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INSTRUCTIONS FOR COMPLETING A PETITION FOR CHANGE IN (University of Baltimore)

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1
INSTRUCTIONS FOR COMPLETING A PETITION FOR CHANGE IN
CLASSIFICATION FOR TUITION PURPOSES
Submit the completed petition and all supporting documentation to the University of Baltimore, 1420 N. Charles St.
Baltimore, MD 21201. Faxes and emails are not accepted.
Important Information Regarding Petitions:
The petition below is based upon USM BOR VIII-2.70 Policy on Student Classification for Admission and Tuition Purposes
(“Policy”), which contains the requirements for establishing in-state status and which is found at:
Bylaws changes in classification
• The petition submission deadline is the last add/drop date of each semester.
• Read the petition carefully and complete all sections of the petition that apply to you. Petitions with incomplete
applicable sections, and petitions missing required supporting documentation will not be evaluated.
• 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.
• Only one petition may be filed per semester.
• Petitions and requests for retroactive reclassification for tuition purposes are not accepted.
• No materials or documentation will be returned after the petition is submitted.
• The review of the petition and the initial determination of the status may take as long as six (6) weeks. Not
including subsequent appeals. While petitions are under review, petitioners are required to make full tuition
payment at the out-of- state rate. If the University determines that the petitioner meets all of the requirements for
in-state residency, the petitioner’s classification will be changed and a refund or account credit will be issued as
appropriate.
• If claiming financial dependence, the person upon who the petitioner is dependent must sign the petition and
have his/her signature notarized.
• Affidavits must be typed, dated, notarized, and contain information as specific as possible including dates,
addresses, amounts, etc. Please check in advance for instructions.
• The petition refers to “the 12-month period prior to the last date to register for classes” which is defined as the
twelve (12) consecutive months immediately prior to and including the last date available to register for courses in
the semester/term for which the petitioner seeks in-state tuition status.
Please note: Graduate Assistants who were admitted as out-of-state students are assessed tuition at the in-state rate
only as a benefit of their employment. All out-of-state graduate assistants who have met all residency requirement and
wish to change their status to in-state must file a timely petition with the Residency Reclassification Services in
accordance with Policy requirements.
2
UNIVERSITY OF BALTIMORE
PETITION FOR CHANGE IN CLASSIFICATION FOR TUITION PURPOSES
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. Only one petition for
change in status may be filed per semester. All petitioners mush complete Section 1(Petitioner Information), Section 2
(Income, Support, and Expense Information of Petitioner), Section 3 (Petitioner Residency Information), and Section
6(Affirmation of Petitioner and Person upon Whom Petitioner is Financially Dependent). Petitioners who raised the
presumption that they are in the State of Maryland primarily for the purpose of attending an educational institution and
wish to rebut the presumption will need to complete Section 5 (Rebuttal Evidence) (see Section 5 for explanation).
Provide documentation where appropriate/required.
SECTION 1: PETITIONER INFORMATION (To be completed by Petitioner)
This section must be completed by the petitioner for in-state status.
Program (Check One): Undergraduate Graduate
1) Are you currently registered? Yes No
2) Semester and Year Admitted: ___________________
3) Current Class Status: freshman sophomore junior senior graduate/professional
4) Name: Last: _________________________________ First: _________________________MI: _________________
5) University ID Number: ________________________ 6) Date of Birth (mm/dd/yy): ____________________________
7) Address: Street: _________________________________________________________________________________
City: ___________________________________State:_________________________Zip: ______________
8) Daytime/Cell Phone: _____________________________ 9) Email: ________________________________________
10) Semester/Year of Petition:
11) Have you filed a residency petition before? Yes No
If Yes, indicate the semester and year: ________________
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SECTION 2: INCOME, SUPPORT, AND EXPENSE INFORMATION OF PETITIONER
This section must be completed by all petitioners. The evidence should document any employment and earnings history
through sources 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. The petitioner must list all employers for
the past two (2) years, with specific dates of employment.
1) Have you been employed within the past two years? Yes No. If Yes, list all employers below (most recent first)
for the past 2 years. Use a separate sheet if necessary.
