Change of Residency
Application
Statement explaining
enclosed documents
Jeffrey Lee Gauthier
1. When I first came to
4. I do not own a
car. For transportation when I first
arrived in
6. I qualify as financially independent under criterion 7.
7. I lived in
10. When I first
moved to
11. I have a telephone line established in my name. It was installed in October 2002. There have been no paper bills since March 2003 because I am using the “eBill” service to pay online. The August 2003 bank statement shows the deduction for my most recent eBill payment.
The account for internet access in my apartment is in the name of my roommate, Nick Killingsworth [his last name is misspelled as “Kellingsworth” on the statements]. Nevertheless, I usually pay the bill. Enclosed are photocopies of the first and last bills, and evidence that I paid them: I paid the first bill (October 2002) with a check (enclosed is a photocopy of the check and the checking account statement which shows the deduction). The bill for August 2003 was automatically deducted from my checking account as seen on the August 2003 bank statement. Also enclosed is a photocopy of the most recent bill (September 2003), which has not yet been automatically deducted from my checking account.
Other utilities (water, electric, gas) are included in my monthly rent.
In addition to the above documents, I have also enclosed a
photocopy of my airline luggage ticket showing that I traveled from