Application For Resident Classification Page 3
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4b. Will they claim you as a dependent in future years?
Yes
No
c. Did the parent/guardian who c laimed you a s a dependent file an Iowa resident state income tax
return for the last tax year?
Yes
No
Year
18. Where and for what year did you file your most recent state resident income tax return?
State
Year
If you did not file an Iowa resident income tax return, indicate why.
Prepare your responses to Questions 19-21, on a separate sheet of paper and submit with your completed
application for Resident Classification.
19. List your places of residence and primary activity engaged in for the past five years. Be sure to include
date(s), location(s) and activities (examples: school at City College, work at Big Buy, etc.).
20. Describe your sources of support. Please indicate if financial support is received from parents or
others, and the date such support ended (or will end).
21. Why do you believe you should be classified as an Iowa resident? W
hat steps have you taken to
establish your permanent residence in Iowa? Be specific. If you have established yourself as an
Iowa resident through 12 qualifying months of living and working in Iowa, complete page 3 and
provide the required documentation as requested. [Responses to this question are rarely more than
a page.]
You may be asked to supply documents in support of your application, including (but not limited to):
employment verifications, tax forms, lease(s) of residence, driver’s license, voter registration, etc.
I certify that the information contained in this application is true, correct and complete.
Signature
Date
*For students completing their qualifying year, go on to page 4.
If you have been living and w orking in Iowa to establish yourself as an Iowa Resident for tuition purposes
(a minimum 12-consecutive month process), you must be certain to complete Page 4 of this application
and provide ALL of the requested supporting documents. Incomplete Applications will encounter delay.
University of Iowa—Office of the Registrar—January 2015
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