Residency Requirement Waiver - Us Customs And Border Protection Page 2
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1
2U.S. Customs and
Border Protection
RESIDENCY REQUIREMENT
Do you meet the residency requirement? Check one of the boxes below:
A.
No, I do not meet this requirement and I am NOT requesting an exception. I understand that
since I do not meet CBP’s residency requirement, I cannot be considered for the position at this
time and my tentative offer of employment will be withdrawn. Therefore, I am only returning
this form, not any of the other forms.
B.
The residency requirement does not apply to me because I am a current CBP employee.
C.
Yes, during the three years prior to filing this application I physically resided within the United
States or its protectorates or territories.
D.
Yes, during the three years prior to filing this application I worked for the U.S. government as
an employee overseas in a Federal or military capacity, and/or I was a dependent of a U.S.
Federal or military employee overseas.
Note: Applicants working for overseas private companies under contract in support of the military
during the last three years would not meet the residency requirement and are required to request
an exception by checking block E and completing the contact information requested below.
E.
No, I do not meet this requirement and am therefore requesting an exception to the residency
requirement. Below, I have provided information on a stateside-based company, school,
religious organization, and/or individual(s) who will account for any periods of my residency
outside the United States over the last three years.
State-side Company/School/Organization: __________________________________________________
Company/School/Organization Address: ____________________________________________________
Contact Person(s):__________________________________Telephone Number: ___________________
(Note: Reference must be a state-side reference associated with the state-side company, school or
organization. Do not list family members.) Additional references can be provided on separate sheet.
List all countries of foreign residence/employment/education in the past 3 years, dates in each country,
and a brief explanation as to the reason you were in each country. Additional information (i.e.,
explanation for reason in each country, etc.) can be provided on a separate sheet.
Country
Dates
Brief Explanation
Begin:
End:
Begin:
End:
Begin:
End:
Begin:
End:
Applicant Name (Printed): ________________________________ Last 4-Digits SSN #:___________
Applicant Signature: ______________________________________ Date: ______________________
Approved
Disapproved Approving Official: ________________________ Date: _________
Version 02-22-2013
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