The University of North Carolina at Chapel Hill Residence Status Supplemental Form for Non-U.S. Citizens If you are not a U.S. citizen, you must complete this supplemental form. Non-U.S. citizens must show that they have certain visa or immigration statuses in order to have the legal ability to maintain a domicile in North Carolina. Upon meeting these requirements, applicants who are non-U.S. citizens will be subjected to the same considerations as U.S. citizens in determining residence status for tuition purposes. If you are a dependent relying upon the domicile of your parent(s) or guardian(s) to establish residence for tuition purposes, this form should be completed by those parent(s) or guardian(s). Please complete this form in addition to the Residence and Tuition Status Application. The directions from the Residence and Tuition Status Application form are incorporated herein by reference. Please type all responses or print them clearly in ink. 1. Student’s full name: __________________________________________ PID: ___________________________ 2. Full name of Parent(s)/Guardian(s) (if applicable):__________________________________________________ 3. Do you (the student or parent/guardian, where applicable) possess a valid and current U.S. immigration status? Yes No If so, what is the designation of your current immigration status? _________________ (For example, provide the designation of your current visa or identify any pending immigration applications.) 4. When was your current immigration status (listed above) issued? (Month/Day/Year) ____/_____/____ When does your current immigration status expire? (Month/Day/Year)____/_____/____ 5. Please identify each and every immigration status, if any, that have been issued to you by the United States government and, where necessary, identify the specific types of visas by both letter and number (e.g., A-1, E- 2, G-4, H-1B, etc.) in the space provided. Please identify only those statuses which are presently valid and in effect: A Visa N Visa USCIS-issued Notice of Type(s):____________ Type(s):____________ Approval of Form I-485 B Visa NATO Visa (Application to Adjust Type(s):____________ Type(s):____________ Status) C Visa O Visa Type(s):____________ Type(s):____________ Approved I-130 Immigrant D Visa P Visa Petition Type(s):____________ Type(s):____________ E Visa Q Visa Approved I-360 Immigrant Type(s):____________ Type(s):____________ Petition F Visa R Visa Type(s):____________ Type(s):____________ Approved I-140 Immigrant G Visa S Visa Petition Type(s):____________ Type(s):____________ H Visa T Visa Permanent Resident Card Type(s):____________ Type(s):____________ I-551 I Visa TN Visa Type(s):____________ Type(s):____________ Conditional Permanent J Visa U Visa Resident Card Type(s):____________ Type(s):____________ K Visa V Visa Refugee Status Approval Type(s):____________ Type(s):____________ Documentation L Visa Type(s):____________ Pending Form I-485 Asylee Status Approval M Visa (Application to Adjust Documentation Type(s):____________ Status) Page 1 of 3 6. If any of the documents identified above were issued before the date you provided in response to Question No. 3, please identify which ones and provide their date of issue: __________________________________________________________________________________________ 7. Required Documentation a. Please provide us with a copy of every document identified in Question No. 5, above, if permitted by law. If not permitted, please be prepared to provide us with each applicable document for inspection upon request. b. Please provide us with a copy of any other documentation that you believe may be relevant. 8. Signature and Certification I certify that all the information I have provided is true to the best of my knowledge. I understand that intentionally providing false or misleading information may result in a University Honor Code violation. I also understand that I must advise the University of any change in facts or circumstances that may impact my state resident status. If, at any time, it is discovered that my visa or immigration status was obtained fraudulently, the University shall have the right to seek and collect payment of full, out-of-state tuition, along with any fees and costs associated with such collection. My eligibility may be reviewed by the University at any time. Finally, I understand that I must advise the University of any change in the facts or circumstances that may impact my resident status. If, at any time, it is discovered that my resident status was obtained using false or fraudulently submitted information, the University shall have the right to seek and collect payment of full, out-of-state tuition for the applicable semester(s), along with any fees and costs associated with such