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FLORIDA RESIDENCY DECLARATION FOR TUITION PURPOSES (Polytechnic University of Puerto Rico)

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FLORIDA RESIDENCY DECLARATION FOR TUITION
PURPOSES
A Florida “resident for tuition purposes” is a person who has, or a dependent person whose parent or legal guardian has,
established and maintained legal residency in Florida for at least twelve (12) consecutive months preceding the first day
of classes of the term for which Florida residency is sought.
• Residence in Florida must be a bona fide domicile rather than for the purpose of maintaining a residence incident
to enrollment at an institution of higher education.
• To qualify as a Florida resident for tuition purposes, you must be a U.S. citizen, a foreign national in a
nonimmigrant visa classification that grants you the legal ability to establish a bona fide domicile in the United
States, a permanent resident alien, parolee, asylee, Cuban-Haitian entrant, legal alien granted indefinite stay by
the U.S. Citizenship and Immigration Services, or other qualified alien as defined under federal law. Other
persons not meeting the twelve-month legal residence requirements may be classified as Florida residents for
tuition purposes only if they fall within one of the limited special categories authorized by the Florida Legislature
pursuant to section 1009.21, Florida Statutes (see “Qualification by Exception” below). All other persons are
ineligible for classification as a Florida “resident for tuition purposes.”
• Living in or attending school in Florida will not, in itself, establish legal residence. Students who depend upon out-
of-state parents for support are presumed to be legal residents of the same state as their parents.
• Residency for tuition purposes requires the establishment of legal ties to the state of Florida. A student must verify
that the student has broken ties to other states if the student or, in the case of a dependent student, his or her
parent has moved from another state.
Please print if submitting hard copy.
Name of Student: Date of Birth:
Student is a:
Alien Registration Number: Issue Date:
Visa Category:
All non-U.S. citizen students seeking classification as a Florida resident for tuition purposes are required to submit
documentation of their legal status in the United States as issued by the United States Citizenship and Immigration
Services office.
U.S. Citizen Non-U.S. Citizen Permanent Resident Other
NON-FLORIDA RESIDENT
I do not qualify as a Florida resident for tuition purposes for the term for which this application is submitted. I understand
that should I qualify for a future term, it will be necessary for me to submit an updated Residency Declaration while
providing prescribed, supporting documentation to substantiate as “reclassification” of my status. I understand being
classified as a non-Florida resident will not exclude me from the possibility of receiving a waiver to cover part or all of the
out-of-state fee as defined in s. 1009.26, Florida Statutes. Submission of an updated Residency Declaration must occur
prior to the beginning of the term for which residency is sought. I do not have to complete any further portion of this form,
with the exception of signing below.
Student Name:
Signature of Student: (Electronic or ink):_________________________________Date:
Rule 6A-10.044, F.A.C., Form FRD-1
Effective December, 2015
Page 1
TERM OF APPLICATION: (check one):
FALL WINTER SPRING
YEAR:
Print Form
TO BE COMPLETED BY THE STUDENT SEEKING FLORIDA RESIDENCY FOR TUITION PURPOSES:
I qualify as a resident for tuition purposes, as defined by s. 1009.21, Florida Statutes, for the term for which this application is
submitted . I understand that it will be necessary for me to present evidence of residency for tuition purposes, supporting my claim as a
Florida resident for tuition purposes. I have read the residency information on qualifying as a dependent or independent student, and
declare that: (select one of the options below):
I am a dependent student, as defined by s. 1009.21(1)(a), Florida Statutes, in that I am eligible to be claimed as a dependent
under the federal income tax code by the claimant below. The claimant is my “parent” as defined by s. 1009.21(1)(f), Florida
Statutes, (i.e., either or both parents of the student, any guardian of a student, or any person in a parental relationship to the
student). My parent has maintained legal residence in Florida for at least the past 12 consecutive months. As defined by section
1009.21(1)(d), Florida Statutes, “'legal resident' or 'resident' means a person who has maintained his or her residence in this state
for the preceding year, has purchased a home which is occupied by him or her as his or her residence, or has established a
domicile in this state pursuant to s. 222.17.” A copy of your parent's tax return may be requested to establish dependence.
