1 INSTRUCTIONS FOR COMPLETING A PETITION FOR CHANGE IN CLASSIFICATION FOR TUITION Please carefully read the VIII-2.70 POLICY ON STUDENT CLASSIFICATION FOR ADMISSION AND TUITION PURPOSES of the University System of Maryland, which contains residency requirements, procedures and appeal information. The full text of the policy is available at I affirm that I have read the policy and requirements for establishing in-state status as well as the information provided below. Signature: Date: Submit the completed petition and all supporting documentation to the following address (faxes not accepted): UMBC Registrar Office 1000 Hilltop Circle Baltimore, MD Phone: IMPORTANT INFORMATION REGARDING PETITIONS The petition deadline is the last day of late registration for the semester for which you are seeking In-state status. Failure to complete all applicable sections of the petition may result in a denial of in-state status. Only one petition may be filed per semester. No requests are accepted for retroactive changes. No materials or documentation will be returned after the petition is submitted. The review of the petition and an initial determination of the status may take as long as six (6) weeks, not including subsequent appeals. You will be responsible for all late fees and finance charges during the entire process. Read the document carefully and complete all sections of the petition that apply to you. If you cannot provide the required information, you must attach a separate sheet with an explanation or write your explanation in the margins of the petition. If claiming dependence, the person upon whom the student is dependent must have his/her signature notarized. For your convenience, there is a Notary Public at the Residency Classification Office. Please call ahead to check for availability. In the cases where affidavits are accepted, they must be typed, dated, notarized, and contain information as specific as possible including dates, addresses, amounts, etc. Please check in advance. Please note: Graduate Assistants who are not residents of Maryland are not classified as in-state, but are accorded some benefits of in-state status, and must see the Human Resources Office if they are having a billing problem. All graduate students, including graduate assistants, who wish to establish their status as permanent residents of Maryland, may file a petition. Section 1: Student Information This section must be completed by all student petitioners for in-state status. Section 2: Basis for claiming In-State Status This section must also be completed by all student petitioners for in-state status. It is recommended that you again read the residency policy. Please pay particular attention to the definitions of financial independence, dependence, and support. The student petitioner must complete all sections of the petition regardless of dependence status. Section 3: Income and Expense Information for Student This section must be completed by all students who indicated either A or B in Section 2. Please be sure to include with your petition documentation for all sources of funds you list in this section. Any undocumented sources of funds cannot be considered. In most cases, acceptable forms of documentation are W-2 forms, check stubs showing year-to-date income, financial aid award letters, employer confirmation of employment dates and income on employer letterhead, and employment contracts. The evidence should document any Maryland employment and earnings history through sources
2 beyond those incident to enrollment as a student in an educational institution e.g., beyond support provided by work study, scholarships, grants, stipends, aid, student loans, etc. Note: Tuition costs will be considered as a student expense only to the extent tuition exceeds the amount of any educational scholarships, grants, student loans, etc. The purpose of this section is to aid the University in determining financial dependence or financial independence. If you are seeking to demonstrate financial independence, that independence must exist for twelve (12) consecutive months prior to the last day of late registration for the semester you are seeking in-state status. For example, if you are filing a petition for the fall semester, the last day of late registration usually occurs in mid-september. Therefore, the twelve (12) months prior to that date will be the period reviewed. If you have filed a petition prior to the deadline, you may estimate future income; however, you must be able to explain the basis for your estimate. If you are uncertain about your exact expenses, please carefully estimate. Your figures regarding rent/mortgage, tuition and fees, utilities, and motor vehicle insurance should be exact; however, if exact figures are not available, please provide an explanation. Please list all employers for the past two (2) years, with specific dates of employment. Section 4: Student Residency Information The student petitioner must complete Section 4. Please make sure to attach photocopies of all requested documents. Students must complete this section even if claiming financial dependency upon another resident of the State of Maryland. Section 5: Residency Information for Person Upon Whom Student is Financially Dependent The person upon whom the student petitioner is financially dependent must complete Section 5. Please make sure to attach photocopies of all requested documents. Students not claiming financial dependence upon another resident of Maryland should NOT complete this section of the petition. Section 6: Information Pertaining to Full-Time Member of the Armed Forces of the United States Please review the residency policy before