{
    "document_id": 16832,
    "page": 1,
    "width_pt": 612,
    "height_pt": 792,
    "rotation": 0,
    "pipeline_version": "paddleocr-vl-1.6+paul-48",
    "engine": "paddleocr_vl",
    "source_run_id": 16943,
    "item_count": 38,
    "counts_by_type": {
        "figure": 1,
        "footer": 1,
        "form_field": 6,
        "heading": 1,
        "table": 2,
        "table_cell": 18,
        "text": 8,
        "title": 1
    },
    "build_ms": 5,
    "items": [
        {
            "id": "p1.1",
            "order": 1,
            "type": "figure",
            "bbox": {
                "l": 72,
                "t": 755.28,
                "r": 136.8,
                "b": 691.2
            },
            "text": "",
            "attrs": {
                "role": "page_header",
                "block_label": "header_image"
            }
        },
        {
            "id": "p1.2",
            "order": 2,
            "type": "title",
            "bbox": {
                "l": 186.24,
                "t": 718.8,
                "r": 462.24,
                "b": 685.44
            },
            "text": "Office of Residence Life\nUniversity Housing Exemption Request Form",
            "attrs": {
                "block_label": "doc_title"
            },
            "level": 2
        },
        {
            "id": "p1.3",
            "order": 3,
            "type": "text",
            "bbox": {
                "l": 69.36,
                "t": 673.2,
                "r": 526.32,
                "b": 605.52
            },
            "text": "Per University policy, all full-time freshmen and sophomore students of Kentucky State University are required to live in University housing excluding the four designated exceptions (listed below). NOTE: Exceptions must be met before the first day of classes AND requested before signing a Two-Semester Residence Hall contract. Students who are currently in a residence hall contract agreement will not be granted a requested exception during the contracted period."
        },
        {
            "id": "p1.4",
            "order": 4,
            "type": "text",
            "bbox": {
                "l": 236.64,
                "t": 605.04,
                "r": 374.16,
                "b": 592.08
            },
            "text": "Please print and write legibly."
        },
        {
            "id": "p1.5",
            "order": 5,
            "type": "text",
            "bbox": {
                "l": 70.56,
                "t": 580.56,
                "r": 533.76,
                "b": 543.12
            },
            "text": "Student’s Name: ___ SID#: ___",
            "children": [
                {
                    "id": "p1.5.1",
                    "order": 6,
                    "type": "form_field",
                    "bbox": {
                        "l": 72.024,
                        "t": 583.936,
                        "r": 534.82,
                        "b": 567.928
                    },
                    "text": "",
                    "attrs": {
                        "field_kind": "text",
                        "label": "Student’s Name: ___ SID#: ___",
                        "source": "blank_line",
                        "label_source": "parent_text",
                        "label_ref": "p1.5"
                    }
                },
                {
                    "id": "p1.5.2",
                    "order": 7,
                    "type": "form_field",
                    "bbox": {
                        "l": 72.024,
                        "t": 559.096,
                        "r": 534.024,
                        "b": 543.088
                    },
                    "text": "",
                    "attrs": {
                        "field_kind": "text",
                        "source": "blank_line",
                        "label": "Student’s Name: ___ SID#: ___",
                        "label_source": "parent_text",
                        "label_ref": "p1.5"
                    }
                }
            ]
        },
        {
            "id": "p1.6",
            "order": 8,
            "type": "table",
            "bbox": {
                "l": 71.28,
                "t": 547.2,
                "r": 532.56,
                "b": 466.8
            },
            "text": "",
            "attrs": {
                "block_label": "table",
                "n_rows": 2,
                "n_cols": 3,
                "integrity": {
                    "cells_checked": 5,
                    "cells_flagged": 0
                }
            },
            "children": [
                {
                    "id": "p1.6.1",
                    "order": 9,
                    "type": "table_cell",
                    "bbox": {
                        "l": 144.02,
                        "t": 540.05032,
                        "r": 208.51568,
                        "b": 530.11432
                    },
                    "text": "Street Address",
                    "attrs": {
                        "row": 0,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.6.2",
                    "order": 10,
                    "type": "table_cell",
                    "bbox": {
                        "l": 225.04,
                        "t": 547.2,
                        "r": 378.8,
                        "b": 507
                    },
                    "text": "",
                    "attrs": {
                        "row": 0,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1
                    },
                    "children": [
                        {
                            "id": "p1.6.2.1",
                            "order": 11,
                            "type": "form_field",
                            "bbox": {
                                "l": 99.024,
                                "t": 520.666,
                                "r": 513.1,
                                "b": 504.658
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "source": "blank_line",
                                "row": 0,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1
                            }
                        }
                    ]
                },
                {
                    "id": "p1.6.3",
                    "order": 12,
                    "type": "table_cell",
                    "bbox": {
                        "l": 432.1,
                        "t": 540.05032,
                        "r": 474.29488,
                        "b": 530.11432
                    },
                    "text": "Apt/Suite #",
                    "attrs": {
                        "row": 0,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.6.4",
                    "order": 13,
                    "type": "table_cell",
                    "bbox": {
                        "l": 144.02,
                        "t": 501.65032,
                        "r": 163.08608,
                        "b": 491.71432
                    },
                    "text": "City",
