Fillable Texas Core Residency Questionaire (Wayland Baptist University)

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Texas Core Residency Questionaire (Wayland Baptist University)

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RETURN TO: Office of Financial Aid | 101 Gates Hall
1900 W. 7
th
Street, CMB #1266, Plainview, TX 79072
finaid(yourcampus)@wbu.edu or finaidhelp@wbu.edu (Plainview)
Texas Core Residency Questionaire
Student’s Name
Student ID
Last
First
Texas Administrative Code, Title 19, Part 1, Chapter 21, Subchapter B, §21.24 requires students respond to a set of
core residency questions for the purpose of determining the student’s eligibility for classification as a Texas resident
making them eligible to be considered for state financial aid programs. Because Wayland Baptist University being a
private institution, does not offer tuition differential for students classified as Texas residents.
STEP 1: Identity
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 (not including dual credit)?
No. Continue to STEP 2
Yes
What Texas public institution did you last attend? ______________________________________________
In which terms were you last enrolled? Fall __________ Spring __________
During your last semester at a Texas public institution, did you pay resident or nonresident tuition?
Resident Nonresident Unknown
If you paid resident 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 Nonresident with a waiver Unknown
IMPORTANT: If you were enrolled at a Texas public institution during a fall or spring term within the previous 12
months and were classified as a Texas resident, skip to STEP 8. If you were not enrolled, or if you were enrolled but
classified as a nonresident, proceed to STEP 2.
STEP 2: Residency Claim
Are you a resident of Texas?
Yes. Continue to STEP 8
No. I am a resident of __________________(state/country). Continue to STEP 3
STEP 3: High School Diploma or GED
1. Did you graduate from high school or complete a GED in Texas?
No
High School ________________________________ City________________ Grad Date_________________
2. Did you live in Texas during the 36 months leading up to graduation or GED completion?
No
3. When you begin the semester for which you are applying, will you have lived in Texas for
the previous 12 months?
No
4. Are you a U.S. Citizen or Permanent Resident?
No
I answered Yes to all four questions. Continue to STEP 8
I answered Yes to questions 1, 2, and 3, but No to question 4. Continue to STEP 8 and complete Affidavit on
page 4.
I answered No to question 1, 2, or 3. Continue to STEP 4
3/2021 2
STEP 4: Basis of Claim to Residency
1. Do you file your own federal income tax as an independent tax payer?
No
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?
No
3. If you answered No to question 1 and 2, who provides the majority of your support ?
Self Parent/Guardian Other ______________________________________________________
I answered Yes to question 1. Continue to STEP 5
I answered Yes to question 2. Continue to STEP 6
I answered No to question 1 and 2 and Self to question 3. Continue to STEP 5
I answered No to question 1 and 2 and Parent/Guardian to question 3. Continue to STEP 6
I answered No to question 1 and 2 and Other to question 3. Continue to STEP 7
STEP 5: Completed by student who answered Yes to Question 1 or Self to Question 3 from STEP 4
1. Are you a U.S. Citizen?
No
2. Are you a Permanent Resident of the U.S.?
No
3. Are you a foreign national whose application for Permanent Resident status has been
preliminarily reviewed? (Received a fee/filing receipt or Notice of Action [I-797] from
USCIS showing I-485 has been reviewed and not rejected.)
No
4. Are you a foreign national here with a visa or are you a refugee, asylee, parolee, or here
under temporary protective status? Status: ______________________________________
No
5. Do you currently live in Texas?
No
How long have you lived in Texas? Years __________ Months __________
What is your main purpose for living in the state of Texas?
Attend college Establish/maintain a home Work assignment
6. If you are a member of the U.S. military, is Texas your home of record?
No
What state is listed as your military legal residence for tax purposes on your Leave and Earnings
Statement?
State: _____________________________________
7. Do any of the following apply to you?
Hold the title to real property (home/land) in Texas?
Date acquired: _____________________
No
Own a business in Texas?
Date acquired: _____________________
No
Hold a state or local license to conduct business or practice a profession in Texas?
Date acquired: _____________________
No
8. For the past 12 months have you:
Been gainfully employed in Texas?
No
Received services from a social service agency that provides services to homeless
persons?
No
9. Are you married to a person who could answer Yes to question 7 or 8?
