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Core Residency Questions (University of Houston-Downtown)

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Core Residency Questions
New Undergraduate and Graduate Students
The residency classification for applicants who have never attended UH-Downtown and students, who will
register or have already registered for their first semester at UH-Downtown, is processed in the Office of
Admissions. If you are a first time applicant or will be registering at UH-Downtown for the first time,
p l e as e direct all residency questions to residency@uhd.edu.
UH-Downtown Office of Admissions
One Main Street, GSB308
Houston, TX 77002-1001
Former and Continuing Students
Former and continuing UHD students must return this form to the Registrar’s Office. Please contact the
Registrar’s Office regarding questions or reclassification of residency status for tuition purposes at
713-221-8999 or uhdrecords@uhd.edu.
UH-Downtown Registrar’s Office
One Main Street, N-330
Houston, TX 77002-1001
Texas Higher Education Coordinating Board rule 21.25 requires each student applying to enroll at an institution to
respond to a set of core residency questions for the purpose of determining the student’s eligibility for classification
as a resident. This information will not be processed unless a current application for admission is on file.
Non- resident students currently enrolled may also use this form to apply for consideration for reclassification to
Texas resident for tuition purposes. A l l requests for reclassification s u b m i t t e d t o e i t h e r t h e O f f i c e o f
A d m i s s i o n s o r t h e R e g i s t r a r ’ s O f f i c e must be received prior to the official census date, also known as
the Day of Record, of the term for which you are requesting residency reclassification. To find out the census
date (Day of Record) for each term at UHD, please see the Academic Calendar at
www.uhd.edu/academic/calendar.htm.
PART A. Student Basic Information.
All Students must complete this section.
Name:
UHD ID Number:
Date of Birth:
Telephone Number: County :(Harris, Galveston, etc.)
Residency change requested for
Semester Year
First semester enrolled:
Semester Year
PART B. Previous Enrollment.
For all students.
1. During the 12 months prior to the term for which you are applying, did you attend a public college or
university in Texas in a fall or spring term?
Yes No
If you answered “no”, please continue to Part C.
If you answered “yes”, complete questions 2-5:
2. W hat Texas public institution did you last attend? (Give full name, not just initials.)
3. In which terms were you last enrolled? (check all that apply)
fall,20
spring, 20
4. During your last semester at a Texas public institution, did you pay resident (in-state) or nonresident (out-
of-state) tuition?
Resident (in-state) Non resident (out-of-state) unknown
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5. If you paid in-state tuition at your last institution, was it because you were classified as a resident or
because you were a nonresident who received a waiver?
Resident Non resident with a waiver unknown
IMPORTANT: If you were enrolled at a Texas public institution during a fall or spring semester within the previous 12
months and were classified as a Texas resident, skip to Part I, sign and date this form and submit it to your institution. If
you were not enrolled, or if you were enrolled but classified as a nonresident, proceed to Part C.
Page 1 of 5
PART C. Residency Claim.
Are you a resident of Texas? Yes No
If you answered yes, continue to Part D.
If you answered no, complete the following question and continue to Part I.
Of what state or country are you a resident?
If you are uncertain, continue to Part D.
PART D. Acquisition of High School Diploma or GED.
Yes No
1. a. Did you graduate or will you graduate from high school or complete a
GED in TX prior to the term for which you are applying?
1. b. If you graduated or will graduate from high school, what was the name
and city of the school?
2. Did you live or will you have lived in TX the 36 months leading up to high
school graduation or completion of the GED?
3. When you begin the semester for which you are applying, will you have
lived in TX for the previous 12 months?
4.
Are you a U.S. Citizen or Permanent Resident? (If you are a permanent
resident, please submit a copy of your card.)
Instructions to Part D:
If you answered “no” to question 1a or 2 or 3, continue to Part E.
If you answered “yes” to all four questions, skip to Part I.
♦ If you answered “yes” to questions 1, 2 and 3, but “no” to question 4, complete a copy of the
Affidavit of Intent to Become a Permanent Resident, skip to Part I of this form, and submit
both this form and the affidavit to your institution.
