11. What was your federal filing status for the following tax years:
2013 federal filing status:
Single Married, filing jointly Married, filing separately Head of household
2014 federal filing status:
Single Married, filing jointly Married, filing separately Head of household
2015 federal filing status:
Single Married, filing jointly Married, filing separately Head of household
12. Are you married? Yes No
If yes, date of marriage ________________________________________
If married, please provide information on your spouse.
If not married, please go to #20 below, sign the form, and return it to the Office of Admissions.
INFORMATION ON SPOUSE
13. Full Name: _______________________________________________________________________________________________________________
14. List all addresses where your spouse has lived for the past two years (do not use Post Office box number).
Address
Dates
______________________________________________________________________________
______________________________________
Street, City, State, Zip code
From: (month/year) To: (month/year)
______________________________________________________________________________
______________________________________
Street, City, State, Zip code
From: (month/year) To: (month/year)
______________________________________________________________________________
______________________________________
Street, City, State, Zip code
From: (month/year) To: (month/year)
15. What is the citizenship status of your spouse? **
US Citizen
US Permanent Resident– Effective Date: __________
Foreign Citizen with valid Visa– Visa Type: __________
** REQUIRED: If citizenship status is permanent resident or foreign citizen with a valid visa, please attach a legible copy of the document.
16. When did your spouse’s residence in South Carolina begin? Month/Year ___________________
17. Has your spouse been in active military service within the last two years?
Yes No
If yes, current duty station: ______________________________
Or
Discharge date if applicable: (Month/Day/Year)_______________
If yes, State of Legal Residence _______________________
18. What is the current employment status of your spouse? Employed
Not currently employed
Retired
If currently employed: ___________________________________________________________________________________________________________
Employer Name
City, State, Zip code
Beginning date of employment
Hours per week
19. ADDITIONAL INFORMATION:
Does your spouse have a driver’s license? Yes No
If yes, from what state? ________
Issue date on current license (Month/Day/Year)________________________
If less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? (Month/Day/Year)_______________
Does your spouse have a motor vehicle registered in his/her name? Yes No
If yes, in what state is the vehicle registered? _________ Issue date on current motor vehicle registration (Month/Day/Year) _______________________
If less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? (Month/Day/Year)_________________
20. I hereby certify that the information I have provided is accurate and that I am making this application in good faith based on the belief that I am eligible to pay
tuition and fees at the rate afforded to legal residents of South Carolina.
Signature
Date _________________________________