dashboard – Defect</option>
<option label="PowerBI Dashboard – New Dashboard" value="e18c809b1bd38918a58ca798624bcbdd">PowerBI Dashboard – New Dashboard</option>
<option label="Access Issues" value="0151897c97028e90a66619900153afa3">Access Issues</option>
<option label="Agent/Sponsor Relationship Application" value="61424df097428e90a66619900153afd5">Agent/Sponsor Relationship Application</option>
<option label="Establishing/Updating Payment Account" value="6953497497428e90a66619900153afa8">Establishing/Updating Payment Account</option>
<option label="Lender Auto Authority Application" value="fd5245f097428e90a66619900153af8a">Lender Auto Authority Application</option>
<option label="Lender Initial Enrollment Application" value="ac1245f097428e90a66619900153af4e">Lender Initial Enrollment Application</option>
<option label="Lender Reinstatement Application" value="4962c53497428e90a66619900153afba">Lender Reinstatement Application</option>
<option label="Lender Renewal/Validation" value="e072053497428e90a66619900153af4a">Lender Renewal/Validation</option>
<option label="Mergers/Acquisitions" value="9063c57497428e90a66619900153afd9">Mergers/Acquisitions</option>
<option label="PPM Payment or Refund Issue" value="44a24df097428e90a66619900153afcf">PPM Payment or Refund Issue</option>
<option label="Removing Sponsor/Agent Relationships" value="4ee20d3497428e90a66619900153af84">Removing Sponsor/Agent Relationships</option>
<option label="Reporting Changes of Employment" value="b7b2493497428e90a66619900153afb2">Reporting Changes of Employment</option>
<option label="Reports" value="f3b10db097428e90a66619900153af4c">Reports</option>
<option label="Salesforce Error" value="3dc10db097428e90a66619900153af4f">Salesforce Error</option>
<option label="Staff Appraiser Reviewer Application" value="57f141f097428e90a66619900153af8d">Staff Appraiser Reviewer Application</option>
<option label="System Issue" value="baa2c93497428e90a66619900153af6f">System Issue</option>
<option label="Underwriter Application" value="c6e145f097428e90a66619900153af48">Underwriter Application</option>
<option label="Updating VARMs, UWs, SARs, or Points of Contacts (POCs)" value="83d20d3497428e90a66619900153af91">Updating VARMs, UWs, SARs, or Points of Contacts (POCs)</option>
<option label="VA Relationship Manager Application" value="afd1c1b097428e90a66619900153afb8">VA Relationship Manager Application</option>
<option label="VARM (Lender/Servicer) Needs Own Account Activated" value="13910d7097428e90a66619900153af07">VARM (Lender/Servicer) Needs Own Account Activated</option>
<option label="Vendor Code" value="5382c53497428e90a66619900153afc4">Vendor Code</option>
<option label="Printing problems" value="377dc7241bbf5094a25d0d08ec4bcb90">Printing problems</option>
<option label="Production Outage" value="8ef34a8c1b742cd4a25d0d08ec4bcbe1">Production Outage</option>
<option label="Registration, Activation, or Login Issues" value="7f7d47241bbf5094a25d0d08ec4bcbb4">Registration, Activation, or Login Issues</option>
<option label="Reports" value="8b21a8f41b49c1100ef2cbf7624bcb64">Reports</option>
<option label="Request API Test Account" value="0cb5ab601b7f70100ef2cbf7624bcb22">Request API Test Account</option>
<option label="Request API Production Account" value="ee53cc4a1b184290d24020a5624bcbab">Request API Production Account</option>
<option label="Servicer Setup/Maintenance" value="3ff43ba387ec8a9034d68737cebb35ae">Servicer Setup/Maintenance</option>
<option label="SFTP - New Servicing Setup" value="250399421bfb0150e993eac4604bcb43">SFTP - New Servicing Setup</option>
<option label="SFTP - Connectivity Issues" value="43f1598e1bbb0150e993eac4604bcbf6">SFTP - Connectivity Issues</option>
<option label="SFTP - Whitelisting New IP Addresses" value="ae6355821bfb0150e993eac4604bcb31">SFTP - Whitelisting New IP Addresses</option>
<option label="Site is very slow or timing out" value="bf7dc7241bbf5094a25d0d08ec4bcb90">Site is very slow or timing out</option>
