RESIDENCY STATEMENT FOR NEW HAMPSHIRE RESIDENTS

This form is ONLY for those who have established legal residency in New Hampshire at least 12 months or more.

Lawful Resident of the United States Affidavit

New Hampshire State law requires all students paying in-state tuition rates to verify under penalty of perjury, attesting they are lawful residents of the United States.

, hereby attest that I am a lawful resident of the United States

Printed legal name of student:

By checking this box, I confirm, under penalty of perjury and punishable by one or more sanctions including but not limited to denial of admission to UNH, dismissal from UNH, and criminal prosecution, that the above information is accurate.

Student's UNH ID Number:

Your student ID number can be found on the bottom of your acceptance later.

Domicile in the United States

Please see the "Rules Governing Tuition for the University System of New Hampshire," for the criteria by which we determine your eligibility for in-state tuition. In particular, please know you will be eligible only if you are domiciled in New Hampshire. That means New Hampshire must be your true, fixed and permanent home and place of habitation, to the exclusion. It is the place where you intend to remain and to which you expect to return when you leave New Hampshire without intended to establish a new domicile elsewhere.

Misrepresentation of facts to establish claim to New Hampshire domicile will be viewed as justification for revoking an acceptance or returning an application without consideration. Students and parents/guardians hereby attest, under penalty of perjury and punishable by criminal prosecution, that the information provided on this form is accurate.

General notes regarding Residency Statement

If necessary, a student can provide a statement submitted to the Admissions Office detailing all the facts upon which your claim for New Hampshire domicile is based.

If you are claiming New Hampshire domicile but are not currently in the state, be certain to explain the circumstances that require you to live elsewhere.

Dependent students whose parents are divorced or legally separated where one, and only one, of the parents is domiciled in New Hampshire are advised to have that parent inform us in a notarized letter of his/her legal custody of the students or that he/she claims the student as a dependent on the NH resident parent's federal tax forms.

New Hampshire residents who are military personnel on assignment outside the state and who are applying for admissions or have dependents doing so, should submit a statement establishing that they entered the armed forces as residents of the state of New Hampshire. This statement should be certified by a commanding officer.

Complete Section A or B (not both)

Complete Section A or B

A. If you are financially dependent on, or are living with your parents:B. If you are not living with your parents and are financially independent:

Section A

Please fill out the following information:

Student's full legal name:

Student's date of birth:

MM/DD/YYYY

Legal domicile (home address):

Street

City

State

Zip/Postal Code

The parents/guardian of the above-named applicant have been legally domiciled in the state of NH for the past 12 months. The family has no other domicile.

Printed Signature of Parent/Guardian:

Section B

Please fill out the following information:

Student's full legal name:

Student's date of birth

MM/DD/YYYY

Legal domicile:

Street

City

State

Zip/Postal Code

I have been legally domiciled in the state of NH for the past 12 months. I have no other domicile and I am financially independent.

Printed signature of student

Contact Information