I am an independent person who has maintained legal residence in Florida for at least the past 12 consecutive months. I provide
more than 50% of my own support. An independent student generally includes a person who is at least 24 years old, married, a
graduate or professional student, a veteran, a member of the armed forces, a ward of the court, or someone with legal
dependents other than a spouse, pursuant to the United States Department of Education for the purposes of federal financial aid
eligibility. There may be limited cases where a person under the age of 24 years old may qualify as an independent student.
Such students will be required to verify independence (including financial independence.) A copy of your tax return may be
requested to establish independence.
I meet residency requirements through one of the Qualifications by Exception below (check appropriate exception):
QUALIFICATION BY EXCEPTION (to be completed by the student.)
As provided in s. 1009.21, Florida Statutes, I qualify for residency based on the following permitted exception (documentation required):
I am married to a person who has maintained legal residence in Florida for at least the past 12 consecutive months. I now have established legal residence and
intend to make Florida my permanent home. (Required: copy of marriage certificate and/or other documents required to establish residency.)
I am a qualified beneficiary under the terms of the Florida Prepaid College Program (s. 1009.98, Florida Statutes.) (Required: Copy of Florida Prepaid Recipient card.)
I was previously enrolled at a Florida state postsecondary institution and classified as a Florida resident for tuition purposes. I am transferring to another Florida
state postsecondary institution within 12 months of the previous enrollment. (Required: Evidence of previous enrollment as a FL resident)
I was previously enrolled at a Florida state postsecondary institution and classified as a Florida resident for tuition purposes. I abandoned my Florida domicile less than
12 months ago and am now re-establishing Florida legal residence.
Active duty members of the Armed Services of the United States residing in this state and their spouses and dependent children, and active drilling members of the
Florida National Guard. (Required: Copy of military orders or DD2058 showing home of record.)
Active duty members of the Armed Services of the United States and their spouses and dependents attending a Florida College System institution or state
university within 50 miles of the military establishment where they are stationed, if such military establishment is within a county contiguous to Florida. (Required:
Copy of military orders.)
United States citizens living on the Isthmus of Panama, who have completed 12 consecutive months of college work at the Florida State University Panama Canal
Branch, and their spouses and dependent children. (Required: Copy of marriage certificate or proof of dependency.)
Full-time instructional and administrative personnel employed by state public schools and institutions of higher education and their spouses and dependent children.
(Required: Employment Verification)
Full-time employees of state agencies or political subdivisions of the state when the student fees are paid by the state agency or political subdivision for the purpose
of job-related law enforcement or corrections training. (Required: Employment verification/payment agreement).
Southern Regional Education Board's Academic Common Market graduate students attending Florida's state universities. (Required: Certification letter from
State Academic Common Market Coordinator.)
McKnight Doctoral Fellows and Finalists who are United States citizens. (Required: Verification from graduate studies.)
United States citizens living outside the United States who are teaching at a Department of Defense Dependent School or in an American International School and
who enroll in a graduate level education program which leads to a Florida teaching certificate. (Required: Proof of enrollment in graduate program for FL teaching
certificate.)
Active duty members of the Canadian military residing or stationed in this state under the North American Air Defense (NORAD) agreement, and their spouses and
dependent children, attending a Florida College System institution or state university within 50 miles of the military establishment where they are stationed.
(Required: Proof of active duty membership for specified purpose.)
Active duty members of a foreign nation's military who are serving as liaison officers and are residing or stationed in this state, and their spouses and dependent
children, attending a Florida College System institution or state university within 50 miles of the military establishment where the foreign liaison officer is stationed.
(Required: Proof of active duty membership for specified purpose.)
Students from Latin America and the Caribbean who receive scholarships from the federal or state government. Any student classified pursuant to this paragraph shall attend,
on a full-time basis, a Florida institution of higher education. (Required: proof of scholarship and Latin America or Caribbean residency.)