<option label="Suggested Improvement" value="a306e0b51bc8e8d812979796bc4bcb29">Suggested Improvement</option>
<option label="Supplemental Claim" value="19516cb81b49c1100ef2cbf7624bcba5">Supplemental Claim</option>
<option label="System Interruption" value="f37d47241bbf5094a25d0d08ec4bcbb4">System Interruption</option>
<option label="Training" value="3b7d47241bbf5094a25d0d08ec4bcbb4">Training</option>
<option label="Transfer Of Custody" value="bd9e89261bfacdd0f76287f4604bcb29">Transfer Of Custody</option>
<option label="Upload Problems" value="7b7dc7241bbf5094a25d0d08ec4bcb90">Upload Problems</option>
<option label="VASP - VA Servicing Purchase" value="5452df2c87784ed01e4d77b5cebb356d">VASP - VA Servicing Purchase</option>
</select> <!-- <p ng-show="c.options.debug == 'true'">
Category Dependent Value: {{c.data.categorySelect.dependent_value}}
Category Options: {{c.data.categoryOptions}}
</p>-->
<p ng-show="case_creation.lgy_category.$invalid && c.submitted && c.data.accessSelect" class="help-block ng-hide" aria-hidden="true">Product category is required.</p>
</div>
<div class="form-group" ng-class="{ 'has-error' : case_creation.browser.$invalid && c.submitted}"> <label class="sr-only" for="browser">Browser</label>
<input type="text" ng-init="c.data.browser=setBrowser();" name="browser" id="browser" placeholder="Browser" class="form-control ng-pristine ng-untouched ng-valid ng-not-empty ng-valid-required" ng-model="c.data.browser" ng-required="false"
ng-disabled="c.data.submitted" ng-class="{ 'input-has-error' : case_creation.browser.$invalid && c.submitted}" role="textbox">
<p ng-show="case_creation.browser.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Enter a valid browser name.</p>
</div> <!-- new end--> <!--
<div class="form-group">
<div class="dropdown">
<button class="btn-dropdown btn-primary btn-block dropdown-toggle"
data-toggle="dropdown"
aria-expanded="false"
type="button">{{c.data.issueType}} <span class="caret"></span></button>
<ul class="dropdown-menu" role="menu">
<li role="presentation" ng-click="c.data.issueType = 'Service Degradation'"><a>Service Degradation</a></li>
<li role="presentation" ng-click="c.data.issueType = 'Service Outage'"><a>Service Outage</a></li>
<li role="presentation" ng-click="c.data.issueType = 'Something is Broken'"><a>Something is broken</a></li>
</ul>
</div>
</div>
-->
<div class="form-group" ng-class="{ 'has-error has-feedback' : case_creation.case_description.$invalid && c.submitted}"> <textarea name="case_description" id="case_description" maxlength="4000"
placeholder="Please give us a detailed description of your issue, so we can get you adequate help." class="form-control noresize ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-maxlength" ng-model="c.data.description"
ng-required="true" ng-class="{ 'input-has-error' : case_creation.case_description.$invalid && c.submitted}" ng-change="c.getKnowledge()" ng-disabled="c.data.submitted" ng-model-options="{ debounce: 2000 }" role="textbox"
required="required">
</textarea>
<p ng-show="case_creation.case_description.$invalid && c.submitted" class="help-block ng-hide" aria-hidden="true">Please describe your issue before submitting the case.</p>
</div> <!-- Added by Timothy Oh for STRY3504283--> <!--<div ng-bind-html="c.data.u_case_source"></div> -->
<div class="form-two-col">
<input type="hidden" ng-init="c.data.u_case_source;" name="u_case" id="u_case" value="Virtual Agent" class="form-control ng-pristine ng-untouched ng-valid ng-not-empty ng-valid-required" ng-model="c.data.u_case_source" ng-required="false"
ng-disabled="c.data.submitted" autocomplete="off">
</div>
<!-- ngIf: c.data.isvalid --> <!-- Alert Messages -->
<div class="messages">
<div role="alert" class="alert alert-success ng-hide" ng-show="c.showCaseSuccessMessage" aria-hidden="true"> <button type="button" class="close" data-dismiss="alert" aria-label="Close"><span aria-hidden="true">×</span></button> <span
