diff --git a/lib/pdf_fill/forms/va1010ez.rb b/lib/pdf_fill/forms/va1010ez.rb
index a5673ad0b37..cb470bb4e42 100644
--- a/lib/pdf_fill/forms/va1010ez.rb
+++ b/lib/pdf_fill/forms/va1010ez.rb
@@ -10,6 +10,297 @@ class Va1010ez < FormBase
       KEY = {
         'veteranFullName' => {
           key: 'F[0].P4[0].LastFirstMiddle[0]'
+        },
+        'mothersMaidenName' => {
+          key: 'F[0].P4[0].MothersMaidenName[0]'
+        },
+        'gender' => {
+          key: 'F[0].P4[0].BirthSex[0]'
+        },
+        'isSpanishHispanicLatino' => {
+          key: 'F[0].P4[0].HispanicOrLatino[0]'
+        },
+        'isAmericanIndianOrAlaskanNative' => {
+          key: 'F[0].P4[0].Race[0]'
+        },
+        'isAsian' => {
+          key: 'F[0].P4[0].Race[1]'
+        },
+        'isWhite' => {
+          key: 'F[0].P4[0].Race[2]'
+        },
+        'isBlackOrAfricanAmerican' => {
+          key: 'F[0].P4[0].Race[3]'
+        },
+        'isNativeHawaiianOrOtherPacificIslander' => {
+          key: 'F[0].P4[0].Race[4]'
+        },
+        'hasDemographicNoAnswer' => {
+          key: 'F[0].P4[0].Race[5]'
+        },
+        'placeOfBirth' => {
+          key: 'F[0].P4[0].PlaceOfBirth[0]'
+        },
+        'veteranAddress' =>
+          {
+            'street' => {
+              key: 'F[0].P4[0].MailingAddress_Street[0]'
+            },
+            'city' => {
+              key: 'F[0].P4[0].MailingAddress_City[0]'
+            },
+            'postalCode' => {
+              key: 'F[0].P4[0].MailingAddress_ZipCode[0]'
+            },
+            'state' => {
+              key: 'F[0].P4[0].MailingAddress_State[0]'
+            }
+          },
+        'homePhone' => {
+          key: 'F[0].P4[0].HomeTelephoneNumber[0]'
+        },
+        'mobilePhone' => {
+          key: 'F[0].P4[0].MbileTelephoneNumber[0]'
+        },
+        'email' => {
+          key: 'F[0].P4[0].EmailAddress[0]'
+        },
+        'veteranHomeAddress' =>
+          {
+            'street' => {
+              key: 'F[0].P4[0].HomeAddress_Street[0]'
+            },
+            'city' => {
+              key: 'F[0].P4[0].HomeAddress_City[0]'
+            },
+            'postalCode' => {
+              key: 'F[0].P4[0].HomeAddress_ZipCode[0]'
+            },
+            'state' => {
+              key: 'F[0].P4[0].HomeAddress_State[0]'
+            }
+          },
+        'maritalStatus' => {
+          key: 'F[0].P4[0].CurrentMaritalStatus[0]'
+        },
+        'vaMedicalFacility' => {
+          key: 'F[0].P4[0].PreferredVACenter[0]'
+        },
+        'wantsInitialVaContact' => {
+          key: 'F[0].P4[0].ScheduleFirstAppointment[0]'
+        },
+        'purpleHeartRecipient' => {
+          key: 'F[0].P4[0].Section2_2A[0]'
+        },
+        'isFormerPow' => {
+          key: 'F[0].P4[0].Section2_2B[0]'
+        },
+        'postNov111998Combat' => {
+          key: 'F[0].P4[0].Section2_2C[0]'
+        },
+        'disabledInLineOfDuty' => {
+          key: 'F[0].P4[0].Section2_2D[0]'
+        },
+        'swAsiaCombat' => {
+          key: 'F[0].P4[0].Section2_2E[0]'
+        },
+        'vaCompensationType' => {
+          key: 'F[0].P4[0].Section2_2F[0]'
+        },
+        'radiationCleanupEfforts' => {
+          key: 'F[0].P5[0].RadioButtonList[2]'
