102 Aldrich Hall
(949) 824-8262
Irvine, CA 92697-2825
2012-13 Domestic Partnership Status for Parents
Name _________________________________________ UCI ID Number____________________________
Domestic Partnerships
The California Domestic Partner Rights and Responsibilities Act of 2003 extends rights, benefits and obligations to individuals in
Registered Domestic Partnerships, effective January 1, 2005. This may impact your eligibility for state and university financial aid
only. You must complete this form and return it to our office in order to be considered for such aid including Cal Grant, UC Irvine
Grant and University Loan. This does not impact your current eligibility for federal student aid (i.e Pell Grant, Perkins Loan, Direct
Loan).
Federal Aid –
Your eligibility for federal financial aid is not based on your custodial parent’s status as a Registered Domestic
Partner.
You must complete the Free Application for Federal Student Aid (FAFSA) using only your and your custodial
parent’s information.
State/University Aid -
If your custodial parent is in a Registered Domestic Partnership you must provide information regarding that partner
for state and university financial aid purposes. This is in addition to the FAFSA information already submitted for
federal aid.
A copy of the Declaration of Domestic Partnership or Certificate of Domestic Partnership issued by the Secretary of
State must be submitted with the Domestic Partnership Form.
If the partnership is recognized outside of the state of California documentation from the issuing state must be
submitted.
In addition to the submission of the Declaration or Certificate, the attached form must be must be completed,
including the signatures of your parent and their partner.
The information collected on the attached form is used only to determine your financial aid eligibility for state and university funds.
Information is collected and retained only by the UCI Office of Financial Aid and Scholarships and is subject to FERPA and
university privacy policies.
2/15/2012