Voter Residency Questionnaire
1a. Address Considered Primary Place Of Abode: b. Length of time applicant has lived at this address : _______ Months _______ Years c. Length of time applicant intends to continue living at this address : 2a. (CIRCLE ONE) Former Other Current address : b. Length of time applicant has lived at this address : _______ Months _______ Years c. Length of time applicant intends to continue living at this address : 3a. Is applicant on active duty in the U.S. Armed Forces ? _______ Yes _______ No b. If yes, does applicant intend to make (GR LOCALITY) his home of record? _______ Yes _______ No 4a. Is applicant currently enrolled in an institution of higher learning? _______ Yes _______ No b. If yes, does applicant intend to continue living in (GR LOCALITY), return to parent’s home, or move elsewhere upon graduation? _______ GR Locality _______ Parent’s Home _______ Elsewhere _______ Uncertain c. If yes, is applicant paying out-of-state tuition? _______ Yes _______ No 5a. Is applicant claimed as a dependent on any individual’s income tax return? _______ Yes _______ No
b. If yes, name and address of taxpayer(s) : c. If applicant files own income tax return, what address is shown on the return (if different from 1a.) 6a. Name and address of current employer, if any : b. If employed, does applicant work : _______ Full-time _______ Part-time 7a. Does applicant own or lease place of abode in (GR LOCALITY)? _______ Own _______ Lease b. Does applicant own or lease any other home in another locality? _______ Yes _______ No c. If yes, address of other home :