Petition For In-State Tuition Classification Form - State Of New Mexico Page 2
ADVERTISEMENT
1
27. List all employers, addresses and dates of employment in the previous year. Use additional pages if necessary.
EMPLOYER
City
State
FT/PT
FROM
TO
FROM
TO
YES
NO
8. Did your parents or legal guardian claim you as a dependent on federal tax returns in the immediate preceding tax year?
If yes, who:
Parents
Mother
Father
Guardian
If you were under the age of 23 in the most recent tax year, a copy of your parents’ 1040, 1040A, 1040EZ tax form is required.
If parents filed separately, submit a copy of both parents’ returns.
9. If you are less than 19 years of age or answered yes to question 8, please provide the following information:
A. Parent/Guardian Name:
Address:
City/State/Zip:
B. If parents’ addresses differ, explain:
YES
NO
10. Are you registered to vote in New Mexico? If so, provide Voter Registration Number: _____________________
If no, what state are you registered to vote? __________________________________
YES
NO
11. Did you file a New Mexico income tax return for the previous year?
If no, in what state did you file your taxes? __________________________________
12. Your driver’s license number:
State:
Expires:
YES
NO
13. Do you have a New Mexico State issued ID card? If yes, ID Number:
Expiration Date:
YES
NO
14. Do you own residential property in New Mexico? If yes, location:
YES
NO
15. Do you have utilities in your name? If yes, which:
YES
NO
16. Do you own a motor vehicle? If yes, license number:
State:
17. List any other information which may be pertinent to your classification as a New Mexico resident for tuition purposes:
YES
NO
18. In the previous year, were you participating in the Texas, Arizona or Colorado tuition reciprocity program?
YES
NO
19. Are you participating in the Western Undergraduate Exchange Program?
YES
NO
20. Have you been receiving financial assistance from any state other than New Mexico?
If yes, complete the following: Name of granting agency: ___________
________________________________
__
State: __________________________ Date Received: ____________________________________________
YES
NO
21. Have you separated from the U.S. Armed Forces in the previous two years?
A. Home of record on original entry papers: _______________________________________________________
B. Home of record on State of Legal Residence Certificate (DD 2058): _________________________________
YES
NO
22. Are you a citizen of the United States? If no, applicant must complete this section:
Country of Citizenship: _______________________________________________
Date of entry into the United States: _____________________________________
Type of Visa: _______________________________________________________
Permanent Resident Alien Registration Number: ____________________________
I certify that the above is true and correct to the best of my knowledge. I am aware that the Institution may cancel my
admission or registration for any false or misleading statement on this petition and assess retroactive tuition and fees.
Petitioner Signature__________________________________________
Date ____________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Rpd-41305 - Declaration Of Services Purchased For Resale - State Of New Mexico Taxation And Revenue Department
Financial
Form Rpd-41071 - Application For Refund - State Of New Mexico Taxation And Revenue Department
Financial
Form Rpd-41168 - Application For New Mexico Investment Credit - Shedule A - State Of New Mexico Taxation And Revenue Department
Financial
Form Rpd-41296 - Report On Sales Or Use Fuel Specially Prepared And Sold For Use In Turboprop Or Jet-type Engines - State Of New Mexico Taxation And Revenue Department
Financial
Form Rpd-41083 - Affidavit To Obtain Refund Of New Mexico Tax Due A Deceased Taxpayer - State Of New Mexico Taxation And Revenue Department
Financial
Form Mvd-11268 - Affidavit Of Non-use Of Vehicle Or Affidavit Of Out-of-state Vehicle Insurance - State Of New Mexico - Motor Vehicle Division
Legal
Form Rpd-41211 - Application For Refund Of Cigarette Tax - State Of New Mexico Taxation And Revenue Department
Financial
Related Categories
Parent category: Legal