completing this section. Section 7: Rebuttal Evidence Satisfying the requirements listed in paragraphs A through I of Section II of the policy does not rebut the presumption that a student is in Maryland primarily to attend an educational institution. To overcome the presumption, a student must present additional evidence. To determine a student's intent, the University will evaluate evidence of a student's objectively verifiable conduct. Evidence that does not document a period of at least twelve (12) consecutive months immediately prior to and including the last date available to register for courses in the semester/term for which the student seeks in-state tuition status is generally considered an unfavorable factor under this policy. Evidence of intent must be clear and convincing and will be evaluated not only by the amount presented but also based upon the reliability, authenticity, credibility and relevance of the evidence. The absence of objective, relevant evidence is generally considered an unfavorable factor. A student's statement of intent to remain in Maryland in the future is generally not considered to be objective evidence under this policy. In addition to financial evidence documenting a student s independent status, or dependence upon a Maryland resident, other evidence that may be considered includes, but is not limited to, substantial participation as a member of a professional, social, community, civic, political, athletic or religious organization in Maryland, including professionally related school activities that demonstrate a commitment to the student's community or to the State of Maryland; registration as a Maryland resident with the Selective Service, if male; evidence showing the student uses his or her Maryland address as his or her sole address of record for all purposes including on health and auto insurance records, bank accounts, tax records, loan and scholarship records, school records, military records, leases, etc.; an affidavit from a person unrelated to the student that provides objective, relevant evidence of a student's conduct demonstrating the student's intent to live permanently in Maryland. Section 8: Affirmation of Petitioner and, if Dependent, of the Person Upon Whom Student is Financially Dependent The student petitioner must sign this section but a notarized signature is not required. A NOTARIZED signature is required of the person upon whom the student petitioner is financially dependent.
3 UNIVERSITY SYSTEM OF MARYLAND PETITION FOR CHANGE IN CLASSIFICATION FOR TUITION DIRECTIONS: This form is intended for use by those who seek a change in residency classification or by those whose status cannot be determined from the information submitted with the application for admission. THE DEADLINE for which conditions for in-state classification must be met is the last day for late registration for the semester for which instate status is being sought. Only one petition for change in status may be filed per semester. All petitioners must complete Section 1 (Student Information), Section 2 (Basis for claiming in-state status), and Section 8 (Affirmation). Other sections to be completed are indicated in Section 2. Please provide documentation where appropriate/required. SECTION 1: STUDENT INFORMATION (To be completed by Petitioner/Student) Institution: Program (please check one): Undergraduate Graduate Professional Other Semester & Year Admitted: Current Class Status: Freshman Sophomore Junior Senior Graduate Professional (1) Name: Mr. Ms. Last First MI (2) Student Identification Number: (3) Address: (4) Date of Birth (mm/dd/yy): Street (5) Home Telephone: City State Zip (6) Cell/Work Telephone: (7) Semester:/Year of Petition: (8) (9) Have you filed a residency petition before? Yes No If yes, indicate semester and year: (10) Are you financially dependent upon another person? Yes No a) If yes, name of person upon whom you are financially dependent (i.e. person who has claimed you on their most recent tax return): b) Is this person a Maryland Resident? Yes No SECTION 2: BASIS FOR CLAIMING IN-STATE STATUS (To be completed by Petitioner/Student) Check only one: A) I am seeking in-state status because I am a permanent Maryland resident. Complete sections 1, 2, 3, 4, and 7. If you answered yes to question (10)(b) in Section I, that person must complete section 5. B) I am seeking in-state status because I am a full-time or part-time (50%) regular employee of a University System of Maryland institution, or the spouse or financially dependent child of such an employee. Complete Section 1, 2, and 8 and provide verification of employment. If you are a spouse or financially dependent child of an employee, provide documentation, i.e., marriage certificate, birth certificate, or court order of adoption, and a copy of the most recent
4 federal and state income tax returns of the person upon whom dependent. C) I am seeking in-state status because I am a full-time member of the U.S. Armed Forces, residing or stationed in Maryland, or whose home of residency is Maryland, or the spouse or dependent child of such a member of the armed forces. Complete Sections 1, 2, 6, and 8 and provide requested documentation. If you are a spouse or financially dependent child of a full-time member of the U.S. Armed Forces, provide documentation, i.e., marriage certificate, birth certificate, or court order of adoption, and a copy of the most recent income federal and state tax returns of the person upon whom dependent. D) I am seeking in-state status because I am an eligible member of the Maryland National Guard Nonresident Tuition Exemption. Complete Sections 1, 2, 6, and 8 and provide requested documentation.
