University System of Georgia Petition for Classification of Students for Tuition Purposes. STEP #1 Determine your dependency status:

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1 University System f Gergia Petitin fr Classificatin f Students fr Tuitin Purpses STEP #1 Determine yur dependency status: Wh may be eligible fr in-state status fr tuitin purpses? The criteria cnsidered when determining a student s eligibility fr in-state tuitin depends n a student s status as an independent r dependent student are: An independent student wh has nt lived utside f Gergia r wh: Mved t the state fr reasns ther than attending a pst-secndary educatinal institutin; Abandned all ties t their previus state r cuntry f residence; Has taken apprpriate steps t assume the respnsibilities f a Gergia resident; Has lived in the state fr at least 12 cntinuus mnths immediately preceding the first day f classes; Receives n financial assistance frm utside f Gergia; Is nt claimed as a dependent n the taxes f smene wh resides utside f Gergia; and Is a U.S. citizen, Lawful Permanent Resident, refugee, asylee, r ther eligible nncitizen as defined by federal Title IV regulatins. A dependent student whse parent r U.S. curt-appinted legal guardian has nt lived utside f Gergia r whse parent r U.S. curt-appinted legal guardian: Mved t the state fr reasns ther than attending a pst-secndary educatinal institutin; Abandned all ties t their previus state r cuntry f residence; Has taken apprpriate steps t assume the respnsibilities f a Gergia resident; Has lived in the state fr at least 12 cntinuus mnths immediately preceding the first day f classes; Receives n financial assistance frm utside f Gergia; and Is a U.S. citizen, Lawful Permanent Resident, refugee, asylee, r ther eligible nncitizen as defined by federal Title IV regulatins. In additin t the abve, a dependent student f a Gergia-dmiciled parent must either: A. Be a graduate f a Gergia high schl r earned a GED in Gergia; r B. Be claimed as a dependent n their Gergia-dmiciled parent s state r federal incme taxes. A dependent student f a Gergia-dmiciled U.S. curt-appinted legal guardian must prvide evidence that the guardianship was nt appinted t avid payment f ut f-state tuitin. STEP #2 Cmplete the petitin and include the fllwing required dcuments: NOTE: Residency petitin is a separate matter and NOT part f yur Admissins prcess. Any f the same dcuments belw that yu may have submitted t the Office f Admissins will nt be shared and must be submitted again with yur petitin. If yu are under age 24 and dependent n yur parents r legal guardian: 1. Cpy f yur and yur parents Gergia driver s license 2. NOTARIZED cpy f yur parents 2014 Gergia State Incme Tax Return, r fficial transcript frm a Gergia High Schl shwing that yu graduated r fficial Gergia GED transcript 3. Cpy f yur U.S. passprt, U.S. birth certificate, Certificate f Naturalizatin, Permanent Resident card r valid visa 4. If yu are NOT a U.S. citizen, submit yur parent s r U.S. curt appinted legal guardian s U.S. passprt, Certificate f Naturalizatin, Permanent Resident card r valid visa 5. If yu are dependent n a U. S. curt-appinted legal guardian, submit guardianship dcuments If yu are independent and filed yur wn taxes and get n ther supprt frm yur parents: 1. Cpy f yur Gergia driver s license 2. NOTARIZED cpy f yur 2014 Gergia State Incme Tax Return 3. Cpy f yur U.S. passprt, U.S. birth certificate, Certificate f Naturalizatin, Permanent Resident card r valid visa 4. Prf f additinal incme (if applicable) such as public assistance, unemplyment cmpensatin, alimny r child supprt received in the last 12 mnths

2 Sectin I T be cmpleted by the STUDENT Student name: Student ID: Hme Phne: Cell Phne: Wrk Phne: Present Permanent Date f Birth: Place f Birth: Legal Status in the United States: U.S. Citizen Permanent Resident Date Permanent Resident Card Expires: Plitical Asylee Deferred Actin (NOTE: Deferred Actin status des nt qualify fr in-state tuitin) Other: Term applying fr reclassificatin: Fall Spring Summer Year: Have yu established and maintained dmiciled in Gergia fr at least 12 cnsecutive mnths immediately preceeding the first day f classes fr the term yu are requesting in-state classificatin? N Have yu ever lived in any place ther than the state f Gergia? (answer questins 1-3 belw) N 1. Where did yu live befre mving t Gergia? 2. When did yu establish dmicile in the state f Gergia? / (mm/yyyy) 3. What was yur reasn fr mving t Gergia?

