2023-2024 Independent Student Residency Questionnaire for State Aid

2023-2024 Independent Student Residency Questionnaire for State Aid
Campus Location: *
In accordance with RCW 28B.15.012 determining your residency within the State of Washington, state law requires that you establish a bona fide domicile in the state of Washington for a perior of one year, for purposes other than educational, prior to the start of the quarter for which you intend to register.
Student Information
Name*

First NameLast Name
Student ID
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Definition of Domicile
A domicile is a legal term used to describe a person's true, fixed, and permanent home. A person can only have one legal domicile in the U.S. at a time. To establish a domicile in the State of Washington, a person must prove physical presence in the state plus intent to permanently reside in the state. There are different ways to show proof of a domicile. The following documents may be used to prove Washington domicile. In order to meet state residency laws, they must be dated one year prior to the start of the quarter for which you intend to register: (This is a non-exhaustive list and there are other documents that could demonstrate domicile such as address on a tax return or location of a business.)
- WA State driver's license or WA State issued ID
- WA State vehicle registration
- WA State voter registration
Upload of Supporting Documentation
Upload below one of the supporting documents listed in the Definition of Domicile:

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Purpose of Moving to Washington State
Explain below your purpose of moving to the State of Washington:
Statement of Intent and Certification
Statement of Intent: I certify that I have declared Washington as my true, fixed, and permanent place of habitation. Certification: I certify under penalty of perjury under the laws of the State of Washington, RCW 94.72.085 that the foregoing and all supporting documentation are true and correct.*

Clear
Date

MonthDayYear
Date
Do You Have Questions About Your Financial Aid?

Financial Aid Office Contact Information

Address: ATTN: Financial Aid Office 3240 Fort Rd., Toppenish, WA 98948 | Phone: (509) 865-8502 | Email: financial_aid@heritage.edu
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2023-2024 Independent Student Residency Questionnaire for State Aid

Student Information

Definition of Domicile

Upload of Supporting Documentation

Purpose of Moving to Washington State

Statement of Intent and Certification