DATA TO DETERMINE DOMICILE
Students (and parents) seeking New Jersey resident tuition status must furnish the information
requested below. Please note that any false statements or withholding of pertinent information
will be referred to the Institute Committee on Professional Conduct.
A. If it is claimed that your parent or guardian is a legal resident of New Jersey even though the
address you have given is not in New Jersey, please state the basis for this claim.
B. If you claim that you have established a domicile in New Jersey as an independent person
(24 years or older), you must give the basis for this claim by means of an explanatory statement
under the applicable heading below.
1. I was married on_________________ to ____________________________ at
___________________________ and we have been living
at_____________________________ since_______________. My spouse was a
resident of the state of __________________________ at the time of marriage. (Supply a
copy of your marriage certificate)
2. I claim to be emancipated by mutual consent of myself and parents. Yes __ No __ a.
My parents contribute to my support. Yes __ No __
b. My parents claim me as a dependent on their tax return. Yes __ No __
(Supply a copy of parent's signed most recent federal tax return.)
3. I claim to be emancipated by virtue of formal court action.
(Attach copies of supporting documents)
4. I claim to be emancipated by virtue of
_________ death of both parents and no legal guardian;
_________ other causes.
Explain fully below and provide documentation: