Residency Questionnaire Form

A residency questionnaire form is widely filled by the immigrants in order to claim the residency of a permanent state & country by completing the legitimate terms. Availability of ID cards, property and permanent address within that particular state, country are the major terms of such a questionnaire form.

Sample Residency Questionnaire Form:

Name of the residency application: _____________________

First Name: ______________ Middle Name: ______________ Last Name: _________________

Date of Birth: ____/ ___/ ____ Age: __________ Sex: ________

Mariel Status: _______________ Married/ Unmarried/ Divorced/ Separated

Number of kids (if any): ________________

Provide the details of children: ______________________________

Enclose the details of family members (independents): _______________________

Permanent Address: ______________________

Current Address: _________________________

Authorized phone number: _________________

Occupation: ____________________________

Social security number: ___________________

Q1. Are you filing your income tax including other taxes of this state?

Yes. Please provide the details: _______________

No

Other remarks: ___________________

Q2. Are you registered for vote in this state?

Yes

No

Others: __________________

Q3.Which of the identification cards do you have?

State Drive License

Voter ID card

All of the above: ______________

Others: ____________________

Q4. Do you own any property in this state?

Yes. Please provide details: _______________

No

Others, please mention: ___________________

Q5. Are you staying in this state for more than three years?

Yes

No

Other remarks: __________________

For official purpose only:

Signed by the residency applicant: _________________-

Signed by the concerned residency authority: ________________

Government Seal: ______________________________________

Date: ____/ ___/ ___

Download Residency Questionnaire Form

Category: Questionnaire Forms