class="ng-binding"><strong>Thank you!</strong> Your Case has been submitted.</span>
<div> <button type="submit" class="btn-alert btn-primary" ng-click="c.reloadForm()">Create Another Case</button>
</div>
</div>
<div role="alert" class="alert alert-info ng-hide" ng-show="c.showUserCreationMessage" aria-hidden="true"> <button type="button" class="close" data-dismiss="alert" aria-label="Close"><span aria-hidden="true">×</span></button> <span><strong
class="ng-binding">Welcome to !</strong> We automatically created an account for this e-mail address. You will receive a notification with login instructions.</span>
</div>
<div role="alert" class="alert alert-danger ng-hide" ng-show="c.showUserDuplicateMessage" aria-hidden="true"> <button type="button" class="close" data-dismiss="alert" aria-label="Close"><span aria-hidden="true">×</span></button> <span
class="ng-binding"><strong>Oh, snap!</strong> There is already a user with this E-Mail address (). Is that your account? If yes, just click on "Create Case" and we will related this Case to your account. If you forgot your password and you
want to reset it, feel free to do so now. You can always reset your password afterwards. </span>
<div class="alert-buttons"> <button id="submit" class="btn-alert btn-primary" ng-click="c.createCase()">That's me! Create Case</button> <button type="submit" class="btn-alert btn-primary" ng-click="c.openResetPass()">Reset Pass</button> <button
type="submit" class="btn-alert btn-primary" ng-click="c.setFocus()">Change E-Mail</button>
</div>
</div>
</div> <!-- Google Recaptcha -->
<script src="https://www.google.com/recaptcha/api.js?render=" {{data.sitekey}}=""></script>
<div class="form-group col-md-6 nopadding">
<div>
<div class="grecaptcha-badge" data-style="bottomright"
style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-kqbf17bjhokp" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LdTeXAaAAAAAM1a1NAaDyhwBqz7ZA3qdAQ5hZH-&co=aHR0cHM6Ly95b3VyaXQudmEuZ292OjQ0Mw..&hl=de&v=8k85QBI-qzxmenDv318AZH30&size=invisible&sa=submit&cb=3k038gi678sf"></iframe>
</div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div><button class="g-recaptcha btn btn-primary" data-sitekey="6LdTeXAaAAAAAM1a1NAaDyhwBqz7ZA3qdAQ5hZH-" data-callback="onSubmit" data-action="submit" style="width: 100%" ng-show="c.showSubmit" type="submit"
ng-click="c.submitForm(case_creation.$valid)" aria-hidden="false">Create Case</button> <!-- <button type="submit"
class="btn btn-primary"
ng-click="c.submitForm(case_creation.$valid)"
ng-show="c.showSubmit"
style="width: 100%"
>Create Case
</button>
<button type="submit" class="btn btn-primary" ng-click="c.redirectHome()" ng-show="c.showHomeButton">Home</button>-->
</div>
<div class="clearfix">
</div>
</form>Text Content
Skip to page content Department of Veterans Affairs Menu VA | Service Portal * * Guest User (Guest) CSM Anonymous Case Creation (Scoped) VA CUSTOMER SERVICE WELCOME, HOW CAN WE HELP YOU TODAY? SUBMIT A CASE If you want to contact us, please fill out the form below. No Personal Identifiable Information (PII) should be entered into any ticket. Do not provide any other information other than what is requested on the form (Ex. SSN, Address, Veteran Information). For more information about VA PII policies and best practices, visit the VA's Privacy Service website https://www.oprm.va.gov/privacy/faqs_privacy.aspx. You will receive an email from Yourit@va.gov to confirm your case submission and for all case updates. Please whitelist this email address for all future updates. If you did not receive an email after submitting your case, please check your Spam folder. Your First Name is required. Your Last Name is required. Email Enter a valid email. Enter a valid phone number. Are you having trouble logging in or registering for a VA LGY Product (VALERI, LGYHub, FFPS)?No, I'm logged