Depending on your age below, there are at least two or three documents required in order for you to participate in a 2021 MISS TEEN USA® State pageant. One document will show proof of your age and one or two documents showing proof of residency. You must attach these files to this form or mail copies to the pageant office.

All contestants must submit a photocopy of their birth certificate, even if you have participated in prior years’ competitions. Attach a photocopy of your Birth Certificate below. (It does not need to be a certified or notarized copy.) We cannot accept any other document for this requirement.

If you were not born in the United States, you must also attach a photocopy of your passport or naturalization papers, in addition to your birth certificate, establishing that you are a citizen of the United States.

I now reside and have resided in my State as my “permanent and primary residence” (as defined below) for a period of at least ninety (90) consecutive days immediately prior to the date of the State Pageant. “Permanent and primary residence” or “Permanent and primary residency” means my true, fixed and permanent domicile which I intend to make my permanent home. In order to establish my Permanent and primary residence in the State, I must satisfy either (1), (2), or (3) regarding the residency and documentation requirements:

(1) If I am 16 years of age or older as of January 1, 2021, I am attaching photocopies of at least two of the following types of bona-fide documents, at least one of which must be of document type (a) through (e):

(a) my driver’s license;

(b) my voter identification or registration card and/or proof of voter history provided by the state;

(c) my resident tax return from the most recent tax year;

(d) my current school records (e.g., transcript or report cards with my address);

(e) employment documents in my name (Form W-2 and pay stubs only) evidencing employment in the state for at least ninety (90) consecutive days immediately prior to the date of the State Pageant;

(f) lease or deed for a dwelling in my name (evidencing occupancy of dwelling for at least ninety (90) consecutive days immediately prior to the date of the State Pageant);

(g) telephone or utility bills in my name (both the current bill and a bill dating back at least ninety (90) consecutive days immediately prior to the commencement of the State Pageant); or

(h) bank or credit card statements in my name (both the current statement and a statement dating back at least (90) consecutive days immediately prior to the commencement of the State Pageant).

(2) If I am 16 years of age or older as of January 1, 2021, I either:

(a) reside in the State as a full time student at a school, college or university and will have completed one entire semester, trimester or summer session immediately prior to December 31, 2020, and I will continue to reside in the State as a full time student at that same school, college or university (although I may have spent or be spending the summer in another State). For the avoidance of doubt, I will not satisfy the requirements of option (2) if I reside in one state, and I am enrolled in an online school, college or university located in another state; or

(b) retain full-time employment in the State (i.e., I work at least forty (40) hours per week in the State, and I qualify for employment benefits provided by my employer) and have maintained such full-time employment for a period of at least ninety (90) days prior to the date of the State Pageant.

In order to establish my compliance with the residency requirements of option (2), I am attaching either bona-fide copies of my current school records (e.g., transcript or report cards with my address) or employment documents in my name (Form W-2 and pay stubs only) evidencing employment in the state for at least ninety (90) days immediately prior to the date of the State Pageant.

(3) If I am under 16 years of age as of January 1, 2021, I am attaching my current bona-fide school records (e.g., transcript or report cards with my address), and I understand that only my current bona-fide school records will be acceptable to show my residency if I am under 16.

I will maintain such residency through the State Pageant and, if I win the State Pageant, through the 2021 Miss Teen USA Pageant. If I do not win the State Pageant, and I intend to establish Permanent and primary residency in another state, I may not compete in another state’s pageant preliminary to the 2021 Miss Teen USA Pageant for a period of at least ninety (90) consecutive days after the date of the State Pageant, unless I am 16 years of age or older as of January 1, 2021, and I qualify to compete under option (2) above.

I understand and agree that you have the right to reject information or documentation you feel has not been gathered or provided in good faith. I will maintain such residency through the State Pageant and, if I win the State Pageant, through the 2021 Miss Teen USA Pageant.

Notwithstanding the foregoing, Miss Universe reserves the right to review and evaluate the residency documentation that I submit. If Miss Universe determines, in its sole discretion, that the documentation I submitted to fulfill my residency requirements was for the sole purpose of competing in the State Pageant, with no intention of maintaining my residency in the State, Miss Universe will have the right, in its sole judgment, to take any action that it deems appropriate, including without limitation disqualifying me from competing in the State Pageant, terminating my reign as Miss (State) Teen USA 2021 if I win the State Pageant, withholding any Prizes or other compensation to which I may have been entitled, and requiring me to return any Prizes or other compensation I may have already received.

I understand that you will not accept any documents other than the documents referred to above in order to determine whether I comply with the applicable residency requirements.

These documents must be issued in your name and show an address from the state you which you plan to compete. Any sensitive information, such as credit card numbers, account balances, etc. may be crossed out.