                    "attrs": {
                        "row": 1,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p1.6.4.1",
                            "order": 14,
                            "type": "form_field",
                            "bbox": {
                                "l": 72.024,
                                "t": 482.146,
                                "r": 288.024,
                                "b": 466.138
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "source": "blank_line",
                                "row": 1,
                                "col": 0,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "City",
                                "label_source": "parent_text",
                                "label_ref": "p1.6.4"
                            }
                        }
                    ]
                },
                {
                    "id": "p1.6.5",
                    "order": 15,
                    "type": "table_cell",
                    "bbox": {
                        "l": 324.07,
                        "t": 501.65032,
                        "r": 346.12792,
                        "b": 491.71432
                    },
                    "text": "State",
                    "attrs": {
                        "row": 1,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    },
                    "children": [
                        {
                            "id": "p1.6.5.1",
                            "order": 16,
                            "type": "form_field",
                            "bbox": {
                                "l": 324.07,
                                "t": 482.146,
                                "r": 534.07,
                                "b": 466.138
                            },
                            "text": "",
                            "attrs": {
                                "field_kind": "text",
                                "source": "blank_line",
                                "row": 1,
                                "col": 1,
                                "rowspan": 1,
                                "colspan": 1,
                                "label": "State",
                                "label_source": "parent_text",
                                "label_ref": "p1.6.5"
                            }
                        }
                    ]
                },
                {
                    "id": "p1.6.6",
                    "order": 17,
                    "type": "table_cell",
                    "bbox": {
                        "l": 432.1,
                        "t": 501.65032,
                        "r": 473.35648,
                        "b": 491.71432
                    },
                    "text": "Zip Code",
                    "attrs": {
                        "row": 1,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                }
            ]
        },
        {
            "id": "p1.7",
            "order": 18,
            "type": "text",
            "bbox": {
                "l": 105.36,
                "t": 465.6,
                "r": 468.96,
                "b": 452.16
            },
            "text": "Primary Telephone Number KSU E-mail Address"
        },
        {
            "id": "p1.8",
            "order": 19,
            "type": "text",
            "bbox": {
                "l": 145.44,
                "t": 441.84,
                "r": 465.6,
                "b": 428.64
            },
            "text": "Below, please mark an \"X\" in the box next to the appropriate exception."
        },
        {
            "id": "p1.9",
            "order": 20,
            "type": "table",
            "bbox": {
                "l": 71.28,
                "t": 428.88,
                "r": 557.52,
                "b": 250.56
            },
            "text": "",
            "attrs": {
                "block_label": "table",
                "n_rows": 4,
                "n_cols": 3,
                "integrity": {
                    "cells_checked": 9,
                    "cells_flagged": 0
                }
            },
            "children": [
                {
                    "id": "p1.9.1",
                    "order": 21,
                    "type": "table_cell",
                    "bbox": {
                        "l": 79.344,
                        "t": 425.21032,
                        "r": 106.8888,
                        "b": 402.55432
                    },
                    "text": "Select One",
                    "attrs": {
                        "row": 0,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true,
                        "column_header": true,
                        "header_source": "pdf"
                    }
                },
                {
                    "id": "p1.9.2",
                    "order": 22,
                    "type": "table_cell",
                    "bbox": {
                        "l": 119.78,
                        "t": 412.49032,
                        "r": 287.15144,
                        "b": 386.11432
                    },
                    "text": "Exception - I am a student who\nIs at least 21 years of age",
                    "attrs": {
                        "row": 0,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true,
                        "merged_continuation": true,
                        "column_header": true,
                        "header_source": "pdf"
                    }
                },
                {
                    "id": "p1.9.3",
                    "order": 23,
                    "type": "table_cell",
                    "bbox": {
                        "l": 319.27,
                        "t": 412.49032,
                        "r": 515.89336,
                        "b": 373.51432
                    },
                    "text": "Required Documents/Information\nBirth Certificate, valid Driver's License or government issued Photo ID",
                    "attrs": {
                        "row": 0,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true,
                        "merged_continuation": true
                    }
                },
                {
                    "id": "p1.9.4",
                    "order": 24,
                    "type": "table_cell",
                    "bbox": {
                        "l": 71.28,
                        "t": 357.552,
                        "r": 233.36,
                        "b": 321.888
                    },
                    "text": "",
                    "attrs": {
                        "row": 1,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p1.9.5",
                    "order": 25,
                    "type": "table_cell",
                    "bbox": {
                        "l": 119.78,
                        "t": 367.23032,
                        "r": 289.59152,
                        "b": 332.09432
                    },