PART E. Basis of Claim to Residency. TO BE COMPLETED BY EVERYONE WHO DID
NOT ANSWER
“YES” TO QUESTIONS 1a, 2, AND 3 OF PART D.
1. Do you file your own federal income tax as an independent tax payer? Yes No
(An independent tax payer should not be claimed as a dependent for tax purposes by another person. If you file a joint return
with your spouse, answer “yes.”)
2. Are you claimed as a dependent or are you eligible to be claimed as a dependent by a parent or court-appointed
legal guardian? Yes
No (To be eligible to be claimed as a dependent, your parent or legal guardian
must provide at least one-half of your support. A step- parent does not qualify as a parent if he/she has not adopted
the student.)
3.
If you answered “No” to both questions above, who provides the majority of your support?
Self
parent or guardian
other: (list)
Instructions to Part E.
If you answered “yes” to question 1, and “no” to question 2, continue to Part F.

If you answered “yes” to question 2, skip to Part G.
 If you answered “yes” to both questions 1 and 2, skip to Part G.
If you answered “no” to 1 and 2 and “self” to question 3, continue to Part F.
If you answered “no” to 1 and 2 and “parent or guardian” to question 3, skip to Part G.
If you answered “no” to 1 and 2 and “other” to question 3, skip to Part H and provide an explanation, and
complete Part I.
Page 2 of 5
PART F. Questions for students who answered “Yes” to Question 1 or “Self” to Question
3 of PART E.
Yes No Years Mo. Visa/Status
1. Are you a U.S. Citizen?
2.
Are you a Permanent Resident of the U.S.?(Submit Copy)
3. Are you a foreign national whose application for
Permanent Resident Status has been preliminarily reviewed?
(You should have received a fee/filing receipt or Notice of
Action(I-797) from USCIS showing your I-485 has been
reviewed and has not been rejected).
(Submit Documentation)
4 .Are you a foreign national here with a visa or are you a
Refugee, Asylee, Parolee or here under Temporary Protective
Status? If so, indicate which.(Submit Documentation)
5. Do you currently live in Texas? If you are out of state due
to a temporary assignment by your employer or another
temporary purpose, please check “no” and explain in Part H.
6. a. If you currently live in Texas, how long have you
been living here?
b. What is your main purpose for being in the state? If for
reasons other than those listed, give an explanation in
Section H
Years
Mo.
Go to
College
Establish/maintain
a home
Work
Assignment
7. a. If you are a member of the U.S. military, is
Texas your Home of Record?
b. If not, what state will have been listed as your military
legal residence for tax purposes on your Leave and
Earnings Statement for the 12 months prior to enrollment?
State
Yes No
8. Do any of the following apply to you? (Check all that apply)
a. Hold the title (Warranty Deed, Deed of Trust, or other similar instrument that
is effective to hold title) to residential real property in Texas?
If yes, date acquired:
b. Have ownership interest and customarily manage a business in Texas
without the intention of liquidation in the foreseeable future?
If yes, date acquired:
9. While living in Texas, have you: (Check all that apply)
a. Been gainfully employed for a period of at least 12 consecutive months?
(Gainful employment requires an average employment of at least 20 hours per
week for one year or earnings equal to at least half of tuition and living
expenses for one 9-month academic year. Employment conditioned on student
status such as work-study, the receipt of stipends, fellowships or research or
teaching assistanceships does not constitute gainful employment.)
b. Received primary support through services from a social service agency for a
period of at least 12 consecutive months?
10.
a. Are you married to a person who has been classified as a Texas resident by a Texas
public institution or who could answer “yes” to any part of question 8 or 9?
b. If yes, indicate which question (and which part of the question) could be answered yes by
your spouse:
c. How long will you have been married to the Texas resident prior to enrollment?
Question:
Years
Mo.
Skip Part G and Continue to Part H.
Revised December 2014 Page 3 of 5
PART G. Questions for students who answered “Yes” to Question 2 of Part E or who
answered “Parent or
Guardian” to Question 3 of PART E.
Yes No Years Mo. Visa/Status
1. Is the parent or legal guardian upon whom you base your
claim of residency a U.S. citizen?
