Residency Classification Application - University Of Northern Iowa
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1
2Application for Resident Classification
(For Fee and Admission Purposes)
University of Northern Iowa
Cedar Falls, Iowa
The University of Northern Iowa requests this information for the purpose of determining residence classification. Only directory information
may be released to third parties. Responses to all items are required. If you fail to provide the required information or documentation as noted,
the University may not act on this application. (Pursuant to Chapter 22, Code of Iowa.)
Date _______________ Social Security No. __________________________________ Effective semester _______________
1.
Name: ___________________________________________________________________________________________
Last
First
Middle/Maiden
2.
Current Address: __________________________________________________________________________________
Street
City
State
Zip
Phone No.
3.
Permanent Home Address: __________________________________________________________________________
Street
City
State/Country/Zip
Phone No.
4.
Birth date: ___________________________ Birthplace: __________________________________________________
City
State/Country
5.
(For aliens only) What is your current visa classification? ____________________________________ (Provide Copy)
(If permanent resident please provide photocopy of “green card” – I-551 Resident Alien Card)
6.
Date you moved to Iowa: ___________________________________________________________
a. Reason for coming to Iowa: _______________________________________________________
b. Activities primarily engaged in since moving to Iowa: __________________________________________________
________________________________________________________________________________________________
c. Had you previously been a resident of Iowa?
Yes ___
No ___
Dates: _________________________
7.
If you own a motor vehicle, in which state is it registered? ___________________________________ (Provide Copy)
a. From which state is your current driver’s license issued? __________________________________ (Provide Copy)
8.
In which state are you registered to vote? _________________________________________________(Provide Copy)
Dependent Students (Students who are claimed as dependents on income tax returns or whose primary support is provided
by parents/guardians.)
9.
Parents’ name and address ___________________________________________________________________________
Father
Mother
Address (if different show both) ______________________________________________________________________
If under guardianship, list name and address of guardian: __________________________________________________
_______________________________________________________________________
(Provide certified copy of court order.)
10. Did your parents/guardians claim you as a dependent on their last federal income tax return?
Yes___ No___
Year last claimed _____________________________ (Please provide copy)
a. Will they claim you for this tax year?
Yes___ No___
b. In what state did your parents/guardians file their state income tax return? __________________________________
If filed in Iowa, please provide a copy.
State
Year
c. If you did not file an Iowa Income Tax return for this last year, indicate in which state you did file and why you did
not file in Iowa. _________________________________________________________________________________
where
reason
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