Mcknight Doctoral Fellowship Program Residency Affidavit Page 2

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I first being duly sworn, on my oath say that I am 18 years of age or married and the information given above is complete and accurate and that by virtue of this
information the student for whom this application is submitted is entitled to classification as a Florida student for tuition purposes under the terms and conditions
prescribed for citizens and residents of the State of Florida.
___________________________________________________
________________________
Signature of Person Completing PART II
Date
MUST BE SIGNED IN PRESENCE OF NOTARY PUBLIC
MUST BE 18 YEARS OF AGE OR MARRIED
State of ___________________________________________________________
County of __________________________________________________________
Sworn to and subscribed before me this
___________ day of __________________________________ 20 ___________
__________________________________________
_________________________________
Notary Public
Expiration Date
NOTE: Whether or not you are claiming Florida residency, you must submit this form.
Please mail the signed affidavit to the FEF at
201 East Kennedy Blvd., Suite 1525, Tampa, FL 33602
by January 15.
MDF Application Residency Affidavit - Page 2

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