Mcknight Doctoral Fellowship Program Residency Affidavit

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McKNIGHT DOCTORAL FELLOWSHIP PROGRAM
RESIDENCY AFFIDAVIT
RESIDENCY INFORMATION (Please read and follow these instructions very carefully.)
For the purpose of assessing registration fees, students are classified as Florida or non-Florida. If the student applying for admission is at least 18 years of age
or married, classification is based on the residency in the State of Florida of the student or spouse as appropriate. (See NOTES below.) In addition, there are
certain SPECIAL CATEGORIES that may be treated as Florida residents for fee purposes if adequate documentation is provided as determined by the
university to which you are applying. (See PART II below for SPECIAL CATEGORIES.)
NOTES: Unless the contrary appears to the satisfaction of the registering authority at the institution at which a student is enrolling, it shall be presumed that:
1.
The spouse of any person who is eligible for classification as an in-state student is likewise entitled to classification as an in-state student. This provision
does not apply to non-resident aliens or persons who are in the United States on a non-immigrant visa.
2.
No person over the age of 18 shall be deemed to have gained residency while attending any educational institution in the State of Florida as a full-time
student, as such status is defined by the Board of Regents, in the absence of a clear demonstration that the student has established domicile in the State.
3.
“Domicile” for fee paying purposes denotes a person’s true, fixed, and permanent home and place of habitation. It is the place where the person lives and
remains and to which he/she expects to return when he/she leaves without intent to establish domicile elsewhere.
4.
A “dependent student” for fee paying purposes is the same as a dependent as defined in Sections 151(e)(1)(2)(3) and (4) of the Internal Revenue Code of
1954. (Note: If applicant is claimed as a dependent student, proof of dependency under Internal Revenue Regulations must be provided.)
The person whom the applicant’s claim to Florida residence is based must complete and have notarized the Residency Affidavit below. An applicant who does
not qualify as a Florida student should check the box and sign immediately below.
9
I do not qualify as a Florida resident and understand that I must be assessed out-of-state tuition.
(If Box is checked, sign here.)
____________________________________________________________________
___________________
Signature of non-Florida applicant (in ink)
Date
RESIDENCY AFFIDAVIT:
This part to be completed only by those claiming Florida residency.
PART I (Check Box A or B as appropriate--CHECK ONLY 1 BOX.)
9
A.
I, _____________________________________________, am the ____________________. I am or will be 18 years of age or older (or married) and
(Name of person claiming residency)
(Applicant or Spouse)
I will have had domicile and residency in the State of Florida for at least twelve (12) consecutive months immediately preceding the first day of classes of the
term for which this application is filed. OR I qualify as a Florida resident under the SPECIAL CATEGORY that I have indicated in PART II below. (If claimant is
the spouse, a photocopy of the marriage certificate must be submitted.)
9
B.
I, _____________________________________________, am the ________________________ of _______________________________________
(Name of person claiming residency)
(Parent or Guardian)
(Student submitting this application)
who is less than 18 years of age. I will have had domicile and residency in the State of Florida for at least twelve (12) consecutive months immediately
preceding the first day of classes of the term for which this application is filed. OR I qualify as a Florida resident under the SPECIAL CATEGORY that I have
indicated in Part II below. (If claimant is the court-assigned legal guardian, proof of financial responsibility or legal guardianship must be submitted.)
PART II (Person claiming residency in Box A or B above must complete PART II and sign in the presence of a Notary Public.)
1.
My permanent legal address is __________________________________________________________________________________________________
Street Address
City
State
Zip Code
2.
I have continuously maintained my domicile and residency in the State of Florida since
_____________
______________
______________
Month
Day
Year
3.
I am a resident alien or eligible refugee. My Alien Registration Number is _________________________ and it was issued on ______________ OR I
received a Cuban or Vietnamese Refugee Parole Card on __________________. (Complete only if applicable.)
4.
My eligibility for classification as a Florida resident is based on the SPECIAL CATEGORY checked below. I have attached the documentation required for
the category as well as proof of dependency under Internal Revenue Regulations if the applicant is claimed as a “dependent student.” (Note: Additional
information to support claim may be required.)
9
MILITARY PERSONNEL: (Military personnel of the USA on active duty and stationed in Florida, including dependent member of their immediate
families - DOCUMENTATION: Copy of order indicating date assigned to Florida.)
9
RETIRED VETERAN: (Veterans of the USA retired within 20 years or more active military service, including dependent members of their immediate
families, who are in Florida at the time of retirement, or who move to Florida within 1 year following retirement and intend to make Florida their
permanent home - DOCUMENTATION: Copy of DD Form 214 reflecting retirement after 20 years service, plus Declaration of Domicile filed with the
clerk of the court within one year after retirement.)
9
FULL-TIME TEACHER: (Full-time elementary, secondary and community college faculty members under current teaching contracts in the State of
Florida - DOCUMENTATION: Verification of full-time employment from school.)
9
FULL-TIME SUS EMPLOYEE: (Full-time faculty, administrative and professional and career service employees of the Florida State University System
and their dependent students - DOCUMENTATION: Letter from institution Director of Personnel reflecting status as a full-time SUS employee.)
9
FLORIDA DOMICILIARY LIVING IN CANAL ZONE: (Florida domiciliaries living in the Panama Canal Zone who have not established domicile
elsewhere, including dependent members of their immediate families - DOCUMENTATION: Proof of previous Florida residency.)
9
FLORIDA RESIDENT STATIONED OUTSIDE FLORIDA PURSUANT TO MILITARY ORDER: (Florida residents who had their residency in Florida
interrupted by service in the U.S. Armed Forces - DOCUMENTATION: Proof of previous Florida residency and military status.)
9
FLORIDA RESIDENT SERVING IN A VOLUNTARY ORGANIZATION FOSTERED BY U.S. GOVERNMENT: (Florida residents who had their
residency in Florida interrupted by service in the Peace Corps or other similar volunteer organizations fostered by the U.S. Government -
DOCUMENTATION: Copy of assignment and proof of Florida residency.)

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