Name of Employer: __________________________ Address (City and State): ______________________________
Period of Employment (mm/dd/yy): _____________________
Name of Employer: ___________________________ Address (City and State): _____________________________
Period of Employment (mm/dd/yy): ________________________
2) Income Tax Information: For the 12-month period prior to the last date to register for classes, including the most recent
tax year, did you file a state income tax return(s)? Yes No
If No, attach an explanation.
If Yes, list the following information regarding state income taxes (attach a supplemental sheet, if necessary):
Income Tax Returns: Indicate state(s) and Year(s) filed below:
State: _____________ Year Filed: __________, State: ______________ Year Filed: _______________,
State: _____________ Year Filed: __________, State: ______________ Year Filed: _______________,
Attach photocopies of all your completed, signed and filed state income tax returns with all attachments and W-2
forms for the tax year ending within the 12-month period prior to the last date to register for classes. If you did
not file a Maryland state income tax return for that year, attach an explanation. If you filed state income tax
returns in more than one state, attach all returns and an explanation.
For Maryland Income Tax returns, attach a Maryland Comptroller’s certified copy of each Maryland tax return. To
obtain Maryland Comptrollers certified copies, complete the Maryland Comptroller’s Office Form 129 found at:
Request a Certified Copy of Income Tax.
3) Ar
e you financially dependent upon another person who has claimed you as their dependent on their most recent tax return?
Yes No
If Yes, name the person and relationship to the person who has claimed you as a dependent on their most recent tax return.
Name: ______________________________________ Relationship to petitioner: __________________________________
Is this person a Maryland resident? Yes No
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) Complete the following Expense and Fund Tables and attach documentation of all sources of income for the 12-month
period prior to the last date to register for classes including the most recent pay stubs showing year-to-date earned
totals for each employer.
Expense Table
Expenses
Annual Amount
Tuition and Fees
Housing and Food ( on or off campus)
Personal Expenses (health insurance, transportation, clothing etc.
Books and Supplies ( if applicable)
Other
Total Annual Amount
Source of Funds Table
Source of Funds
Annual Amount
Income (employment and self-employment income)
Contribution from another person(alimony, child support, family support or others)
Trust and or Investment Funds
Loans, Grants, Fellowships, Stipends, Scholarships
Savings and Checking Account Balances
Other
Total Annual Amount
SECTION 3: PETITIONER RESIDENCY INFORMATION (To be completed by Petitioner)
1) Did you move to Maryland primarily to attend an educational institution? Yes No.
If No, attach a statement regarding the circumstances that brought you to the State of Maryland.
2) If you were admitted as a freshman or transfer student, indicate the names and addresses of all high schools you
attended. Use a separate sheet if necessary.
Name of High School: _________________________________________________________________________
Address: Street: ________________________________________________________________________________
City: _______________________________________State: ____________________Zip: ______________
Name of High School: _________________________________________________________________________
Address: Street: ________________________________________________________________________________
City: _______________________________________State: ____________________Zip: ______________
If you were enrolled in another higher education institution(s) during the previous 12 months, complete the following:
Name of Institution: ________________________________________________________________________
Address: Street: _______________________________________________________________________________
City: ___________________________________________State: _______________ Zip: _____________
Were you assessed in-state or out of state tuition and fees while enrolled at that institution?
In-state out-of- state Not Applicable If you attended more than one institution, attach a list
and indicate whether you were assessed in-state or out-of-state tuition and fees at each of those institutions.
5
3) Did you own or rent and occupy living quarters in Maryland during the entire 12-month period prior to the last date to
register for classes? Yes No If No, attach and explanation.
Attach a photocopy of deed(s) or lease agreement(s) or affidavit, and cancelled rent checks (front and back of
checks) or evidence of payment from your rental agent if cancelled rent checks are not available or applicable,
for the 12-month period prior to the last date to register for classes, or evidence of residing with a spouse, parent
or legal guardian, relative, or non-family member.
List residences and dates of occupancy for the 12-month period prior to the last date to register for classes.
Address: Street: __________________________________ City: ___________________________________________
State: ___________________ Zip: __________ Dates of Occupancy (mm/dd/yy): from: ______ to ________
Address: Street: __________________________________ City: _________________________________________
State: ___________________ Zip: ___________ Dates of Occupancy (mm/dd/yy): from: ____ to _________
4) Are all, or substantially all, of your personal property such as household effects, furniture, and pets in the
State of Maryland? Yes No If No, attach and explanation.