5 SECTION 3: INCOME AND EXPENSE INFORMATION OF STUDENT (To be completed by Petitioner/Student) Support and Expense Information During the Past Twelve Months Student s Sources of Funds and Other Support Total prior 12 months Indicate Dates Please Be as Specific as Possible Student s Expenses Self-Generated Income Rent or Mortgage 3 Total prior 12 months Indicate Dates Please Be as Specific as Possible Father s Contribution Mother s Contribution Legal Guardian Tuition and Fees Specify full or parttime/credit hrs. Books and Supplies Food Spouse Transportation 4 Other Person Providing Support Loans 1 Savings Gifts (estimated value) Trusts Social Security &/or VA Benefits Alimony &/or Child Support Scholarships and Grants 1,2 Utilities (phone, water, electric, etc.) Motor Vehicle Insurance Other Insurance Clothing Recreation Motor Vehicle Payments Medical Dental Other (describe) TOTAL Miscellaneous (describe) TOTAL Identify type and source. If you receive scholarship or grant funds from a state other than Maryland, indicate state. If you share living quarters with parents, estimate the fair market value of housing costs. If you had use of a motor vehicle registered in another person s name, indicate name and relationship. List all employers (most recent first) for the past 2 years. Use a separate sheet if necessary.
6 Name of Employer Address (City and State) Period Employed (mm/dd/yy) PLEASE ATTACH DOCUMENTATION OF ALL SOURCES OF INCOME FOR THE PREVIOUS 12 MONTHS AND A COPY OF THE STUDENT'S MOST RECENT FEDERAL AND STATE INCOME TAX RETURNS. SECTION 4: STUDENT RESIDENCY INFORMATION Items correspond to the policy requirements established by the USM Board of Regents. (To be completed by the Petitioner/Student) (1) Are you residing in Maryland primarily to attend an educational institution? Yes No If yes, proceed directly to Section 8. (2) If you were admitted as a freshman or transfer student, indicate name(s) of high school(s) attended: Address: Street City State Zip Please attach a statement/explanation (not to exceed one typed page) regarding circumstances that brought you to the State of Maryland. Please indicate whether you were assessed tuition and fees as an in-state or out-of-state resident. (3) Did you own or rent and occupy living quarters in Maryland during the entire 12 month period prior to the deadline? Yes No If no, please attach explanation. Please attach a photocopy of your deed(s) or lease agreement(s) or affidavit as allowed by policy, and cancelled rent checks (front and back of checks-if cancelled checks are not available or applicable, submit evidence of payment from your rental agent) for the twelve (12) months prior to the deadline, or evidence of residing with a spouse, parent or legal guardian. List residence(s) for the 12-month period prior to the deadline. Address (Street Address, City and State) Dates Owned or Rented and Occupied (mm/dd/yy) (4) Are all, or substantially all, of your possessions (including bank accounts) in the State of Maryland? If not, please attach explanation. (5) Income Tax Information: For the last 2 years prior to the deadline, list the following information regarding federal and state income taxes (if necessary, attach a supplemental sheet): Income Tax Returns Year(s) Filed Federal State [indicate state(s)]: Please attach photocopies of your federal and state income tax returns with all attachments and W-2 forms for the tax year ending within the 12-month period prior to the deadline. If you did not file income tax, indicate reason. (6) Motor Vehicle Registration: Do you own or have you owned any vehicle(s) during the 12 months prior to the deadline? If yes, for each owned motor vehicle, please provide the following information (if necessary, attach a supplemental sheet): Year, Vehicle Make & Model State of Registration(s) (For the past 12 months) Date of Vehicle Purchase Currently Owned? If not, date vehicle sold.
