2014-2015 Georgia Residency Verification Form
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12014-2015 Georgia Residency Verification Form
Student Name:
Student ID #:
(please print)
Section I- All Students Must Complete
1.
Were you born in Georgia?
Yes (If yes, answer questions 3,4, and 5)
No (If no, answer questions 2 and 5)
2. When did you move to Georgia? ___________________________(Month/Year)
3. Did you graduate from a Georgia high school or receive a GED in Georgia?
Yes
No
4. What is the name of the Georgia high school? ________________________ Date of graduation or receipt of GED? ______
5. What is your legal state of residency? State ______________
How many years? ______________________
Section II – Complete this section if you are a Dependent Students
?
1. Have your parent(s); or primary parent (if parents are divorced) lived in Georgia for two consecutive years
Yes
No
2.
If no, in what state does your parent(s) reside? _________________________________
3. Did your parent(s) file Georgia state taxes for the past 2 years?
Yes
No
4. Are your parent(s) active duty military?
Yes (if yes, include a copy of their recent orders)
No
Section III- Complete this section if you are an Independent Student
1. Do you file a Georgia state income tax return?
Yes
No
2. Do you live in Georgia year-round, e.g. through breaks and summers?
Yes
No
3. Are you active duty military?
Yes (if yes, include a copy of your recent orders)
No
4. If married, is your spouse active duty military?
Yes (if yes, include a copy of their recent orders)
No
Section IV- All Students
You will be required to submit documentation to prove your (and if you are dependent) your parent(s) Georgia residency status for the
years prior to the semester that you are planning to attend Savannah Technical College. Examples of documents you may use are:
2012 and 2013 Georgia state income tax return, a lease agreement, mortgage, a copy of driver’s licenses, voter registration, or military
orders, etc. The documentation you provide will be used to determine if you are considered a Georgia resident for state aid purposes.
By signing below you are certifying that all information provided is true and accurate. Providing false or misleading information to
obtain aid may result in loss of eligibility to receive financial aid, and result in fines, jail, or both.
Student Signature: ____________________________________________________________
Date: ____________________
Parent Signature: _____________________________________________________________
Date: ____________________
(for Dependent Students only)
Rev: 06-16-14
CODE: GAVR15
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