TO BE COMPLETED BY THE CLAIMANT/PERSON CLAIMING FL RESIDENCY:
Note: If the student is a dependent, the parent is the claimant and will complete this section and provide evidence of
residency supporting the claim. If the student is independent, the student is the claimant and will complete this section and
provide evidence of residency supporting the claim. No single document shall be conclusive in establishing residency.
Additional documentation, other than what is prescribed, may be requested in some cases. All documentation
provided is subject to verification. Evidence of ties to another state may result in denial of Florida residency for
tuition purposes.
Claimant/Name of Person Claiming FL Residency: Claimant's Relationship to Student:
Claimant's Address: Telephone Number:
Date Claimant began establishing legal FL residency (if upon birth, enter birthdate):
PROVISION OF DOCUMENTS TO SUPPORT CLAIM OF FLORIDA RESIDENCY
Per s. 1009.21(3)(c), Florida Statutes, the residency determination must be documented by the submission of
written or electronic verification that includes two or more of the documents identified below. No single piece of
evidence shall be conclusive.
A. Claimant must provide at least one of the following of his/her personal documentation:
Florida Voter's registration card. Number:
Florida Driver's license. Number:
Florida State identification card. Number:
Florida Vehicle registration. Number:
Proof of permanent home in Florida occupied as primary residence for 12 consecutive months prior to the student's enrollment.
(Required: document such as a deed or other evidence of title to property used as primary residence, a homeowner's policy, a title
insurance policy, evidence of a property tax payment on the primary residence, multiple leases reflecting a Florida address, or a
lease of multiple years' duration.)
Proof of a homestead exemption in Florida. (Required: document from the county tax collector demonstrating the application of a
homestead exemption to the claimant's primary residence.)
Official transcripts from a Florida high school for multiple years (2 or more years), if the Florida high school diploma or GED® was earned
within the last 12 months.
Proof of permanent full-time employment in Florida for at least 30 hours per week for a 12-month period. (Required: pay stubs or W-2
form for past 12 consecutive months and/or verification from employers, and/or an IRS 1099 with verification of employment for the past
12 consecutive months from an employer.)
Issue Date:
Original Issue Date: Current Issue Date:
Original Issue Date: Current Issue Date:
Original Issue Date: Current Issue Date:
Dates of Attendance: Graduation Date:
(Required: transcript)
B. Claimant may provide one or more documents from the following categories to demonstrate residency in
Florida (to be used in conjunction with one document from above):
Declaration of domicile in Florida in accordance with s. 222.17, Florida Statutes.
Florida professional or occupational license.
Florida incorporation.
Document evidencing family ties in Florida.
Proof of membership in a Florida-based charitable or professional organization.
Any other documentation that supports your request for resident status, including, but not limited to, utility bills and proof of 12 consecutive
months of payments; a lease agreement and proof of 12 consecutive months of payments; or an official state, federal, or court document
evidencing legal ties to Florida.
Rule 6A-10.044, F.A.C., Form FRD-1
Effective December, 2015
Page 3
RESIDENCY DECLARATION:
I, the undersigned, hereby declare that I have read the foregoing document and that the facts stated in it are true and further
affirm the authenticity of the information provided on all pages of this Residency Declaration. I understand that any false or
misleading information on this Residency Declaration, or provided in support of this Residency Declaration, will subject me to
penalties pursuant to section 837.06, Florida Statutes, for making a false statement. I give permission for the institution to review
or examine any and all documents and records, including those accessible electronically, which may assist in support of my claim
as a Florida resident for tuition purposes.
Student Name (Please Print):
Claimant Name (if not the Student):
Signature of Claimant (Electronic or ink): Date:
Rule 6A-10.044, F.A.C., Form FRD-1
Effective December, 2015
Page 4
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FLORIDA RESIDENCY DECLARATION FOR TUITION PURPOSES (Polytechnic University of Puerto Rico)

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Completed 23 July 2020

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