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    Notarized Residency-Verification-Form

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    Coach Ellis
    This document is a Hawaii residency verification form for school enrollment. It requires the student's name, the name and signature of the relative or friend they are residing with, the residential address and phone number. It must be notarized and include proof of residency, such as a rental/lease agreement, utility bill, or notarized statement from the relative/friend along with their proof of residency. Falsifying documents is subject to penalty, and homeless students have separate enrollment guidelines.

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    Notarized Residency-Verification-Form

    Uploaded by

    Coach Ellis
    40 views2 pages
    This document is a Hawaii residency verification form for school enrollment. It requires the student's name, the name and signature of the relative or friend they are residing with, the residential address and phone number. It must be notarized and include proof of residency, such as a rental/lease agreement, utility bill, or notarized statement from the relative/friend along with their proof of residency. Falsifying documents is subject to penalty, and homeless students have separate enrollment guidelines.

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    This document is a Hawaii residency verification form for school enrollment. It requires the student's name, the name and signature of the relative or friend they are residing with, the residential address and phone number. It must be notarized and include proof of residency, such as a rental/lease agreement, utility bill, or notarized statement from the relative/friend along with their proof of residency. Falsifying documents is subject to penalty, and homeless students have separate enrollment guidelines.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    40 views2 pages

    Notarized Residency-Verification-Form

    Uploaded by

    Coach Ellis
    This document is a Hawaii residency verification form for school enrollment. It requires the student's name, the name and signature of the relative or friend they are residing with, the residential address and phone number. It must be notarized and include proof of residency, such as a rental/lease agreement, utility bill, or notarized statement from the relative/friend along with their proof of residency. Falsifying documents is subject to penalty, and homeless students have separate enrollment guidelines.

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    © All Rights Reserved
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    Hawaii Educational

    RESIDENCY VERIFICATION FORM

    According to state law, Hawaii Revised Statutes §302A-1143 and Hawaii Administrative Rule
    chapter 8-13, school aged children are required to attend the school in the area in which they
    reside, unless permitted to attend another school through a geographic exception.

    This is to certify that the following are residing with me:


    (PRINT Student(s) Names)

    PRINT Name (Relative/Friend) Signature

    Residential Address Phone Number(s)


    ***Attach Proof of Residency (see Verification of
    Residency on back of form)
    City State Zip Code

    Child’s Parent/Legal Guardian

    I certify that the above information is true.

    PRINT Name Signature

    Notarized Statement

    Subscribe and sworn to before me:

    This day of , .

    Notary Public:
    State of Hawaii

    My commission expires:
    Proof of Residence, VERIFICATION
    ► Verification of Identity of parent, licensed foster parent, or Court–appointed legal guardian

    • A Driver’s License (any photo drivers license is permitted), passport with photo ID, or
    State Identification card.

    ► Verification of Residency preferred documentation:

    1. Rental/lease agreement, mortgage document or current real property assessment


    document in the parent/guardian’s name.
    2. Utility bill for water, electric, gas or telephone that indicates that the billing is in the
    parent/guardian’s name and is being sent to the house.
    3. Notarized statement by the relative/friend can be accepted by the school with the
    following stipulation:
    • Notarized statement must state that the parent/legal guardian and child are living
    with the relative/friend;

    • Notarized statement must state the name of relative/friend that is on


    the relative/friend’s proof of legal residence;
    • Notarized statement must state the same address of relative/friend that is on the
    relative/friend’s proof of legal residence;

    • A copy of the relative/friend’s proof of legal residence must be attached to the


    notarized statement; and

    • Notarized statement must be signed by same name of relative/friend that is on the

    relative/friend’s proof of legal residence.


    4. Depending on a school’s past experiences, a school can request that one or more of the
    above be provided.

    5. A home visit can be made by school staff should there be questionable documentation.
    6. Falsification on documents submitted is subject to penalty under HRS 710-1063. When
    such a violation is found, the child will be sent back to the school where he/she should
    properly be attending. The DOE may pursue prosecution at its discretion.
    7. For a homeless child, please refer to the school selection and enrollment guidelines that
    are provided by the McKinney-Vento Education for Homeless Children & Youth
    Program (as reauthorized by the NCLB Act of 2001).

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