5) Motor Vehicle Registration: Do you own or lease or have you owned or leased any vehicle during the 12 months prior
to the last date to register for classes? Yes No If Yes, complete the following information.
Vehicle Information Table
Vehicle Make Model and Year
State of Registration (for the
twelve month period prior to the
last date to register for classes)
Date of
Registration
Purchase or
Currently Owned or
Leased If not, date vehicle
sold or lease terminated
Attach a photocopy of the current and previous registrations(s) and title(s) of all vehicles. If your current
registration and title were issued less than 12 months ago, provide a photocopy of previous of previous
registrations and titles of all vehicles listed; if sold, a photocopy of the Bill of Sale. If the vehicle was purchases
within the previous 12 consecutive months, include a photocopy of the Purchase Order.
6) Motor Vehicle Operator’s License Information: Do you possess a valid driver’s license? Yes No
If Yes, in what state: _______________ If Maryland, what was the initial date of issue? ___________________
If you’ve renewed your license, what is the most recent date of issue (not expiration date): __________________
Have you possessed a driver’s license in a state other than Maryland within the last 12 months? Yes No
Attach a photocopy of any driver’s license you currently possess. If issued or renewed during the 12-month period prior to
the date to register for classes, provide a photocopy of previous license or MVA driving records.
7) Voter Registration
Are you currently registered to vote? Yes No If Yes, in what state? ____________
Attach a photocopy of your most recent voter’s registration.
6
8) Do you receive any public assistance (i.e. Housing assistance, Medicaid or food vouchers) from a state or local
agency other than one in Maryland? Yes No
If Yes, indicate source and type of assistance: _____________________________________________________
__________________________________________________________________________________________
9) Citizenship Status
a) Are you a citizen of the United States? Yes No (If No, complete “b” through “f”, as applicable).
If Yes, attach satisfactory evidence of U.S. citizenship (e.g. Copy of birth certificate or passport or naturalization
certificate).
b) Country of Citizenship: ________________________________________________________________________
c) Visa Type: ____________________________________ Alien Registration Number: ________________________
Date of Issue: __________________________________Date of Expiration_______________________________
Attach a photocopy of visa.
d) Are you a permanent resident of the U.S.? Yes No Alien Registration Number___________________
Date of Issue: __________________________________Date of Expiration: ______________________________
Attach a copy of Permanent Resident Card (front and back) that covers the 12-month period prior to the last date
to register for classes.
e) Are you an applicant for Permanent Residence and have filed the I-485 Application to Register Permanent
Residence or Adjust Status? Yes No
If Yes, provide receipt date of application _____________ and attach a copy of I-485/I-797C document.
f) Other status (explain): ______________________________________________________________________
Attach a photocopy of current citizenship status for the 12-month period prior to the last date to register for
classes.
7
SECTION 4: RESIDENCY INFORMATION FOR PERSON UPON WHOM PETITIONER IS
FINANCIALLY DEPENDENT (To be completed by the person who has claimed the petitioner as a dependent
on the most recent state income tax return)
1) Did you own or rent and occupy living quarters in Maryland for the 12-month period prior to the last date
for the petitioner to register for classes?
Yes No If No, attach an explanation.
List residences for the 12-month period prior to the last date to register for classes below.
Address: Street: ____________________________________ City: ______________________________________
State: ________ Zip: _______________ Dates of Occupancy (mm/dd/yy): from: _______ to ___________
Address: Street: ____________________________________ City: _______________________________________
State: ________ Zip: _______________ Dates of Occupancy (mm/dd/yy): from: ________ to __________
Address: Street: ____________________________________ City: ________________________________________
State: __________ Zip: _____________ Dates of Occupancy (mm/dd/yy): from: ________ to _________
If you owned or rented an occupied living quarters in Maryland for the 12-month period prior to the last date for
the petitioner to register for classes, attach a photocopy of your deed(s) or lease agreement(s) or affidavit, and
cancelled rent checks (front and back of checks) or evidence of payment from your rental agent if cancelled rent
checks are not available or applicable, for the 12-month period prior to the last date for the petitioner to register
for classes.
2) Are all, or substantially all, of your personal property such as household effects, furniture and pets in the
State of Maryland?
Yes No If No, attach an explanation.
3) Will you claim or have you claimed the petitioner as your dependent on your state income tax returns for the tax year(s)
during the 12-month period prior to the last date for the petitioner to register for classes? Yes No
If No, attach an explanation.