                    "text": "Commutes 50 miles or less from the principal residency of a parent or legal guardian",
                    "attrs": {
                        "row": 1,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.9.6",
                    "order": 26,
                    "type": "table_cell",
                    "bbox": {
                        "l": 319.27,
                        "t": 367.23032,
                        "r": 540.508,
                        "b": 319.37432
                    },
                    "text": "Notarized Parent/Legal Guardian Address Verification Form AND clear copy of parent/legal guardian's valid Driver's License or government issued Photo ID",
                    "attrs": {
                        "row": 1,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.9.7",
                    "order": 27,
                    "type": "table_cell",
                    "bbox": {
                        "l": 71.28,
                        "t": 321.888,
                        "r": 233.36,
                        "b": 286.224
                    },
                    "text": "",
                    "attrs": {
                        "row": 2,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p1.9.8",
                    "order": 28,
                    "type": "table_cell",
                    "bbox": {
                        "l": 119.78,
                        "t": 306.15032,
                        "r": 164.72624,
                        "b": 296.21432
                    },
                    "text": "Is married",
                    "attrs": {
                        "row": 2,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.9.9",
                    "order": 29,
                    "type": "table_cell",
                    "bbox": {
                        "l": 319.27,
                        "t": 306.15032,
                        "r": 446.02024,
                        "b": 296.21432
                    },
                    "text": "Marriage License/Certificate",
                    "attrs": {
                        "row": 2,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.9.10",
                    "order": 30,
                    "type": "table_cell",
                    "bbox": {
                        "l": 71.28,
                        "t": 286.224,
                        "r": 233.36,
                        "b": 250.56
                    },
                    "text": "",
                    "attrs": {
                        "row": 3,
                        "col": 0,
                        "rowspan": 1,
                        "colspan": 1
                    }
                },
                {
                    "id": "p1.9.11",
                    "order": 31,
                    "type": "table_cell",
                    "bbox": {
                        "l": 119.78,
                        "t": 278.31032000000005,
                        "r": 301.9976,
                        "b": 255.65431999999998
                    },
                    "text": "Is a veteran of at least two years of active military service",
                    "attrs": {
                        "row": 3,
                        "col": 1,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                },
                {
                    "id": "p1.9.12",
                    "order": 32,
                    "type": "table_cell",
                    "bbox": {
                        "l": 319.27,
                        "t": 278.31032000000005,
                        "r": 390.54136,
                        "b": 268.37432
                    },
                    "text": "Military DD214",
                    "attrs": {
                        "row": 3,
                        "col": 2,
                        "rowspan": 1,
                        "colspan": 1,
                        "bbox_refit": true
                    }
                }
            ]
        },
        {
            "id": "p1.10",
            "order": 33,
            "type": "text",
            "bbox": {
                "l": 68.88,
                "t": 240.24,
                "r": 537.84,
                "b": 171.84
            },
            "text": "All supporting documentation must be submitted to the Office of Residence Life before the first day of classes. Forms submitted without the required documentation will be automatically denied. Any requests submitted and approved after the first day of classes will have charges assessed per the University’s Tuition and Fee Refund Schedule. Students will receive the decision notification via e-mail to their KSU e-mail address; students may submit a written appeal to the Residence Life Appeals Committee."
        },
        {
            "id": "p1.11",
            "order": 34,
            "type": "text",
            "bbox": {
                "l": 69.12,
                "t": 162.48,
                "r": 515.52,
                "b": 121.2
            },
            "text": "By signing below, I certify that accurate information is enclosed on this form and on the supporting documents. In addition, I understand submitting false information may result in disciplinary actions including but not limited to restitution from the University and/or other actions."
        },
        {
            "id": "p1.12",
            "order": 35,
            "type": "text",
            "bbox": {
                "l": 68.88,
                "t": 109.2,
                "r": 385.68,
                "b": 96
            },
            "text": "Student's Signature: _____\nDate: _____",
            "children": [
                {
                    "id": "p1.12.1",
                    "order": 36,
                    "type": "form_field",
                    "bbox": {
                        "l": 72.024,
                        "t": 110.7691,
                        "r": 532.08,
                        "b": 96.0417
                    },
                    "text": "",
                    "attrs": {
                        "field_kind": "text",
                        "label": "Student's Signature: _____\nDate: _____",
                        "source": "blank_line",
                        "label_source": "parent_text",
                        "label_ref": "p1.12"
                    }
                }
            ]
        },
        {
            "id": "p1.13",
            "order": 37,
            "type": "heading",
            "bbox": {
                "l": 398.16,
                "t": 108.24,
                "r": 533.76,
                "b": 96
            },
            "text": "Date:",
            "level": 3
        },
        {
            "id": "p1.14",
            "order": 38,
            "type": "footer",
            "bbox": {
                "l": 454.56,
                "t": 49.44,
                "r": 541.2,
                "b": 36.24
            },
            "text": "Rev. March 2016",
            "attrs": {
                "block_label": "footer"
            }
        }
    ],
    "excluded_furniture": {
        "first": [],
        "last": []
    }
}