2. Is the parent or legal guardian upon whom you base your
claim of residency a Permanent Resident?
3. Are you a foreign national whose application for Permanent
Resident Status has been preliminarily
reviewed? (You should have received a fee/filing receipt or
Notice of Action(I-797) from USCIS showing your I-485 has
been reviewed and has not been rejected).
4. Is this parent or legal guardian a foreign national here with a
visa or a Refugee, Asylee, Parolee or here under Temporary
Protective Status? If so, indicate which.
(Documentation may be required)
5. Does this parent or guardian currently live in Texas? If he or
she is out of state due to a temporary assignment by his or her
employer or another temporary purpose, please check “no” and
explain in Part H..
6. a. If he or she is currently living in Texas, how long has he
or she been living here?
b. What is your parent’s or legal guardian’s main purpose for
being in the state? If for reasons other than those listed, give
an explanation in Part H.
Years
Mo.
Go to
College
Establish/maintain
a home
Work
Assignment
7. a. If he or she is a member of the U.S. military, is Texas his
or her Home of Record?
b. If not, what state will have been listed as his or her military
legal residence for tax purposes on his or her Leave and
Earnings Statement for the 12 months prior to enrollment?
State
Yes No
8. Do any of the following apply to your parent or guardian? (Check all that apply)
a. Hold the title (Warranty Deed, Deed of Trust, or other similar instrument that is
effective to hold title) to residential real property in Texas?
If yes, date acquired:
b. Have ownership interest and customarily manage a business in Texas without
the intention of liquidation in the foreseeable future?
If yes, date acquired:
9. While living in Texas, has your parent or guardian: (Check all that apply)
a. Been gainfully employed for a period of at least 12 consecutive months? (Gainful
employment requires an average employment of at least 20 hours per week for one year or
earnings equal to at least half of tuition and living expenses for one 9-month academic year.
Employment conditioned on student status such as work-study, the receipt of stipends,
fellowships, or research or teaching assistanceships does not constitute gainful employment.)
b. Received services from a social service agency for a period of at least 12 consecutive
months? Note: the dollar value of social services received may be combined with earnings to
total at least one-half of tuition and living expenses for one 9-month academic year.
10.
a. Is your parent or legal guardian married to a person who has been classified as a Texas
resident by a Texas public institution or who could answer “yes” to any part of question 8 or 9?
b. If yes, indicate which question (and which part of the question) could be answered yes by
your parent or guardian’s spouse:
c. How long will your parent or guardian have been married to the Texas resident prior to
enrollment?
Question:
Years
Mo.
Revised December 2014 Page 4 of 5
Part H. General Comments. Is there any additional information that you believe your college/university should know in
evaluating your eligibility to be classified as a resident? If so, please provide it below:
PART I. Certification of Residency. All students must complete this section.
I understand that officials of my college/university will use the information submitted on this form to determine my
status for residency eligibility. I authorize the college/university to verify the information I have provided. I agree to
notify the proper officials of the institution of any changes in the information provided. I certify that the information
on this application is complete and correct and I understand that the submission of false information is grounds for
rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment and/or appropriate
disciplinary action.
Signature Date:
Note: Colleges and universities are subject to certain federal and state recordkeeping and reporting requirements for the
administration of applicable laws and regulations, including civil rights laws and regulations. In order to comply with these
requirements, UHD wishes to collect your racial and/or ethnic background information. Your responses to the following
questions are strictly voluntary and will in no way affect your academic record. The information will be used ONLY for
reporting purposes. Although providing this information is strictly voluntary, we would appreciate your responses because it
is important that we have an accurate record of our students’ ethnic/racial demographics.
Question 1:
Are you Hispanic or Latino/a? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish
culture or origin, regardless of race.)
Yes
No
Question 2:
Please select the racial category or categories with which you most closely identify. Choose one or more.
American Indian or Alaska Native - A person having origins in any of the original peoples of North and South
America (including Central America) and who maintains cultural identification through tribal affiliation or community
attachment.
Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands,
Thailand, and Vietnam.
Black or African American - A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam,
Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
For Office Use Only:
Received By Date
Processed By Date
Revised November 2015 Page 5 of 5
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