Florida Residency Declaration for Tuition Purposes

If mailed separately, send to Florida A&M University, Office of Admissions and Recruitment,1735 Wahnish Way, CASS Building, Suite 207, Tallahassee, Florida 32310 ● 850-412-6604 Fax

A Florida “resident for tuition purposes” is a person who has, or a dependent person whose parent or legal guardian has, established and maintained legal residency in

Florida for at least (12) consecutive months preceding the first day of classes of the term for which Florida residency is sought. Residence in Florida must be as a bona

fide domicile rather than for the purpose of maintaining a residence incident to enrollment at an institution of higher education. To qualify as a Florida resident for tuition

purposes, you must be a U.S. citizen, a foreign national in a nonimmigrant visa classification that grants you the legal ability to establish a bona fide domicile in the

United States, a permanent resident alien, or legal alien granted indefinite stay by the U.S. Citizenship and Immigration Services. Other persons not meeting the

twelve-month legal residence requirements may be classified as Florida residents for tuition purposes only if they fall within one of the limited special categories

authorized by the Florida Legislature pursuant to section 1009.21, Florida Statutes. All other persons are ineligible for classification as a Florida “resident for tuition

purposes.” Living in or attending school in Florida will not, in itself, establish legal residence. Students who depend upon out-of-state parents for support are presumed

to be legal residents of the same state as their parents. Residency for tuition purposes requires the establishment of legal ties to the state of Florida. Students must

verify that they have broken ties to other states if the student or, in the case for dependent students, his or her parent has moved from another state.

PLEASE TYPE OR PRINT if submitting hard copy.

Name of Student: ____________________________________ FAMUID: ____________________

Student is a:



 U.S. Citizen



 Non-U.S. Citizen



 Permanent Resident



 Other



Date of Birth: ____________________

Alien Registration Number: _____________________________ Issue Date: _________________________

All non-U.S. citizen students are required to submit documentation of their legal status in the United States as issued by the United States Citizenship and Immigration Services office.

NON-FLORIDA RESIDENT

I do not qualify as a Florida resident for tuition purposes for the term for which this application is submitted. I understand that should I qualify for a future term, it will be

necessary for me to submit an updated Residency Declaration while providing prescribed, supporting documentation to substantiate as “reclassification” of my status.

Submission of this required document must occur prior to the beginning of the term for which residency is sought. I do not have to complete any further portion of this

form except for the signing below.

Student Name: ______________________________________________________________ FAMUID: _______________________

Signature of Student: (Electronic or ink):___________________________________________ Date: __________________________

TO BE COMPLETED BY THE STUDENT SEEKING FLORIDA RESIDENCY FOR TUITION PURPOSES:

I qualify as a resident for tuition purposes, as defined by s. 1009.21, Florida Statutes, for the term for which this application is submitted. I understand that it will be

necessary for me to provide copies of the required documentation upon admission, in order to be considered as a Florida resident for tuition purposes. I have read the

residency information on qualifying as a dependent or independent student, and declare that: (select one of the options below):

 I am a dependent student, as defined by s. 1009.21(1)(a), Florida Statutes, in that I am eligible to be claimed as a dependent under the federal income tax code

by the claimant below. The claimant is my “parent” as defined by s. 1009.21(1)(f), Florida Statutes, (i.e., either or both parents of the student, any guardian of a

student, or any person in a parental relationship to the student). My parent has maintained legal residence in Florida for at least the past 12 consecutive months. As

defined by section 1009.21(1)(d), Florida Statutes, “’legal resident’ or ‘resident’ means a person who has maintained his or her residence in this state for the

preceding year, has purchased a home which is occupied by him or her as his or her residence, or has established a domicile in this state pursuant to s. 222.17.”

 I am a dependent student who has resided with an legal guardian or adult relative other than my parent, and my legal guardian or adult

relative has maintained legal residence in Florida for at least the past 12 consecutive months. (Proof of Guardianship (required if claimant is NOT the student's

parent: Documents showing Court appointed guardianship (power of attorney is NOT sufficient) or Five consecutive years of tax returns in which the student is

claimed as a dependent by the claimant.)

