STATE of NEW YORK, COUNTY OF SARATOGA
AFFIDAVIT AND APPLICATION FOR CERTIFICATE OF RESIDENCE
IN CONNECTION WITH ATTENDANCE AT A COMMUNITY COLLEGE

Treasurer Certificate of Residency Application
I,

, hereby swear (or affirm) that I reside* at:

I have lived at the above address from

to present.

My current physical address is located in the Town of
My current physical address is located in the County of
I've been a resident* of the County of Saratoga for

of the six months immediately prior to the date of this application.

My current physical address is located in the Town of , in the County of , State of New York. I swear (or affirm) that I have been a resident* of the State of New York for a period of at least one year immediately prior to the date of this affidavit and application, and that I have been a resident* of the County of Saratoga for of the six months immediately prior to the date of this affidavit, and that I have resided at the following places during the year immediately prior to the date of this application (knowingly providing false information is a crime punishable by law):

I further swear (or affirm) the following information:

I am registered / expect to be registered at

Community College.

I will attend the college during the

term.

I further state that I am registered / expect to be registered at Community College and will attend the college during the semester.

*Refer to Education Law, Section 6301 paragraph 4, and Section 6305.

In order to have Saratoga County participate in the cost of his or her community college education, a student must obtain a Certificate of Residency and submit it to the college. Military personnel on active duty, as well as their spouses and dependents, are entitled to the lower “Resident” rate.

A student must apply for a certificate no sooner than 60 days prior to the student’s registration date and no later than 30 days after the college’s first day of classes. Certificates remain valid for one year of semesters, provided the student attends during the semester the certificate is issued. A student that does not register for the semester the certificate was issued, must apply for and receive a new certificate.

Students can obtain a certificate in person at the County Treasurer’s Office. Students, who are U.S. citizens residing at their current address for at least twelve consecutive months, without moving, may obtain a certificate from their town or city clerk prior to the cut- off date. Cut-off dates are dictated by the start of classes at each college and will vary. Town and city clerks are only authorized to issue certificates until the start of the college semester. Students applying for a certificate after the beginning of the college semester must apply at County Treasurer’s office. An application will be accepted from an individual other than the student only if the student’s signature on the affidavit and sufficient proof is submitted.

• A student must be a continuous resident of New York State for one year immediately preceding the date of application
AND
• A student must have been a resident of Saratoga County for at least one month within the six months immediately preceding
the date of application. A student that has not been a resident of Saratoga County for that entire six-month period must
obtain a certificate from each county of residence within the six-month period. He/she must apply at the County Treasurer’s
Office.

• Non-citizens are required to document their resident status and must apply at the County Treasurer’s Office for their first
certificate. Non-citizens renewing a certificate of residency that have resided at their current residence for twelve
consecutive months, without moving may obtain their certificate from their town or city clerk providing the proof used for
residence status has not expired.

• At a minimum, two proofs are required: One must be 12-18 months old and one less than 30 days old.

• Each document must be dated and include name and physical street address. Documents with a post office box will not
suffice unless a physical address is also indicated.

• Each residence on the application must be documented. Proof will be required within 30 days of the date of any move in
the past year.

• No claim of residency will be accepted solely on your testimony or that of your parents, relatives, friends or other individuals.

• The standard of proof will not be compromised because you have left yourself insufficient time to obtain acceptable proof.

• College correspondence including bills or schedule of classes
• Bank statements
• Utility bills
• Medical records including prescriptions
• Report cards with an issue date of 1year old, or within 30 days
• Dated mail or postmarked envelopes
• Income tax return with preprinted label or W2’s
• Formal lease
• Driver’s license, car registration and insurance card may be used when the issue date reflected is 1 year old, or within 30 days of application.

Required documentation:
• Permanent Resident Card
• Visa
• Immigration papers indicating permanent resident status

Acceptable proof is not limited to the above examples, but proof must contain all required elements to be accepted.

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