7 Please attach photocopy of the registration(s) and title(s) of all vehicles listed; if sold, a photocopy of the Bill of Sale. (7) Motor Vehicle Operator s License: a) Do you possess a Maryland driver s license? Yes No If yes, date issued: b) Have you possessed a driver s license in any other state? Yes No If yes, state? Date issued: c) Has your driver s license been renewed in the last 12 months? Yes No Please attach a photocopy of any driver s license you currently possess. (8) Voter Registration a) Are you currently registered to vote? Yes No If yes, in what state? b) Have you been registered to vote in any other state during the twelve month period directly prior to the deadline? Yes No Please attach a photocopy of your voter s registration card(s) for the past 12 months. (9) Have you received public assistance in the twelve months prior to the deadline from a state other than the State of Maryland or from a city, county or municipal agency other than one in Maryland? Yes No If yes, please indicate source and type of assistance: (10) Citizenship Status a) Are you a citizen of the United States? Yes No (If no, complete b and c, or d, or e) b) Country of Citizenship: c) Visa Type: Alien Registration Number Date of Issue: Expires: Please attach a photocopy of visa. d) Are you a permanent resident? Yes No Alien Registration Number: Date of Issue: Expiration Date: Please attach a copy of Permanent Resident Card (front and back) that covers the entire twelve (12) month period. e) Other (please explain): SECTION 5: RESIDENCY INFORMATION FOR PERSON UPON WHOM STUDENT IS FINANCIALLY DEPENDENT (To be completed by the person upon whom the petitioner is dependent.) (1) Did you own or rent and occupy living quarters in Maryland for the 12 months prior to the deadline? If no, please attach explanation. Please attach a photocopy of your deed(s) or lease agreement(s) or affidavit as allowed by policy, and cancelled rent checks (front and back of checks-if cancelled checks are not available or applicable, submit evidence of payment from your rental agent) for the twelve (12) months prior to the deadline, or evidence of residing with a spouse, parent or legal guardian. List residence(s) for the 12-month period prior to the deadline. Address (Street Address, City and State) Dates Owned or Rented and Occupied (mm/dd/yy) (2) Are all, or substantially all, of your possessions, such as furniture and pets, in the State of Maryland? Yes No If not, please attach explanation. (3) Will you claim or have you claimed as a dependent the student seeking in-state status on your federal income tax returns for the tax year(s) during the12-month period prior to the deadline? Yes No
8 If yes, please attach photocopies of your federal and state income tax returns with all attachments and W-2 forms for the tax year ending within the 12-month period prior to the deadline. If you did not file an income tax return, indicate reason: (4) Citizenship Status a) Are you a citizen of the United States? Yes No (If no, complete b and c, or d, or e) If yes, please attach satisfactory evidence of U.S. citizenship. (e.g., copy of birth certificate or passport or naturalization certificate. If such forms cannot be photocopied, please bring the original to the Residency Classification Officer for inspection.) b) Country of Citizenship: c) Visa Type: Alien Registration Number Date of Issue: Expires: Please attach a photocopy of visa. d) Are you a permanent resident? Yes No Alien Registration Number: Date of Issue: Expiration Date: Please attach a copy of Permanent Resident Card (front and back) that covers the entire twelve (12) month period. e) Other (please explain): SECTION 6: INFORMATION PERTAINING TO FULL-TIME MEMBER OF THE ARMED FORCES (To be completed by the Petitioner/Student or person upon whom the petitioner is dependent) Name of person completing this section: Relationship to petitioner: Last First Middle (1) Are you a full-time member of the U.S. Armed Forces or their associated reserves? Yes No (2) Are you presently stationed in Maryland? Yes No What is your expected separation date from the U.S. Armed Forces or reserves? (3) Are you presently residing in Maryland? Yes No Please attach a copy of your lease, deed, or documentation of base housing. (4) Have you established Maryland as your home of residency? Yes No Please attach your most recently filed state income tax return and military document showing Maryland as your home of residency. All military, please submit a photocopy of your most recent orders and your military I.D. If student petitioner is claiming dependence, please submit a photocopy of military dependent I.D. card. (5) Are you a member of the Maryland National Guard? Yes No If you joined or subsequently served to provide a critical military occupational skill, or are a member of the Air Force critical specialty code, please submit documentation from your Company Commander. SECTION 7: REBUTTAL EVIDENCE (To be completed by the Petitioner/Student) Please complete all applicable information.
