Rev. 2019-04-18
CERTIFICATE OF RESIDENCY STEP-BY-STEP INSTRUCTION SHEET
Not Required for Fast Forward (Advanced Opportunities)
CURRENT PRINTABLE PDF FORM:
http://idcounties.org/resources
1. Determine whether completing this form will be beneficial to you (the student).
a. If you are a legal resident of a county in Idaho other than Ada, Bonneville, Canyon, Kootenai, Jerome, or Twin
Falls, you may complete this form and submit it to that county for consideration of tuition and fee assistance.
2. Determine whether you are eligible for county assistance.
a. To be eligible for county assistance, the board of county commissioners of the county of your residence must
verify your legal residence.
b. Residency is explained in Idaho Code §33-2110B. The residence of a minor shall be deemed the residence of the
parent(s) or court-appointed guardian.
3. Obtain your current Idaho EDUID # and your College Student ID #.
a. Each student taking community college courses will have two identifying numbers issued. These numbers are
critical to properly processing your Certificate of Residency application. Not providing both correct student
identifying numbers constitutes an incomplete application and may result in a denial from your county.
b. Your EDUID # can be obtained from your high school guidance counselor if you have attended public school in
Idaho after 2010. If you do not have an EDUID #, contact the registrar at your community college and they will
issue you one.
c. Your College Student ID # is assigned by your community college. You can obtain this number by (i) logging
on to your profile on the community college website, (ii) reading the notices or correspondence to you from
your community college, or (iii) contacting the registrar at your community college and they will issue you one.
4. Fill out the form and gather adequate documentation.
a. To be approved for county assistance, you must complete this form in its entirety and provide appropriate
documentation to your county of legal residence. Additional documentation may be required by the county to
determine residency. Timeliness in submitting the form and documentation is your responsibility.
b. If you are 18 or older, attach the following:
i. A copy of your government-issued identification that shows 1) a picture of you, 2) your address, and 3)
your signature.
ii. If you do not have government-issued identification as required above, then attach documentation that
shows where you have been living for the past 12 months, such as the following: Idaho state income tax
form; utility bills; lease agreement.
c. If you are under 18 years old, attach the following:
i. A copy of your government-issued identification that shows 1) a picture of you, 2) your address, and 3)
your signature.
ii. A copy of your legal guardian’s government-issued identification that shows 1) a picture of your
guardian, 2) your guardian’s address, and 3) your guardian’s signature.
iii. If you do not have government-issued identification as required above, then attach documentation that
shows where you and your legal guardian have been living for the past 12 months, such as the
following: Idaho state income tax form; utility bills; lease agreement.
d. Some counties may require additional information and documentation.
5. Remit in person, by mail, or scan and email a completed Certificate of Residency and accompanying
documentation to your county clerk before December 1st if you plan to take classes in the Fall semester, and
before May 1st if you plan to take classes in the Spring semester. Failure to comply with these deadlines is
sufficient grounds for denial of county assistance for that semester. County contact information is located at:
http://www.idcounties.org/counties.
6. Pay any tuition and fees that you owe.
a. If the county approves your Certificate of Residency, the county may either (i) pay the entire out-of-district
tuition amount (so you only pay resident student tuition), (ii) pay part of the out-of-district tuition amount, or
(iii) pay none of the out-of-district tuition amount. The maximum benefit you can receive from counties for
community colleges is $500 per semester with a lifetime maximum of $3,000 (Idaho Code §33-2110A).
b. If your application is denied, the county has determined you are not eligible and you are responsible for paying
all tuition and fee charges to your community college.
7. Re-file this certificate form when you change your county of residency, or at the beginning of each academic year,
whichever occurs first.
Rev. 2019-04-18
CERTIFICATE OF RESIDENCY
Type of Student: Dual Credit Post High School
Home
Assistance is requested from: County
Academic Year Enrollment Date:
Idaho EDUID #:
School Providing Course(s)/Dual Credit(s): (check all that apply)
College of Southern Idaho
College Student ID #:
College of Western Idaho
College Student ID #:
North Idaho College
College Student ID #:
Student Contact Information
and Residence
Last Name:
First Name:
M.I.
Maiden Name (if married):
Birth Date (mm-dd-yyyy):
Phone #: (numbers only)
High School Last Attended (high school students only)
Current Academic Year:
SSN: (numbers only)
Email address:
Current Mailing Address:
___________________________ County:_____________
City:__________________ State: _______ Zip:________
Current Physical Address:(if different than mailing address)
___________________________ County:_____________
City:__________________ State: _______ Zip:________
Previous Mailing Address:
___________________________ County:_____________
City:__________________ State: _______ Zip:________
Previous Physical Address:(if different than mailing address)
___________________________ County:_____________
City:__________________ State: _______ Zip:________
Dates of Residency at Current Address:
to current.
Dates of Residency at Previous Address:
to
Parents OR Court-
Appointed Guardian
Parent/Guardian Last Name:
Parent/Guardian First Name:
M.I.
Parent/Guardian Email address:
Phone #: (numbers only)
Current Parent/Guardian Mailing Address:
___________________________ County:_____________
City:__________________ State: _______ Zip:________
Current Parent/Guardian Physical Address:(if different)
___________________________ County:_____________
City:__________________ State: _______ Zip:________
Dates of Residency at this Address: to current.
Residency Specifics
(Check and complete all that apply)
I am a registered voter in ______________ County.
My vehicle is registered in ______________ County.
My license plate number is: __________________________.
My parent(s) or court-appointed guardian(s) have lived in
______________ County for at least 12 consecutive months
prior to the start of the term in which I am enrolling.
My parent(s) or court-appointed guardian(s) provide more
than 50% of my financial support.
I provide more than 50% of my support and have lived in
______________ County for at least 12 consecutive months
prior to the start of this term. (continued in next column à)
I am on active military orders stationed at
_______________________ and residing in ______________
County. (Please attach a copy of orders)
I was honorably discharged after serving 2 years and
designated ______________ County as my residence. (Please
attach a copy of the DD214 form)
I am a resident of ______________ County, but have been
living in another county for less than 1 year and have not
established residency.
I have received tuition assistance from another county. (List
all counties and dates below)
___________________________________
Documen-
tation
I have attached a copy of at least ONE of the following to prove my residency in this county (check all that apply):
" For the student: The student’s government-issued identification Other: ___________________
" For the student’s legal guardian (required if student is a minor):
Student’s parent/court-appointed guardian government-issued identification Other: ___________________
I certify that all statements I have made in this Certificate of Residency are complete, true and correct.
Student’s Signature:
X
Parent or Court-Appointed Guardian’s Signature: (required if student is a minor)
Date:
Date:
=================================== For County Use Only Below this Line ====================================
This Certificate of Residency has been: Approved Denied
Reason, if denied: Non-residency Lifetime limit met Incomplete Application Other: ______________
By: _____________________________ Attest: _____________________________ Date: _____________________!
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome