Application for Resident Status for Tuition Purposes (Prior 2019)

THIS APPLICATION IS FOR USE BY GRADUATE STUDENTS ONLY ADMITTED PRIOR TO FALL 2019.

In accordance with PM 31, applications for reclassification from nonresident or undetermined to resident status for tuition purposes must be filed with the Graduate School no later than 21 calendar days following the first day of classes of the term in which such reclassification is sought. The application must include all information on the attached forms and copies of documents required by the University, together with any additional supporting evidence which the student desires to submit. Failure to comply with the appeals procedure shall constitute a waiver of all claims for reclassification for the applicable term or terms.

Please provide copies of any/all of the following items in support of your application. Documents can be uploaded below. Required documents are marked with an *.

Louisiana Driver’s License *
Louisiana Vehicle Registration
Louisiana Voter Registration Card
Copy of Homestead Exemption or Property Tax Bill or Lease Agreement *
Copies of Income Tax Returns for the last two years. (All financial information may be removed.)
Copy of Permanent Residency Card or Visa
Louisiana Marriage Certificate

Applicant must complete all applicable questions. Incomplete forms will not be considered.

APPLICANT INFORMATION

First Name:

Last Name:

Maiden Name:

LSU ID:

Date of Birth:

Place of Birth:

Mailing Address:

Country

Street

City

Region

Postal Code

Email Address:

Date Moved to Louisiana:

Lease Agreement or Homestead Exemption or Property Tax Bill *

CITIZENSHIP STATUS

Are you a U.S. citizen?

Yes

No

If not a U.S. Citizen, Type of Visa:

Date Issued:

Visa Number:

Upload Permanent Residency Card or Visa:

LOUISIANA DRIVER'S LICENSE

Louisiana Driver's License Number:

Date Issued:

If renewal, date original Louisiana license issued:

Louisiana Vehicle Registration Number:

Date Issued:

Louisiana Driver's License *

LOUISIANA VOTER REGISTRATION

Date Registered to vote in Louisiana:

Ward:

Precinct:

Parish:

Louisiana Voter Registration Card *

RESIDENTIAL INFORMATION

Residential Addresses: List all residence addresses (present to first) for the past five years. Account for all time periods of four weeks or longer.

Residential Address

Country

Street

City

Region

Postal Code

State Dates (from-to):

Do you have an additional address? (within past five years)

Additional Address

Country

Street

City

Region

Postal Code

State Dates (from-to):

Do you have an additional address? (within past five years)

Additional Address

Country

Street

City

Region

Postal Code

State Dates (from-to):

Do you have an additional address? (within past five years)

Any additional residential addresses will be reviewed on your resume/CV.

PREVIOUS SCHOOLS

Previously Attended School(s): List all schools attended from high school to present.

School Name:

Address:

Country

City

Region

Postal Code

Dates attended (from-to):

Do you have any additional schools?

School Name:

Address:

Country

City

Region

Postal Code

Dates attended (from-to):

Do you have any additional schools?

Any additional school attendance will be reviewed on your resume/CV.

PREVIOUS EMPLOYMENT

Employment: List all firms/persons who have employed you during the past five years (present employer to first).

Employer Name:

Address:

Country

City

Region

Postal Code

Dates Employed:

Full or Part-Time:

Do you have any additional employment?

Any additional employment history will be reviewed on your resume/CV.

FINANCIAL SUPPORT

Financial Support: Have you received any financial support received during the past five years? This includes gifts, grants, loans, fellowships, scholarships, etc.

Yes

No

Source of Support:

Relationship to You:

Amount/Percent:

Year:

Address of Donor:

Country

Street

City

Region

Postal Code

Did you receive any additional financial support?

If yes, please list any additional financial support below:

FEDERAL AND STATE INCOME TAXES

Were you claimed as a dependent on any person's Federal or State Income Tax return during
either or both of the past two years?

Yes

No

If yes, what tax year:

Name and address of person claiming you as a dependent and relationship:

Name:

Relationship:

Address:

Country

Street

City

Region

Postal Code

Have you filed Federal or State Income Tax during the past two years?

Yes

No

Tax Year:

State filed:

Address on Tax Form:

Country

Street

City

Region

Postal Code

Income Tax Returns:

Do you own property in Louisiana?

Yes

No

Property Address:

Country

Street

City

Region

Postal Code

Are you married to a Louisiana resident?

Yes

No

Spouse Name:

Date Married:

Spouse's Occupation:

Spouse's Employer:

Employer's Address:

Country

Street

City

Region

Postal Code

Louisiana Marriage Certificate:

RESIDENCY APPEAL STATEMENT

Make a brief, but complete statement covering: (1) Your reasons for coming or returning to Louisiana. (2) Your reasons for believing that you are a domicillary of Louisiana. (3) Any other facts relative to your resident status.

Other Supporting Documents (Optional):

SIGNATURE OF APPLICANT

I hereby certify that the information given in this application and in all attachments thereto is true, correct and complete to the best of my knowledge. I authorize Louisiana State University to verify all facts relevant to my claim for residence.

Yes

No

Date: