2014/2015 Florida Resident Proof of Residency Form
for Purposes of Florida Resident Access Grant (FRAG)
Student Name:
Student ID:
Phone #:
Florida Residency Guideline:
An applicant or a parent of a dependent applicant must be a US citizen, US national or eligible non-citizen. S/he
must also be a legal Florida resident for purposes other than education for 12 consecutive months prior to the
first day of classes of the first term of the academic year.
Florida Residency must be determined for all students who wish to take advantage of FRAG. Residency will be
determined based on the current academic year Free Application for Federal Student Aid (FAFSA). In the
absence of a FAFSA, the student must complete this form and provide supporting documents.
Step 1: Florida Residency
The person claiming residency should complete this section in full.
a) Name of person claiming Florida residency: __________________________________________________
b) Claimant’s relationship to student:__________________________________________________________
c) Claimant’s permanent legal address:
______________________________________________________________________________________
Street/ P. O. Box
Apt. Number
City /State/ Zip Code
d) Date claimant began establishing legal Florida residence and domicile:
______________________________________________________________________________________
Step 2: Citizenship Supporting Documents
Check the status you are claiming:
☐ US resident
☐ Eligible non-citizen
You are required to submit at least one document from this list:
• A copy of the claimants birth certificate showing that s/he was born in the United States, which
includes Puerto Rico (on or after Jan. 13, 1941), Guam, the U.S. Virgin Islands (on or after Jan. 17,
1917), American Samoa, Swain’s Island, or the Northern Mariana Islands, unless the person was born
to foreign diplomats residing in the U.S.
• A U.S. passport
• A copy of Form FS-240 (Consular Report of Birth Abroad), FS-545 (Certificate of Birth issued by a
foreign service post), or DS-1350 (Certification of Report of Birth). These are State Department
documents.
• A Certificate of Citizenship (N-560 or N-561), issued by USCIS to individuals who derive U.S. citizenship
through a parent.
• A Certificate of Naturalization (N-550 or N-570), issued by USCIS through a federal or state court, or
through administrative naturalization after December 1990 to those who are individually naturalized.
Step 3: Florida State Supporting Documents
Florida residency statutes require at least two documents, dated 12 months prior to the first day of class for the
term in which assistance is received.
FRAG FL Resident-Proof of Residency Form
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Student Name: _______________ Student ID: _________________
You are required to submit at least one document from this list:
• Florida Driver’s License
• Florida Voter’s Registration Card
• Florida Vehicle Registration
• State of Florida identification card
• Proof of permanent home in Florida which is occupied as the primary residence
• Proof of homestead exemption in Florida
• Proof of permanent full-time employment in Florida (one or more jobs from at least 30 hours per
week for a 12-month period – letter from employer on official letterhead required)
Additional documentation may include:
• A declaration of domicile in Florida
• A Florida professional or occupational license
• Proof of membership in Florida-based charitable or professional organization
• Documents evidencing Florida incorporation
• Proof of membership in Florida-based charitable or professional organization
• Any other documentation that supports the applicant’s request for resident status, including, but
not limited to, utility bills and proof of 12 consecutive months of payment, a lease agreement and
proof of 12 consecutive months of payment, or an official state, federal, or court document
evidencing legal ties to Florida.
Step 4: Submit Forms and all Supporting Documents
Submit this form (completed and signed) as well as legible copies of the Florida state and citizenship supporting
documents to the Saint Leo University Financial Aid Office by email or fax.
Email: [email protected]
Fax: (866) 708 -7770
Please note that students must meet all eligibility requirements for the Florida Resident Access Grant to receive
the award. To view the program requirements visit www.floridastudentfinancialaid.org/SSFAD .
CERTIFICATION: I certify the information on this Proof of Florida Residency Form for Purposes of FRAG and
any supporting documents are accurate, true, and complete to the best of my knowledge. I will provide other
information as requested by the SLU Financial Aid Office. I realize that a final decision cannot be made on this
request unless all steps above are complete and until I submit any additional information as requested by the
SLU Financial Aid Office. I understand any false information may be cause for the denial, reduction, and/or
repayment of student financial assistance and may subject me to a fine, imprisonment, or both under
provisions of the U.S. Criminal Code.
Student Signature: ____________________________________________ Date: ________________________
Parent Signature: ____________________________________________ Date: ________________________
(Parent signature is not necessary for independent students.)
FRAG FL Resident-Proof of Residency Form
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