in but have another issueNo, I'm logging in but trying to help another person with my companyYes VA LGY Product is required. Affected User Affected End-User's First Name is required. Affected End-User's Last Name is required. Email Enter a valid email for the Affected End-User. Enter a valid phone number for the Affected End-User. Please select up to three (3) roles that is associated to the issue you are reporting. What is your role/affiliation with VA Loan Guaranty Systems? AppraiserInspectorLenderOther requestorSAPP SARSARServicerVA Central OfficeVA RLCOther Role Organization Enter a valid Organization name. Affiliate ID Enter a valid Affiliate ID. What product are you trying to access or have experienced a problem with?FFPS (Funding Fee Payment System)LGYHub/WebLGYSAH (Special Adaptive Housing)VALERIAPI SupportLGY TransformationServiceNowData AnalyticsPPM (Program Participant Management) Product access/issue is required. Please select the appropriate product category.Access to existing report, dashboard, or dataset Access IssueAccount Help – One-time Lender/Organization Setup for PaymentsAccount Help – Password/Pin/Admin IssuesAdmin (Lender/Servicer) Needs Own Account ActivatedAdmin (Lender/Servicer) Validation/Activation of User IssuesAd Hoc Data request – One TimeAd Hoc Data request – RecurringAppealNeed help with Appraisal or NOVBasic ClaimBill Of CollectionBulk Load eventsChange of EmploymentNeed help with COEDefectEnhancementPage Gives Error or Blank PageEvent ReportingFeedbackFunding Fee + Loan Guaranty General QuestionGuaranty API General QuestionGuaranty API Testing IssueNeed help with Issue GuarantyHelp analyzing a report, dashboard, dataset, or external data source Loan Review API Production SupportMissing AccessOBIEE Reports (PA&I) – New Report OBIEE Reports (PA&I) – Report DefectOBIEE Reports (PA&I) – Report EnhancementOtherOtherOutage - Entire Site Not WorkingOutage – Entire site not workingOutage – Entire site not workingPage Not WorkingPage Not WorkingPartial ClaimPayment or Refund problemPolicyPowerBI Dashboard – Dashboard enhancementPowerBI Dashboard – DefectPowerBI Dashboard – New DashboardAccess IssuesAgent/Sponsor Relationship ApplicationEstablishing/Updating Payment AccountLender Auto Authority ApplicationLender Initial Enrollment ApplicationLender Reinstatement ApplicationLender Renewal/ValidationMergers/AcquisitionsPPM Payment or Refund IssueRemoving Sponsor/Agent RelationshipsReporting Changes of EmploymentReportsSalesforce ErrorStaff Appraiser Reviewer ApplicationSystem IssueUnderwriter ApplicationUpdating VARMs, UWs, SARs, or Points of Contacts (POCs)VA Relationship Manager ApplicationVARM (Lender/Servicer) Needs Own Account ActivatedVendor CodePrinting problemsProduction OutageRegistration, Activation, or Login IssuesReportsRequest API Test AccountRequest API Production AccountServicer Setup/MaintenanceSFTP - New Servicing SetupSFTP - Connectivity IssuesSFTP - Whitelisting New IP AddressesSite is very slow or timing outSuggested ImprovementSupplemental ClaimSystem InterruptionTrainingTransfer Of CustodyUpload ProblemsVASP - VA Servicing Purchase Product category is required. Browser Enter a valid browser name. Please describe your issue before submitting the case. × Thank you! Your Case has been submitted. Create Another Case × Welcome to ! We automatically created an account for this e-mail address. You will receive a notification with login instructions. × Oh, snap! There is already a user with this E-Mail address (). Is that your account? If yes, just click on "Create Case" and we will related this Case to your account. If you forgot your password and you want to reset it, feel free to do so now. You can always reset your password afterwards. That's me! Create Case Reset Pass Change E-Mail Create Case Our office VA 2225 Lawson Lane Santa Clara, CA 95054 (408) 501‑8550 Customer Service Centre customerservice@va.gov