Application For Clasification As A Legal Resident (Domiciliary) Of North Carolina For Tuition Purposes (Long Form) (Page 2 of 4) in pdf

9. If at any time you have applied previously for a determination of your residence status for tuition purposes to any

public college or university, for EACH

a) give name of college or university ____________________________________________________________

b) if your residence status was determined, circle classification:

Resident

Non-Resident

c) give term and year you were classified __________________________________________________________

10. Father living? Yes __ No __ Name _____________________________ Occupation ______________________

Permanent home address ______________________________________ since (date) ____________________

11. Mother living? Yes __ No __ Name _____________________________ Occupation ______________________

Permanent home address ______________________________________ since (date) ____________________

12. Parents separated or divorced? Yes ___ No ___ Who has/had custody of you? ___________ since (date) _____

13. Legal guardian? __ Yes No __ Name ___________________________ Occupation ______________________

Permanent home address ______________________________________ since (date) ____________________

14. Why and when did you move your home to North Carolina (reason) ____________________________________

______________________________________________________________________ (date) ______________

15. When and from what state or foreign country did you move your home and legal residence to North Carolina?

Moved from _________________________________________________________on (date) _______________

16. When do you claim that you began your legal residence (domicile) in North Carolina? (date) ________________

17. Who (including yourself) last claimed you as an exemption on state and/or Federal income tax returns, for what

tax year, and in what state filed?

a) On state return for ________________ tax year, filed in (state) _______________ On (date)______________

Name __________________________________________________ Relationship to you _______________

b) On Federal return for ______________ tax year, filed in (state) ______________ On (date) ______________

Name ___________________________________________________ Relationship to you ______________

c) Does anyone intend to claim you as a dependent on State and/or Federal income tax returns for the current

tax

year? Yes _________ No_________

If yes, who? ____________________

Relationship to you ___________ Returns to be filed to what State(s)_______

18. List in chronological order to date of this application all places you have spent at least 7 consecutive days during

the past three years. Your response must include your current address, all other places lived, and vacations.

Place (city and state)

Occupation or Purpose

from (date)

to (date)

a) __________________

_______ ___

___________________________ ___________ ___________

b) ________________________________ _______________ _________________ ___________ ___________

c) ________________________________ _______ _________________________ ___________ ___________

If married, list in chronological order to date of this application all places your spouse has spent at least 7

consecutive days during the past three years. Your response must include spouse’s address, all other places

lived, and vacations.

Place (city and state)

Occupation or Purpose

from (date) to (date)

a) ________________________________ ______ __________________________ ___________ __________

b) ________________________________ __ ______________________________ ___________ __________

c) ________________________________ ______ __________________________ ___________ ___________

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Application For Clasification As A Legal Resident (Domiciliary) Of North Carolina For Tuition Purposes (Long Form) Page 2

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