collection. ______________________________________________________ _________________________ Signature of Student Date ______________________________________________________ _________________________ Signature of Parent or Guardian1 Date Printed Name of Parent or Guardian:_____________________________________________________________ 1 The signature of a parent or guardian is required if: (1) the student is relying upon the domicile of the parent/guardian and the form is therefore completed by the parent/guardian; or (2) if the form is completed by the student and the student is a minor (under the age of 18 years). Page 2 of 3 4. Non-U.S. Citizens. Persons who are not U.S. citizens but who have certain visa and immigration statuses that grant them the legal ability to establish and maintain a bona fide domicile in this country are subject to the same considerations as U.S. citizens in determining residence status for tuition purposes. If it is later discovered that the person’s visa or immigration status was obtained fraudulently, the institution shall have the right to seek and collect payment of full, out-of-state tuition, along with fees and costs associated with such collection. If a person possesses one of the types of documentation listed below, that person has capacity to (is legally able to) establish legal residence for tuition purposes; however, that person must still take the actions and have the intent necessary to establish legal residence as discussed elsewhere in this Manual. The following types of documentation enable a non-U.S. citizen who is legally present in this state to have the capacity to establish domicile: a. Evidence of either of the following: (1) A valid A-1, A-2, E-1, E-2, E-3, G-1, G-2, G-3, G-4, H-1B, H-1C, H-4, I, K-1, K-2, K-3, K-4, L1A, L- 1B,L-2, N, O-1, O-3, P-1, P-2, P-3, P-4, R-1, R-2, T-1, T-2, T-3, T-4, T-5, U-1, U-2, U-3, U-4, U-5, V-1, V-2, V-3, NATO-1, NATO-2, NATO-3, NATO-4, NATO-5, or NATO-6 visa status (eligibility for in-state tuition under these visa statuses lasts only so long as the time frame of the authorized stay under the applicable visa status); or (2) A pending Application to Adjust Status (Form I-485) and an approved Immigrant Petition (Forms I- 130, I-360, or I-140). b. One of the following: (1) A Permanent Resident Card I-551; or (2) A USCIS-issued notice of approval of Application to Adjust Status (I-485); or (3) A current Conditional Permanent Resident Card. c. Refugee or asylee status with approval documentation. A non-U.S. citizen possessing an eligible document identified above is not deemed to have any special residential advantage. They are considered only to have the capacity and opportunity to claim and seek to prove eligibility for in-state tuition status under the same residential criteria and burden of proof that is required of U.S. citizens. In making domiciliary determinations of non-U.S. citizens, institutional officials should consider the precise basis for any entry into the United States and its documentation as part of the residential information upon which to assess the non-U.S. citizen’s claim of residence for tuition purposes. With respect to the 12-month (365 days) durational requirement of G.S. 116-143.1(b), claims to domicile of non-U.S. citizens possessing documents identified in any of the eligible classes set forth above should be assessed relative to a time frame beginning not earlier than the effective date of the pertinent documents. The 12-month (365 days) durational requirement must be met prior to the first day of the academic term for which the in-state tuition rate is requested. Non-U.S. citizens present in the United States under certain visa statuses such as tourists, visitors on business, and temporary foreign/international students do not have the legal capacity to establish a bona fide domicile in this country (and thus, not in North Carolina). As examples, holders of non-immigrant visa statuses such as B, C, D, F, J, M, Q, S, and TN visas (and dependent visas for spouses and children such as a TD visa) cannot establish domicile with these documents, in and of themselves, unless there is a change in their visa status. An Employment Authorization Document (EAD) is a document that provides non-U.S. citizens with the authorization to work in this country. An EAD, in and of itself, does not confer any immigrant or non-immigrant status and does not give the EAD holder the legal capacity to establish residency for tuition purposes in this state. The provisions of this section apply to both UNC institutions and community colleges. There are additional special provisions under North Carolina law for certain non-U.S. citizens attending community colleges which do not apply to UNC institutions that are described in Section IV.B.11.