+        },
+        'gulfWarService' => {
+          key: 'F[0].P5[0].RadioButtonList[3]'
+        },
+        'combatOperationService' => {
+          key: 'F[0].P5[0].RadioButtonList[0]'
+        },
+        'exposedToAgentOrange' => {
+          key: 'F[0].P5[0].RadioButtonList[1]'
+        },
+        'gulfWarStartDate' => {
+          key: 'F[0].P5[0].FromDate_3B[0]'
+        },
+        'gulfWarEndDate' => {
+          key: 'F[0].P5[0].ToDate_3B[0]'
+        },
+        'agentOrangeStartDate' => {
+          key: 'F[0].P5[0].FromDate_3C[0]'
+        },
+        'agentOrangeEndDate' => {
+          key: 'F[0].P5[0].ToDate_3C[0]'
+        },
+        'exposureToAirPollutants' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[0]'
+        },
+        'exposureToChemicals' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[1]'
+        },
+        'exposureToRadiation' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[2]'
+        },
+        'exposureToShad' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[3]'
+        },
+        'exposureToOccupationalHazards' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[4]'
+        },
+        'exposureToAsbestos' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[5]'
+        },
+        'exposureToMustardGas' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[6]'
+        },
+        'exposureToContaminatedWater' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[7]'
+        },
+        'exposureToWarfareAgents' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[8]'
+        },
+        'exposureToOther' => {
+          key: 'F[0].P5[0].ExposedToTheFollowing[9]'
+        },
+        'otherToxicExposure' => {
+          key: 'F[0].P5[0].SpecifyOther[0]'
+        },
+        'toxicExposureStartDate' => {
+          key: 'F[0].P5[0].FromDate_3D[0]'
+        },
+        'toxicExposureEndDate' => {
+          key: 'F[0].P5[0].ToDate_3D[0]'
+        },
+        'isMedicaidEligible' => {
+          key: 'F[0].P5[0].EligibleForMedicaid[0]'
+        },
+        'isEnrolledMedicarePartA' => {
+          key: 'F[0].P5[0].EnrolledInMedicareHospitalInsurance[0]'
+        },
+        'providers' =>
+          {
+            'insuranceName' => {
+              key: 'F[0].P5[0].HealthInsuranceInformation[0]'
+            },
+            'insurancePolicyHolderName' => {
+              key: 'F[0].P5[0].NameOfPolicyHodler[0]'
+            },
+            'insurancePolicyNumber' => {
+              key: 'F[0].P5[0].PolicyNumber[0]'
+            },
+            'insuranceGroupCode' => {
+              key: 'F[0].P5[0].GroupCode[0]'
+            }
+          },
+        'dependents' =>
+          {
+            'fullName' => {
+              key: 'F[0].P5[0].ChildsName[0]'
+            },
+            'dependentRelation' => {
+              key: 'F[0].P5[0].RelationshipToYou[0]'
+            },
+            'socialSecurityNumber' => {
+              key: 'F[0].P5[0].ChildsSSN[0]'
+            },
+            'dateOfBirth' => {
+              key: 'F[0].P5[0].ChildsDOB[0]'
+            },
+            'becameDependent' => {
+              key: 'F[0].P5[0].DateChildBecameYourDependent[0]'
+            },
+            'attendedSchoolLastYear' => {
+              key: 'F[0].P5[0].DidChildAttendSchooLastYear[0]'