9 1. Please list participation in all professional, social, community, civic, political, athletic or religious organization in Maryland, including professionally related school activities that demonstrate a commitment to the your community or to the State of Maryland. Activity Start Date End Date 2. Please attach evidence that your sole address of record for all purposes including on health and auto insurance records, bank accounts, tax records, loan and scholarship records, school records, military records, leases, etc., is in the state of Maryland. 3. Please attach notarized affidavit(s) from a person(s) unrelated to the student that provides objective, relevant evidence of a student's conduct demonstrating the student's intent to live permanently in Maryland.
10 SECTION 8: AFFIRMATION OF PETITIONER AND PERSON UPON WHOM DEPENDENT (To be completed by the Student and/or person upon whom the student is dependent.) I hereby swear and affirm that all information provided in this petition is accurate and complete, and that all documents attached hereto are true and unaltered copies of the original documents requested. I understand that failure to include all requested documents will render this petition invalid. If false or misleading information is submitted, the University may, at its discretion, revoke in-state status and take disciplinary action, including suspension or dismissal. I agree to notify the University System of Maryland in writing within fifteen (15) days of any change of circumstances that may alter my eligibility for in-state status. Signature of Petitioner Date NOTARIZED signature of person upon whom dependent. (Petition will not be accepted without notarized signature.) Date Sworn to and subscribed before me this day of Signature of Notary Public My commission expires: Date Attachments: Please be advised the Residency Classification Office will be unable to accept your petition for in-state status if photocopies of the following documents are not provided with your petition. Petitions not having the required documentation will be returned to the sender.
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1 ESSEX COUNTY COLLEGE APPLICATION FOR A CERTIFICATE OF ELIGIBILITY FOR NONIMMIGRANT (F-1) STUDENT STATUS (FORM I-20) MAIN CAMPUS VISIT OUR WEBSITE WEST ESSEX CAMPUS OFFICE OF RECRUITMENT AND MARKETING
Admissions Office P.O. Box 6900, Fullerton, CA 92834-6900 / T (657)-278-2300 / F (657)-278-7699 AB-540 Instructions for Applying for AB-540 Nonresident Tuition Exemption To apply for exemption from paying
FREQUENTLY ASKED QUESTIONS What must a document contain to be notarized? For a document to be notarized, it must contain: 1) text committing the signer in some way, 2) an original signature of the signer,
CHAPTER 21. STUDENT SERVICES SUBCHAPTER B. DETERMINATION OF RESIDENT STATUS Section 21.21. Authority and Purpose. 21.22. Definitions. 21.23. Effective Date of Subchapter. 21.24. Determination of Resident
Deadline 5-2-2014 ELIGIBILITY: LAMAR UNIVERSITY JOANNE GAY DISHMAN DEPARTMENT OF NURSING MAMIE MCFADDIN WARD HEALTH CAREERS SCHOLARSHIP APPLICATION INSTRUCTIONS For Administrative Use Only Required Documents
The University of the State of New York Certified Public Accountant THE STATE EDUCATION DEPARTMENT Office of the Professions Form 1 Division of Professional Licensing Services www.op.nysed.gov Application
Paris Junior College 2400 Clarksville Street Paris, Texas 75460 903-785-7661 Resident Status Form Texas Higher Education Coordinating Board rule 21.731 requires each student applying to enroll at an institution
International Student Admissions Checklist One Main Street, Suite 350S Use this checklist as an old aid to make sure you have completed all necessary steps before submitting your application. Check the
Non-Degree Graduate Admission College of Science Purpose of the COS Non-Degree Studies Option Admission to graduate study in Non-Degree status is suitable for those individuals who do not currently wish
L5U - - Office of the-- PreS id en t Permanent Memorandum No. 31 (), Revised This supersedes and replaces all prior versions of Issue Date: November 6, 2015 Effective Date: August 1, 2016 F. King Alexander,
Conditional Grant Program An investment toward your future. Grant Application Rules and Regulations Application Deadline: March 1 Texas Department of Transportation Conditional Grant Program Human Resources