 I am an independent person who has maintained legal residence in Florida for at least the past 12 consecutive months. I provide 51% or more of my own

support. An independent student generally includes a person who is at least 24 years old, married, a graduate or professional student, a veteran, a member of the

armed forces, a ward of the court, or someone with legal dependents other than a spouse, pursuant to the United States Department of Education for the purposes

of federal financial aid eligibility. There may be limited cases where a person under the age of 24 years old may qualify as an independent student. Such students

will be required to verify independence (including financial independence.) A copy your tax return may be requested to establish independence.

 I meet residency requirements through one of the Qualifications by Exception below (check appropriate exception):

TERM OF APPLICATION: (check one): FALL SPRING SUMMER YEAR: 20 _______

QUALIFICATION BY EXCEPTION (to be completed by the student)

As provided in s. 1009.21, Florida Statutes, I qualify for residency based on the following permitted exception (documentation required):

 A. I am a qualified beneficiary under the terms of the Florida Prepaid College Program (s. 1009.98, Florida Statutes.) (Required: Copy of Florida Prepaid

Recipient card.)

 B. I am married to a person who has maintained legal residence in Florida for at least the past 12 consecutive months. I now have established legal residence

and intend to make Florida my permanent home. (Required: copy of marriage certificate and/or other documents required to establish residency.)

 C. I was previously enrolled at a Florida state postsecondary institution and classified as a Florida resident for tuition purposes. I am transferring

to another Florida state postsecondary institution within 12 months of the previous enrollment.

 D. I was previously enrolled at a Florida state postsecondary institution and classified as a Florida resident for tuition purposes. I abandoned my

Florida domicile less than 12 months ago and am now re-establishing Florida legal residence.

 E. Active duty members of the Armed Services of the United States residing in this state and their spouses and dependent children, and active drilling

members of the Florida National Guard. (Required: Copy of military orders or DD2058 showing home of record.)

 F. Active duty members of the Armed Services of the United States and their spouses and dependents attending a Florida College System

institution or state university within 50 miles of the military establishment where they are stationed, if such military establishment is within a county

contiguous to Florida. (Required: Copy of military orders.)

 G. United States citizens living on the Isthmus of Panama, who have completed 12 consecutive months of college work at the Florida State University

Panama Canal Branch, and their spouses and dependent children. (Required: Copy of marriage certificate or proof of dependency.)

 H. Full-time instructional and administrative personnel employed by state public schools and institutions of higher education and their spouses and

dependent children.

Florida Residency Declaration

for Tuition Purposes

If mailed separately, send to Florida A&M University, Office of Admissions and Recruitment,1735 Wahnish Way, CASS Building, Suite 207, Tallahassee, Florida 32310 ● 850-412-6604 Fax

 I. Students from Latin America and the Caribbean who receive scholarships from the federal or state government. Any student classified pursuant to this

paragraph shall attend, on a full-time basis, a Florida institution of higher education. (Required: proof of scholarship and Latin America or Caribbean residency.)

 J. Southern Regional Education Board’s Academic Common Market graduate students attending Florida’s state universities. (Required: Certification

letter from State Academic Common Market Coordinator.)

 K. Full-time employees of state agencies or political subdivisions of the state when the student fees are paid by the state agency or political

subdivision for the purpose of job-related law enforcement or corrections training.

 L. McKnight Doctoral Fellows and Finalists who are United States citizens. (Required: Verification from graduate studies.)

 M. United States citizens living outside the United States who are teaching at a Department of Defense Dependent School or in an American International

School and who enroll in a graduate level education program which leads to a Florida teaching certificate.

 N. Active duty members of the Canadian military residing or stationed in this state under the North American Air Defense (NORAD) agreement, and their

spouses and dependent children, attending a Florida College System institution or state university within 50 miles of the military establishment where they are

stationed. (Required: proof of active duty membership for specified purpose.)

 O. Active duty members of a foreign nation’s military who are serving as liaison officers and are residing or stationed in this state, and their

spouses and dependent children, attending a Florida College System or state university within 50 miles of the military establishment where the foreign liaison

officer is stationed. (Required: proof of active duty membership for specified purpose.)

