Residency Requirement Form – Fill Out and Use This PDF

U.S. Customs and

Border Protection

CITIZENSHIP/RESIDENCY REQUIREMENT

Applicant must be a U.S. Citizen.

U.S. Customs and Border Protection (CBP) also have a residency requirement that applies to all applicants other than current CBP employees. If you are not a current CBP employee, CBP requires that for the three (3) years prior to filing an application for employment, individuals must meet one or more of the following primary residence criteria:

(a)Applicant resided in the United States or its protectorates or territories (short trips abroad, such as vacations, will not necessarily disqualify an applicant); or

(b)Applicant worked for the U.S. government as an employee overseas in a federal or military capacity; or

(c)Applicant was a dependent of a U.S. federal or military employee serving overseas.

Note: Exceptions may be granted to applicants who can provide complete state- side coverage information required to make a suitability/security determination. Examples of state-side coverage information include: the state-side address of the company headquarters where the applicant’s personnel file is located, the state-side address of the Professor in charge of the applicant’s “Study Abroad” program, the church records for the applicant’s overseas church missions, and/or the state-side addresses of anyone who worked or studied with the applicant while overseas. If you can provide this information you can request an exception for any periods of residency outside of the United States over the last three years by checking block (E) on the form “Do you meet the Residency Requirement?” provide the information requested, and return it with the required pre-employment forms.

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U.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requirement, I cannot be considered for the position at this time and my tentative offer of employment will be withdrawn.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: _________

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