Residency Classification For Alabama/georgia Out Of State Differential Tuition Plan

RESIDENCY CLASSIFICATION FOR ALABAMA/GEORGIA

CHIPOLA COLLEGE

OUT OF STATE DIFFERENTIAL TUITION PLAN

Beginning 2003, the Florida Legislature allowed

The resident status of a dependent student is considered to

Definitions

Chipola College the option of providing Alabama and

be that of the parent or legal guardian of the student. A

Dependent: A person for whom 50% or more of his/her

Georgia residents a different tuition assessment for

dependent student is any person who is eligible to be

support is provided by another as defined by the IRS.

postsecondary classes. The Alabama and Georgia

claimed by another person for Internal Revenue purposes. If

Independent: A person who provides more than 50% of

Tuition Differential is assessed in addition to the

the student requesting the Alabama or Georgia Tuition

his/her own support.

current in state tuition; that is, the eligible Alabama

Differential is under the age of 24, Chipola College will

and Georgia student will pay the current in-state

assume that the student is a dependent, and the parent/

tuition and an additional $1.00 per credit hour.

legal guardian must request the Alabama or Georgia Tuition

Return with Application for Admission to:

Differential for the dependent.

To be eligible for the Alabama and Georgia Tuition

Admissions and Records Office

Differential, resident must have maintained legal

Documents supporting the establishment of legal residence

Chipola College

residence in the State for the 12 months immediately

must be dated, issued or filed 12 months before the first day

3094 Indian Circle

preceding the first class day in the term for which

of classes. Documents are subject to verification.

Marianna, Florida 32446-2053

differential tuition assessment is requested.

1. I am an independent person and have maintained legal residence in Alabama or Georgia for at least twelve months.

NOTE: Independent persons under the age of 24 years must prove independent status with last two years of IRS Tax Forms (1040)

2. I am a dependent person, and my parent or legal guardian has maintained legal residence in Alabama or Georgia for at least twelve months.

NOTE: If the applicant is less than 24 years of age and unmarried he/she will be classified as dependent unless documentation verifies otherwise.

The parent or guardian completes the Residency Affidavit below.

3. I am married to a person who has maintained legal residence in Alabama/Georgia for at least twelve months. I have now established legal residence and intend to make the

Alabama/Georgia my permanent home. (Copy of marriage certificate and spouse completes the Residency)

4. I am a member of the armed services of the United States and am stationed within one of the designated states on active military duty pursuant to military orders, or whose

home of record is Alabama or Georgia or I am the member’s spouse or dependent child. (Required: Copy of military orders, for spouse a marriage certificate; for child the most

recent IRS return for parents)

5. According to the United States Immigration and Naturalization Services (INS), I am a permanent resident alien or other legal alien granted indefinite stay and

have established and maintained legal residence in Alabama/’Georgia for at least 12 months. (Required: INS documentation and proof of residency status.)

Non-U.S. Citizen only: Resident Alien Number________________________________________________________________ Issue Date_________/_________/_________

Information listed below is required to prove Alabama or Georgia residency. Documents must have an issue date of 12 months or older to prove

residency. Additional documents that may be used are the last two years of IRS 1040 Tax Forms, Homestead Exemption, Professional/Occupational

License in Alabama or Georgia. Copies of documents may be required. Failure to complete this form and provide at least two documents will

result in the student being automatically classified as out-of-state for tuition purposes.

AFFIDAVIT OF ALABAMA/GEORGIA RESIDENCY

Student’s Name _____________________________________________________________________

Student’s SSN_______________________________________________

Name of Claimant: ____________________________________________________ (The claimant is the person claiming Residency. All information below pertains to the claimant.)

Claimant's permanent legal address: ___________________________________________________________________________________________________________________

Claimant’s Status:

Student

Parent

Legal Guardian (Copy of documentation of court-appointed guardianship required.)

Other_________________________________

Date Claimant Began Establishing Legal Residence and Domicile:

Alabama_________/_________/___________

Georgia_________/__________/____________

Claimant's Driver’s License:

State __________

Number ___________________________________________________

Current Issue Date ________/________/________

Claimant's Voter Registration:

State __________

County __________________

Number________________________

Issue Date _________/__________/___________

Claimant's Vehicle Registration:* State __________

Lic. Tag Number__________________________________________

*Current Issue Date ________/________/_________

* (List last two consecutive years of registration dates, if using vehicle registration as proof.) *Previous Issue Date ________/________/________

I do hereby swear to affirm that the above named student meets all requirements indicated in the checked category above for classification as an Alabama/Georgia resident for tuition

purposes. I understand that a false statement will subject me to penalties for making a false statement pursuant to 837.06 Florida Statutes, and that a false statement in this affidavit

may subject the above named student to the penalties for making a false or fraudulent statement.

________________________________________

___________________________________________________

___________________________________

Signature of Student

and of

Person Claiming Residency if other than Student

Date

11/06