TO BE COMPLETED BY THE CLAIMANT/PERSON CLAIMING FL RESIDENCY:

NOTE: If the student is a dependent, the parent is the claimant and will complete this section and provide supporting documentation. If the student is

independent, the student is the claimant and will complete this section and provide supporting documentation. No single document shall be conclusive in

establishing residency. Additional documentation, other than what is prescribed, may be requested in some cases. All documentation provided is subject to

verification. Evidence of ties to another state may result in denial of Florida residency for tuition purposes.

Claimant/Name of Person Claiming FL Residency: _________________________________________________________

Claimant’s Relationship to Student: _____________________________________________________________________

Claimant’s Address: _________________________________________________________________________________

Telephone Number: _________________________________

Date Claimant began establishing legal FL residence:

_____/_____/_____

Alien Registration Number: _____________________________ Issue Date:

_____/_____/_____

All non-U.S. citizen are required to submit documentation of their legal status in the United States as issued by the United States Citizenship and Immigration Services office.

PROVISION OF DOCUMENTS TO SUPPORT CLAIM OF FLORIDA RESIDENCY

Per s. 1009.21(3)(c), Florida Statutes, the residency determination must be documented by the submission of written or electronic verification that includes

two or more of the documents identified below. No single piece of evidence shall be conclusive.

A. Claimant must provide at least two of the following of his/her personal documentation:

 Florida voter's registration card Number:______________________ Issue Date:_____/_____/_____

 Florida driver's license. Number:____________________________ Original Issue Date:______/______/______ Current Issue Date: ____/_____/_____

 State of Florida identification card. Number:___________________ Original Issue Date:______/______/______ Current Issue Date: ____/_____/_____

 Florida vehicle registration. Number:_______________ Original Issue Date:______/______/_______ Current Issue Date: ______/_______/_______

 Proof of permanent home in Florida occupied as primary residence for 12 consecutive months prior to the student’s enrollment. (Required: document such as

a deed or other evidence of title to property used as primary residence, a homeowner’s policy, a title insurance policy, evidence of a property tax payment on the

primary residence, or a lease of multiple years’ duration.)

 Proof of a homestead exemption in Florida. (Required: document from the county tax collector demonstrating the application of a homestead exemption

to the claimant’s primary residence.)

 Official transcripts from a Florida high school for multiple years (2 or more years), if the Florida high school diploma or GED® was earned within the last 12 months.

Dates of Attendance:_____________________ Graduation Date: ______/______/_______). (Required: transcript)

 Proof of permanent full-time employment in Florida for at least 30 hours per week for a 12-month period. (Required: pay stubs or W-2 form for past 12 consecutive

months)

B. Claimant may provide one or more documents from the following categories to demonstrate residency in Florida

(to be used in conjunction with one document from above):

 Declaration of domicile in Florida

 Florida professional or occupational license

 Florida incorporation

 Document evidencing family ties in Florida

 Proof of membership in a Florida-based charitable or professional organization

 Any other documentation that supports your request for resident status, including, but not limited to, utility bills (required: proof of 12 consecutive months of

payments); a lease agreement (required: proof of 12 consecutive months of payments); or an official state, federal, or court document evidencing legal ties to

Florida.

RESIDENCY DECLARATION:

I, the undersigned, hereby declare that I have read the foregoing document and that the facts stated in it are true and further affirm the authenticity of the

information provided on all pages of this Residency Declaration. I understand that any false or misleading information on this Residency Declaration, or

provided in support of this Residency Declaration, will subject me to penalties pursuant to section 837.06, Florida Statutes, for making a false statement. I

give permission for the institution to review or examine any and all documents and records, including those accessible electronically, which may assist in

support of my status as a Florida resident for tuition purposes.

Student Name (Please Print): _____________________________________________________________ FAMUID: __________________________

Claimant Name (if not the Student):_________________________________________________________

Signature of Claimant (Electronic or ink): _____________________________________________________ Date: ____________________________

Rev. 9

17/15