D
etermination
of
D
epenDent
/i
nDepenDent
S
tuDent
S
tatuS
a
cceptable
f
ormS
of
D
ocumentation
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r
eSiDency
c
laSSification
• Applicants under 24 years of age are presumed to be dependent.
• Dependent Freshman and Transfer applicants should have a parent/legal guardian complete the residency affidavit.
• Applicants under age 24 who claim independence may be required to submit a copy of his or her most recent tax
return, along with a copy of the most recent tax return of parent or guardian.
• Florida residency statutes require at least two documents, dated 12 months prior to the first day of class for the
entry term sought, to validate a claim for Florida residency for tuition purposes. At least one document must be
from the list below.
r
equireD
D
ocumentation
at least one of the two documents submitted must be from this list
• Florida Driver’s License
• Florida Voter’s Registration card
• Florida Vehicle Registration
• State of Florida identification card
• Proof of a permanent home in Florida which is occupied as the primary residence
• Proof of a homestead exemption in Florida
• Proof of permanent full-time employment in Florida (one or more jobs for at least 30 hours per week for a
12-month period – letter from employer on official letterhead required)
a
DDitional
D
ocumentation
m
ay
i
ncluDe
• A declaration of domicile in Florida (the date that an applicant shall be deemed as establishing residency for tuition
purposes shall be 12 months from the date that the Clerk of Circuit Court notes the declaration)
• A Florida professional or occupational license
• Proof of membership in Florida-based charitable or professional organizations
• Documents evidencing a Florida incorporation
• Any other documentation that supports the applicant’s request for resident status, including, but not limited
to, utility bills and proof of 12 consecutive months of payment, a lease agreement and proof of 12 consecutive
months of payment, or an official state, federal, or court document evidencing legal ties to Florida.
Please return this form and all additional documentation to the campus to which you apply.
012013
Office Of AdmissiOns
4
202 east fowler Avenue, sVc 1036
Tampa, fL 33620
Telephone: +001 (813) 974-3350
fax: +001 (813) 974-9689
email: admissions@usf.edu
Web: www.usf.edu/admissions
infORmATiOn fOR ResidencY cLAssificATiOn
If you are claiming Florida residency for tuition purposes, please fill out this form completely. A Florida resident for tuition purposes is a person
who has (or whose parent or legal guardian has) established and maintained legal residency in Florida for at least twelve months. You must be a U.S.
citizen, permanent resident alien (hold a green card), or legal alien granted indefinite stay by the Immigration and Naturalization Service. Other
persons not meeting the twelve-month legal residence requirement may be classified as Florida residents for tuition purposes only if they fall within
one of the limited special categories authorized by the Florida Board of Regents.
non-florida Residents
I understand that I do not qualify as a Florida resident for tuition purposes for the term for which this application is submitted and that if I should
qualify for some future term, it will be necessary for me to file the required documentation prior to the beginning of the term to be considered for
Florida residency classification.
Signature (in ink): ___________________________________________
Date: ____________________
florida Residents
This section must be completed in full if you claim Florida residency for tuition purposes.
cHecK One:
____ I am an independent person (not claimed as a dependent on parent/legal guardian tax return).
____ I am a dependent person (claimed on parent/legal guardian tax return).
____ I am a dependent person who has resided for five years with an adult relative other than my parent or legal guardian. (Proof is required.)
____ I am married to a person who has maintained legal residence in Florida for at least 12 months. (Required: Copy of marriage certificate)
____ I was previously enrolled at a florida state institution and classified as a Florida resident for tuition purposes. I abandoned my Florida
domicile less than 12 months ago.
____ I am a member of the armed services of the United States and I am stationed in Florida on active military duty pursuant to military orders,
or whose home of record is Florida, or I am a member’s spouse or dependent child. (Required: Copy of military orders or DD2058 showing
home of record)
____ I am an active member of the Florida National Guard who qualifies under s.250.10 (7) and (8) for the tuition assistance program.
____ I am a full-time instructional or administrative employee employed by a florida public school, community college, or institution of
higher education,
or I am the employee’s spouse or dependent child. (Required: Copy of employment verification)
____ I am a qualified beneficiary under the terms of the florida Prepaid college Program. (Required: Proof of participation)
____ According to U.S. Citizenship and Immigration Services, I am a permanent resident alien or other legal alien granted indefinite stay and
have maintained a domicile in Florida for at least 12 months. (Required: USCIS documentation and proof of Florida residency status)
____ I am a full-time employee of a state agency or political subdivision of the state whose student fees are paid by the state agency or political
subdivision for the purpose of job-related law enforcement or corrections training.
____ I am a U.s. citizen living on the Isthmus of Panama and have completed 12 consecutive months of college work at the fsU Panama canal
Branch
, or I am the student’s spouse or dependent child. (Required: Copy of marriage certificate or proof of dependency).
____ I am a part of the Latin American/caribbean scholarship program. (Required: copy of scholarship papers)
PeRsOn cLAiminG ResidencY sHOULd cOmPLeTe THis secTiOn in fULL
• Documents supporting the establishment of legal residence must be dated, issued, or filed 12 months before the first day of classes of the
term for which Florida residence classification is sought. All documentation is subject to verification.
• Additional documentation other than what is required above may be requested in some cases.
• Items #3 through #10 should be filled out with information pertaining to the person claiming Florida residency (item #3).
Please print:
1. Name of Student ____________________________________________ 2. Student’s University ID Number: ________________________
3. Name of person claiming Florida residency ________________________ 4. Claimant’s relationship to student: _______________________
5. Claimant’s permanent legal address:
______________________________________________________________________________________________________________________________________________
Street/ P. O. Box
Apt. Number
City
State
Zip Code
6. Date claimant began establishing legal Florida residence and domicile ______________________
7. Claimant’s voter registration: State ____________ Number _____________________________________ Issue Date _______________
8. Claimant’s driver’s license:
State ____________ Number _____________________________________ Issue Date _______________
9. Claimant’s vehicle registration: State ____________ Number _____________________________________ Issue Date _______________
10. Non-U.S. Citizen only:
Claimant’s Resident Alien Number __________________________________ Issue Date _______________
(A copy of both sides of claimant’s card is required.)
I do hereby swear or affirm that the above named student meets all requirements indicated in the checked category above for classification as a
Florida resident for tuition purposes. I understand that a false statement in this affidavit will subject me to the penalties for making a false statement
pursuant to 240.1201, Florida Statutes, and to 6A-10.044 (F.A.C.).
_________________________________________________________________
_________________________
Signature of person claiming Florida residency (as listed in item #3 above)
Date