8
How long have you been married to a Texas resident? Years __________ Months __________
Skip STEP 6. Continue to STEP 7
3/2021 3
STEP 6: Completed by student who answered Yes to Question 2 or Parent/Guardian to Question 3 from
STEP 4
1. Is the parent/legal guardian upon whom you base your claim of residency a U.S. Citizen?
No
2. Is the parent/legal guardian upon whom you base your claim of residency a Permanent
Resident of the U.S.?
No
3. Is your parent/legal guardian a foreign national whose application for Permanent Resident
status has been preliminarily reviewed? (Received a fee/filing receipt or Notice of Action [I-
797] from USCIS showing I-485 has been reviewed and not rejected.)
No
4. Is your parent or legal guardian a foreign national here with a visa or are you a refugee,
asylee, parolee, or here under temporary protective status? Status: ____________________
No
5. Does your parent or legal guardian currently live in Texas?
No
How long has he/she lived in Texas? Years __________ Months __________
What is his/her main purpose for living in the state of Texas?
Attend college Establish/maintain a home Work assignment
6. If your parent/legal guardian is a member of the U.S. military, is Texas his/her home of
record?
No
What state is listed as his/her military legal residence for tax purposes on his/her Leave and Earnings
Statement?
State: _____________________________________
7. Do any of the following apply to your parent/legal guardian?
Hold the title to real property (home/land) in Texas?
Date acquired: _____________________
No
Own a business in Texas?
Date acquired: _____________________
No
Hold a state or local license to conduct business or practice a profession in Texas?
Date acquired: _____________________
No
8. For the past 12 months has your parent/legal guardian:
Been gainfully employed in Texas?
No
Received services from a social service agency that provides services to homeless
persons?
No
9. Is your parent/legal guardian married to a person who could answer Yes to question 7 or 8?
8
How long has your parent/legal guardian been married to a Texas resident?
Years __________ Months __________
Continue to STEP 7
STEP 7: General Comments
Is there any additional information that you believe your college should know in evaluating your eligibility to be
classified as a Texas resident? If so, please attach separate explanation.
Continue to STEP 8
3/2021 4
STEP 8: Certification of Residency (Completed by ALL students)
I understand that officials of Wayland Baptist University will use the information submitted on this form to
determine my status for residency eligibility as it pertains to state financial aid eligibility. I authorize Wayland Baptist
University to verify the information I have provided. I agree to notify the proper officials of the institution of any
changes to 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 cancellation of any state financial aid offered
based on that false information.
Student Signature
Date
AFFIDAVIT: Complete by student who answered No to Question 4 in STEP 3.
Witness Before a Notary Public
Before me, the undersigned Notary Public, on this day personally appeared _________________, known to me, who
being by me duly sworn upon his/her oath, deposed and said:
1. My name is _______________________________________. I am ____ years of age and have personal
knowledge of the facts stated herein and they are all true and correct.
2. I graduated/will graduate from a Texas high school or received/will receive my GED certificate in Texas.
3. I resided in Texas for three years leading up to graduation from high school or receiving my GED certificate.
4. I have resided/will have resided in Texas for the twelve months prior to the census date of the term in which
I will enroll at Wayland Baptist University.
5. I have filed/will file an application to become a permanent resident at the earliest opportunity that I am
eligible to do so.
6. I have registered/will register with Selective Service on my eighteenth birthday (males only).
Student Signature
Date
Printed Name
ID
State of _______________________, City/County of ________________________________________________
on this ________ day of the ________ month of _________, before me, _________________________________,
personally appeared, ___________________________________________________, and provided me on the basis
of satisfactory evidence of identification _________________________________________ to be the above-named
person who signed the foregoing instrument.
WITNESS my hand and official seal
Notary Signature:
My commission expires on
SEAL
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Texas Core Residency Questionaire (Wayland Baptist University)

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Completed 1 July 2021

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