Attach photocopies of all your completed, signed and filed state income tax returns with all attachments and W-2
forms for the tax year ending within the 12-month period prior to the last date to register for classes. If you did not
file a Maryland state income tax return for that year, attach an explanation. If you filed state income tax returns in
more than one state, attach all returns and an explanation.
For Maryland Income Tax returns, attach a Maryland Comptroller’s certified copy of each Maryland tax return. To
obtain Maryland Comptrollers certified copies, complete the Maryland Comptroller’s Office Form 129 found at:
Request a Certified Copy of Income Tax.
8
SECTION 5: REBUTTAL EVIDENCE (To be completed by the Petitioner)
As provided in Section II.B of USM BOR VIII-2.70 Policy on Student Classification for Admission and Tuition Purposes, either of the
following circumstances raises a presumption that the student is residing in the State of Maryland primarily for the purpose of
attending an educational institution, and, therefore, does not qualify for in-state status under the Policy:
• A student is attending school or living outside of Maryland at the time of application for admission to the USM institution; or
• A student is Financially Dependent on a person who is not a resident of Maryland. A Financially Dependent student is one
who has been claimed as a dependent on another person’s prior year tax returns or is a ward of the State of Maryland. A
student will be considered financially independent if the student provides 50% or more of his or her own living and
educational expenses and has not been claimed as a dependent on another person’s most recent tax returns.
I
f the information received by the institution has raised the presumption set forth above, the student bears the burden of rebutting the
presumption by presenting additional evidence of objectively verifiable conduct to rebut the presumption and show the requisite
intent to reside in Maryland indefinitely and for a primary purpose other than that of attending an educational institution in Maryland.
Rebuttal 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 and the totality of facts known to the institution. 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
-s
tate tuition status is generally considered an unfavorable
factor under the Policy. 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 the Policy.
For purposes of rebutting the presumption, additional evidence that will be considered includes, but is not limited to:
1) Source of financial support:
a. Maryland employment and earnings history through sources 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. (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.), or
b. Evidence the student is Financially Dependent, for the previous 12 months, upon a person who is a resident of
Maryland.
2) 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.
Attach signed statement(s) on letterhead from the professional, social, community, civic, political, athletic, or
religious organizations showing the activity and applicable dates.
3) Registration as a Maryland resident with the Selective Service, if applicable.
Attach a copy of Selective Service registration.
4) Evidence that the student is married to a Maryland resident.
Attach a copy of marriage certificate.
5) Evidence that the student attended schools in Maryland for grades K‐12.
9
Attach a copy of transcripts with years of attendance.
6) 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.
Attach evidence of 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.)
7) 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 reside in Maryland primarily for a purpose other than that of attending an educational
institution in Maryland.
Attach notarized affidavit(s) from a person(s) unrelated to you that provides objective, relevant evidence of your
conduct demonstrating your intent to live permanently in Maryland.
8) Evidence of life and employment changes that caused the student to relocate to Maryland for reasons other than primarily
educational purposes (e.g. divorce, family relocation, taking care of a sick family member, etc.)
Attach evidence of life and employment changes (e.g. employment offer letter) and other documentation
supporting the life changes.
SECTION 6: AFFIRMATION OF PETITIONER AND PERSON UPON WHOM DEPENDENT (To
be completed by the petitioner and/or person upon whom the petitioner is financially dependent.)
I affirm that I have read USM BOR VIII-2.70 Policy on Student Classification for Admission and Tuition Purposes, which contains the
requirements for establishing in-state status and which is found at USM Policy on student classification
.
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 expulsion. I agree to notify the University System of Maryland
institution of enrollment 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 petitioner is dependent: ____________________________________________________
(Petition will not be accepted without notarized signature.)
Date: ____________________________________
Sworn to and subscribed before me: _________________________________ this date: ___________________________________
___________________________________________________________My commission expires: ___________________________
Signature of Notary Public
Attachments: Please be advised the University will be unable to accept your petition for in-state status if photocopies of the
documents are not provided with your petition. Petitions not having the required documentation will not be evaluated.
updated 11/2018 Records Office
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INSTRUCTIONS FOR COMPLETING A PETITION FOR CHANGE IN (University of Baltimore)

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Completed 28 August 2020

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