+            },
+            'disabledBefore18' => {
+              key: 'F[0].P5[0].ChildPermanentlyDiasbledBefore18[0]'
+            },
+            'dependentEducationExpenses' => {
+              key: 'F[0].P5[0].ExpensesPaifByDependentCHild[0]'
+            },
+            'grossIncome' => {
+              key: 'F[0].P6[0].Section7_Child_Q1[0]'
+            },
+            'netIncome' => {
+              key: 'F[0].P6[0].Section7_Child_Q2[0]'
+            },
+            'otherIncome' => {
+              key: 'F[0].P6[0].Section7_Child_Q3[0]'
+            }
+          },
+        'spouseFullName' => {
+          key: 'F[0].P5[0].SpousesName[0]'
+        },
+        'spouseAddress' => {
+          key: 'F[0].P5[0].SpouseAddressAndTelephoneNumber[0]'
+        },
+        'cohabitedLastYear' => {
+          key: 'F[0].P5[0].RadioButtonList[2]'
+        },
+        'veteranDateOfBirth' => {
+          key: 'F[0].P4[0].DOB[0]'
+        },
+        'lastEntryDate' => {
+          key: 'F[0].P4[0].LastEntryDate[0]'
+        },
+        'lastDischargeDate' => {
+          key: 'F[0].P4[0].LastDischargeDate[0]'
+        },
+        'medicarePartAEffectiveDate' => {
+          key: 'F[0].P5[0].EffectiveDate[0]'
+        },
+        'spouseSocialSecurityNumber' => {
+          key: 'F[0].P5[0].SpousesSSN[0]'
+        },
+        'spouseDateOfBirth' => {
+          key: 'F[0].P5[0].SpousesDOB[0]'
+        },
+        'dateOfMarriage' => {
+          key: 'F[0].P5[0].DateOfMarriage[0]'
+        },
+        'provideSupportLastYear' => {
+          key: 'F[0].P5[0].DidYouProvideSupportToChildNotLivingWithYou[0]'
+        },
+        'discloseFinancialInformation' => {
+          key: 'F[0].P6[0].Section6[0]'
+        },
+        'veteranSocialSecurityNumber' => {
+          key: 'F[0].P4[0].SSN[0]'
+        },
+        'lastServiceBranch' => {
+          key: 'F[0].P4[0].LastBranchOfService[0]'
+        },
+        'dischargeType' => {
+          key: 'F[0].P4[0].DischargeType[0]'
+        },
+        'medicareClaimNumber' => {
+          key: 'F[0].P5[0].MedicareClaimNumber[0]'
+        },
+        'spouseGrossIncome' => {
+          key: 'F[0].P6[0].Section7_Spouse_Q1[0]'
+        },
+        'spouseNetIncome' => {
+          key: 'F[0].P6[0].Section7_Spouse_Q2[0]'
+        },
+        'spouseOtherIncome' => {
+          key: 'F[0].P6[0].Section7_Spouse_Q3[0]'
+        },
+        'veteranGrossIncome' => {
+          key: 'F[0].P6[0].Section7_Veteran_Q1[0]'
+        },
+        'veteranNetIncome' => {
+          key: 'F[0].P6[0].Section7_Veteran_Q2[0]'
+        },
+        'veteranOtherIncome' => {
+          key: 'F[0].P6[0].Section7_Veteran_Q3[0]'
+        },
+        'deductibleMedicalExpenses' => {
+          key: 'F[0].P6[0].Section8_Q1[0]'
+        },
+        'deductibleFuneralExpenses' => {
+          key: 'F[0].P6[0].Section8_Q2[0]'
+        },
+        'deductibleEducationExpenses' => {
+          key: 'F[0].P6[0].Section8_Q3[0]'
         }
       }.freeze
 
diff --git a/spec/fixtures/pdf_fill/10-10EZ/unsigned/simple.pdf b/spec/fixtures/pdf_fill/10-10EZ/unsigned/simple.pdf
index 7dc5671fef8..b8c7eebb8a1 100644
Binary files a/spec/fixtures/pdf_fill/10-10EZ/unsigned/simple.pdf and b/spec/fixtures/pdf_fill/10-10EZ/unsigned/simple.pdf differ