3 D yu have a driver s license r state-issued ID? N If yes, in what U.S. state/territry is it issued? Issue date: / / D yu drive a vehicle? N If yes, in what U.S. state/territry is it registered? Registratin date: / / Are yu registered t vte? N If yes, in what U.S. state/territry are yu registered? Did yu file state incme taxes fr the mst recent tax year? N If yes, in what state? Did yu file as a resident, nnresident r part-year resident? Did yu file federal incme taxes fr the mst recent tax year? N List all full-time r part-time emplyment yu have held fr the past tw years, including military service. List mst recent emplyment first. Attach additinal sheets if needed. Emplyer: Full-time r part-time: Emplyer: Full-time r part-time: IF YOU ARE UNDER 24, THE FOLLOWING SECTION MUST BE COMPLETED. IF YOU ARE 24 OR OLDER, SKIP TO SECTION II. Were claimed as dependent n the state r federal incme tax returns f yur parent(s) r U.S. curt-appinted legal guardian filed fr the mst recent tax filing year? N If yes t either f the abve questins, the fllwing must be answered. Did yur parent(s) r U.S. curt-appinted legal guardian prvide yu with any financial supprt in the last year? Has the parent r U.S. curt-appinted legal guardian wh claimed yu as a dependent n their state r federal incme tax return filed fr the mst recent tax year, established and maintained dmicile in Gergia fr at least 12 cnsecutive mnths immediately preceding the first day f classes fr the term yu are requesting in-state classificatin? N N If yes t the abve questin, the fllwing questins in this sectin must be answered.

4 Name f yur Gergia-dmiciled parent r U.S. curt-appinted legal guardian: Relatinship: If the individual listed abve is yur U.S. curt-appinted legal guardian, n what date was the guardianship appinted? / / (mm/dd/yyyy) Has yur parent r U.S. curt-appinted legal guardian ever lived in anther cuntry r in any U.S. state/territry ther than the state f Gergia? N If the parent r U.S. curt-appinted legal guardian listed abve has lived utside f Gergia: When was dmicile established in the state f Gergia? / (mm/yyyy) What was their reasn fr mving t Gergia? Des yur parent r U.S. curt-appinted legal guardian have a driver s license r state-issued ID? N If yes, in what U.S. state/territry is it issued? Issue date: / / D he/she yu drive a vehicle? N If yes, in what U.S. state/territry is it registered? Registratin date: / / Is he/she registered t vte? N If yes, in what U.S. state/territry are yu registered? Did he/she file state incme taxes fr the mst recent tax year? N If yes, in what state? Did yu file as a resident, nnresident r part-year resident? Did he/she file federal incme taxes fr the mst recent tax year? N List all full-time r part-time emplyment the parent r U.S. curt-appinted legal guardian listed abve has held fr the past tw years, including military service. List mst recent emplyment first. Attach additinal sheets if needed. Emplyer: Full-time r part-time: Emplyer: Full-time r part-time:

5 Sectin II Basis fr Request fr In-State Classificatin Indicate under which f the fllwing categries yu are seeking in-state classificatin (select all that apply): I am a Dependent Student My parent(s) have established and maintained dmicile in Gergia fr at least 12 cnsecutive mnths immediately preceding the first day f classes fr the term I am seeking in-state classificatin and I have graduated r will graduate frm a Gergia high schl r I have earned a General Educatin Diplma (GED) in Gergia and/r My Gergia dmiciled parent claimed me as a dependent n their federal r state incme taxes filed fr the mst recent tax year. My U.S. curt-appinted legal guardian established and maintained dmicile in Gergia fr at least 12 cnsecutive mnths immediately preceding the first day f classes fr the term I am seeking in-state classificatin and I can prvide clear evidence that the appintment was nt made t avid payment f ut-f-state tuitin. I am an Independent Student I have established and maintained dmicile in Gergia fr at least 12 cnsecutive mnths immediately preceding the first day f classes fr the term I am seeking in-state classificatin. I did nt mve t Gergia slely fr the purpse f attending a pstsecndary institutin. I was nt claimed as a dependent n my parents mst recent incme tax return and they did nt prvide me with any additinal financial supprt Sectin III Oath and Affirmatin I understand that any material false statement made knwingly and willingly by me n this applicatin, r any dcuments attached heret may, in accrdance with O.C.G.A , which prvides that upn cnvictin, a persn wh knwingly cmmits the ffense f false swearing shall be punished by a fine f nt mre than $1,000 r by imprisnment fr nt less than ne nr mre than five years, r bth, subject me t prsecutin in a curt f law. Additinally, I further understand that any such false statement may subject me t immediate dismissal frm the institutin. Further, I certify that, t the best f my knwledge, the infrmatin submitted n this applicatin is true and cmplete. Student s Signature Date STEP #3 Submit the cmpleted petitin and required dcuments by the due date: Yu shuld return the petitin and required dcuments by visiting the One Stp Shp cunter area f the Admissins Building here n the GGC campus r by mailing them t the address belw. D nt fax yur petitin and supprting dcuments. Mailing address: Enrllment Management ATTN: Tuitin Petitins Gergia Gwinnett Cllege 1000 University Center Lane, Bldg D Lawrenceville, GA Petitin Due Date: (Allw 2-3 weeks fr prcessing) Fall Term August 1 Spring Term: December 1 Summer Term: May 1

6 Incmplete petitins r thse missing dcuments will be returned! Rev 09/06/12