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Savannah State University

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Savannah State University
APPLICATION FOR OUT-OF-STATE TUITION DIFFERENTIAL WAIVER
BORDER STATE RESIDENTS
Prior to submitting a Border State Residents out-of-state tuition waiver application, students are advised to review the University
System of Georgia Border State Residents out-of-state tuition waiver policy found in Section 7.3.4.1 of the Board of Regents
Policy Manual (www.usg.edu/policymanual
). Eligible bordering states are based on the institution of attendance.
Section I – To be completed by the STUDENT
Name: Student ID:
Address:
City: State: Zip:
Email: Phone:
Term applying for waiver: Fall Spring Summer Year:
This waiver application is based on your present and permanent home (domicile) in the following eligible state (Alabama, Florida, South
Carolina, and Tennessee) bordering Georgia:
State:
Will the above state have been in your state of domicile for at least 12 consecutive months immediately preceding the first day of classes
for the term the waiver is requested? Yes No
Have you ever lived outside of the above state above? Yes No
If Yes: The above has been your state of domicile since: (mm/yyyy)
Briefly describe your reason for moving to the above state:
Do you hold a current driver’s license/state-issued ID? Yes No State issued?
Do you own a motor vehicle? Yes No State registered?
Are you registered to vote? Yes No State registered?
Did you file a state income tax return for the most
recent tax year?
Yes No State filed?
Employment Information – Please list all employment for the past two years, including military service. Attach additional sheets if needed.
From To Employer City State # of hours worked per week
Students under the age of 24 must provide the following:
Do you have a parent or U.S. court-appointed legal guardian who has established and maintained domicile in a bordering state for at least
12 consecutive months immediately preceding the first day of classes for the term the waiver is requested? Yes No
If Yes:
Name of the above individual:
State of domicile:
Relationship: Parent U.S. court-appointed legal guardian
Has that individual ever lived outside of the above state? Yes No
If Yes:
They have maintained domicile in the above state since: (mm/yyyy)
Briefly describe their reason for moving to the above state:
Rev. 06/02/17
Do they hold a current driver’s license/state-issued ID? Yes No State issued?
Do they own a motor vehicle? Yes No State registered?
Are they registered to vote? Yes No State registered?
Did they file a state income tax return for the most recent tax year? Yes No
If Yes:
State filed? Were you claimed as a dependent? Yes No
Submit completed form and required documentation to:
(Preferred Method) Email: ssuwaiver@savannahstate.edu
(Secondary) Fax: 912-358-4588
Tuition Classification Officer
Savannah State University
3219 College Street
Box 20209
Savannah, Georgia 31404
For questions please contact us at ssuwaiver@savannahstate.edu or Phone: 912-358-4338
Section II – STUDENT Oath and Affirmation
I understand that any material false statement made knowingly and willingly by me on this application, or any documents attached hereto
may, in accordance with O.C.G.A. 16-10-71, which provides that upon conviction, a person who knowingly commits the offense of false
swearing shall be punished by a fine of not more than $1,000 or by imprisonment for not less than one nor more than five years, or both,
subject me to prosecution in a court of law. Additionally, I further understand that any such false statement may subject me to immediate
dismissal from the institution.
Further, I certify that, to the best of my knowledge, the information submitted on this application is true and complete.
Student Signature Date
Section III –Documentation Requirements
ALL STUDENTS MUST PROVIDE THE FOLLOWING:
Documentation that domicile has been established and maintained in the eligible bordering state for at least 12 consecutive months
immediately preceding the first day of classes for the term the waiver is requested and documentation of current domicile in an eligible
bordering state. Eligible bordering states are based on the institution of attendance.
Students who are under the age of 24 must provide documentation related to the domicile of their parent(s) or U.S. court-appointed legal
guardian.
Please include TWO of the following documents:
• Copy of lease agreement or warranty deed
• Copy of driver’s license or state-issued ID
• Copy of vehicle registration
• Copy of state tax return filed for the most recent tax year (Federal Tax Returns-Florida residents only)
LAWFUL PRESENCE IN THE UNITED STATES
In addition to the above waiver-specific documentation requirements, students must be verified to be lawfully present in the United States
to be eligible for any out-of-state tuition waiver.
NOTE: Additional documentation may be requested to determine waiver eligibility.
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Savannah State University

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Completed 25 July 2020

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