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2. PART A RESIDENT/NONRESIDENT STATUS Check your status in the appropriate box below. NAME (YOURSELF) NAME (SPOUSE) ADDRESS ADDRESS CITY, STATE, ZIP CODE SOCIAL SECURITY NUMBER CITY, STATE, ZIP CODE SOCIAL SECURITY NUMBER 1. NONRESIDENT OF MISSOURI What was your state of residence during 2009? 1. NONRESIDENT OF MISSOURI What was your state of residence during 2009? 2. PART-YEAR MISSOURI RESIDENT 2. PART-YEAR MISSOURI RESIDENT a. Indicate the date you were a Missouri residen.

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