TULSA ACHIEVES PROOF of RESIDENCY

TULSA ACHIEVES PROOF

of RESIDENCY

Revised September 2018

TACNTY

Student Name:

TCC CWID:

Last

First

M.I.

This form is for incoming freshman who were determined to be ineligible for Tulsa Achieves due to

residency and have proof this determination is incorrect. This form is not to request an exception to

county residency rules; all TA students must be residents of Tulsa County.

Complete this form and submit it to any TCC Financial Aid and Scholarship office with proof of Tulsa

County residency. Final determination for residency is verified through the Tulsa County Assessor. All

documentation must have the address the student used to apply for admission.

Address: _____________________________________________________________________________________________________________

Street City State Zip

I physically reside at this address: Yes: ______ No: ______

I am a resident of Tulsa County: Yes: ______ No: ______

Date residency began at this address: Month: _________________ Year: ______________

Proof of Residency Documents

Select the box that describes the type of documentation you are submitting with your appeal.

 Statement from Tulsa County Assessor’s office. You can access this by visiting the Tulsa County

Assessor website.

 Voter registration card

 Copy of lease with record of most recent rent payment

 Copy of deed or most recent mortgage payment

 Residency Affidavit from landlord affirming tenancy with most recent rent payment

 Section 8 agreement

I hereby certify the accuracy of all the information I have provided.

Signature: ____________________________________________________________ Date: _________________________