Fillable Printable Certificate of Residence for New York City Residents

Certificate of Residence for New York City Residents

PLEASE PRINT ALL INFORMATION SEE REVERSE SIDE FOR DIRECTIONS

LAST NAME FIRST NAME

SOCIAL SECURITY # - - COMMUNITY COLLEGE

Important: A Certificate of Residence must be dated two (2) months or less prior to the start of the semester.

CERTIFICATE OF RESIDENCE

AFFIDAVIT (or AFFIRMATION) and APPLICATION

For New York City Residents

InconnectionwithattendanceatcommunitycollegesinNewYorkState.

PursuanttoArticle126,Sections6301&6305oftheEducationLaw.

I, ______________________________________________ ____________ do hereby swear (or affirm) that I reside at

(applicant's full name)

__________________________________________________________________, State of New York; that I now am

(permanent New York City address, including borough and zip code)

and have for a period of at least one year immediately prior to the date of this affidavit (or affirmation) been a resident

of the State of New York; that I now am, and have be en for at least six months immediately prior to the date of this

affidavit (or affirmation), a resident of New York City, county of ____ _________________, and that I have lived at the

(county of residence)

following places during the year immediately prior to the date of this affidavit (or affirmation) and application:

ADDRESS(ES) DATES (From – To)

I further state that I plan to enroll in _____________________________________ ___________ and that this affidavit

(community college)

(or affirmation) is made for the purpose of securing from the Chief Fiscal Officer of the City of New York a certificate of

residence pursuant to the requirements of Article 126 of the Education Law.

___________________________________________________

(sign in presence of Notary Public or Commissioner of Deeds)

Your signature must be notarized before this affidavit (or affirmation) is submitted.

Swornto(oraffirmed)beforemethis

__________dayof________________________________,20________

NotaryPublicorCommissionerofDeeds

EducationLaw,Section6305(3),provides:"Thechieffiscalofficerofeachcounty,asdefinedinsection2.00ofthelocalfinancelaw,shall,uponapplication

andsubmissiontohimofsatisfactoryevidence,issuetoanypersondesiringtoenrollinacommunitycollegeasanon‐residentstudent,acertificateof

residenceshowingthatsaidpersonisaresidentofsaidcounty...Suchpersonshall,uponhisregistrationforeachcollegeyear,filewiththecollegesucha

certificateofresidenceissuednotearlierthantwomonthspriorthereto,andsuchcertificateofresidenceshallbevalidforaperiodofoneyearfromthe

dateofissuance."

Rev. 7/12

THIS SPACE FOR USE OF CHIEF FISCAL OFFICER OF NEW YORK CITY (COMPT ROLLER)

Certificate issued ( ) Certificate not issued ( )

Date _____________________ By _______________ _________

CERTIFICATE OF RESIDENCE

Information and Directions

For Residents of New Yo rk City

A Certificate of Residence issued by your home county entitles you to pay the resident tuition fee to attend a

community college in New York State and not the higher, non-resident tuition. The New York City Comptroller

issues th ese certificates to qualified resi dents living within the five boroughs of New York City.

The Certificate of Residence is EFFECTIVE FOR ONE YEAR from the date it is issued. You must apply for and

submit a new Certificate of Residence to your college once a year, every year at the beginning of the semester

(or quarter), along with your tuition payment. If you do not submit the Certificate of Residence, you will be

charged the higher, non-resident tuition fee.

RESIDENCY QUALIFICATIONS

 Resident of New York State for at least one (1) year immediately prior to the date of application, and also

 Resident of New York City for at least six (6) mon ths immediately prior to the date of application.

Note: Members of the U.S Armed Forces, while on full-time active duty and stationed within New York State,

and their spou ses and dependents are eligible for the resident tuition rate.

TO APPLY

 All applicants (students) must provide two forms of proof to verify residency: ONE THAT IS DATED MORE

THAN SIX MONTHS AGO AND ONE DATED LESS THAN SIX MONTHS AGO. Proof must show applicant's

address (not P.O. Box or in care of a third party) and include the applicant's name.

Examples of acceptable proof of residency are:

 lease or deed, or if not available, a letter from a landlord on the landlord's letterhead indicating dates of

tenancy and r ent payments

 postmarked envelope mailed to you at your current address, dated less than six (6) months ago

 prior year's income tax return (parents' or parent's tax return, if listed as dependent)

 homeowner's or renter's insurance policy

 driver's license or automobile registration certificate

 bank statement

 automobile insurance policy

 utility bill

 cell phone bill

 selective service card

 voter registration.

Note: If residing with parent, you may bring one of the above proofs that show the permanent, New York

City address of the parent/student residence, along with a letter signed by parent and notarized that states

the student is now, and has been for a period of on e year, living with that parent.

 Fill out the AFFADAVIT AND APPLICATION form (reverse side) and have it NOTARIZED. A Notary Public is

available at the NY County Clerk's Office, New York State Supreme Court, 60 Centre Street, Room 141B,

Mon. – Fri. from 9:00 AM – 5:00 PM. (Valid photo ID required.) The Comptroller's Office does not

notarize.

 Present the original, NOTARIZED AFFIDAVIT plus the TWO ITEMS to prove residency in person to:

Office of the New York City Comptroller

One Centre Street (Municipal Building)

Room 1329, Certificate of Residence Desk

New York, NY 10007

Open ONLY during these hours: Mon. – Fri. 8:30 AM – 4:30 PM (Not open on weekends or holidays).

Questions regarding the above may be directed to (212) 669-2784. The affidavit, information and directions are available

at www.comptroller.nyc.gov.