Residency Affidavit - Imagine Columbus Primary Academy printable pdf download

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RESIDENCY AFFIDAVIT

According to Ohio’s School Attendance Law (O.R.C. 3313.63) a student can only attend school tuition-free

where his/her biological/custodial parent resides. This form must be completed, signed by both Parent and

Residence Owner/Lessee and notarized, whenever a parent cannot verify that he/she owns or rents a

residence in the District.

SECTION I (to be completed by the parent/legal guardian of the student and signed before a Notary

Public):

Although I do not own or rent a residence in the Columbus City School District, this is to certify that I am

the custodial parent of the child(ren) named below and our current permanent residence (where the

parent/guardian and student[s] in question eat their meals and sleep on a regular basis, receive their mail,

and if applicable, where the parent is eligible to vote) is:

Name of student(s) (please print) _______________________________________________________

Name of parent (please print) __________________________________________________________

__________________________________________________________________________________

Address (Street Number and Street) (City) (State) (Zip Code)

Should I change this, my permanent residence, I understand that my child may no longer be eligible to

attend school in the Columbus City School District. I promise to notify the school immediately if my

residence changes. I also understand that if in fact the stated information is not true, and in fact my child

does not meet the residency requirements as defined by the State of Ohio, I will be responsible for paying

tuition from the date of enrollment.

Parent/Guardian signature (Affidavit)____________________________ Date_____________________

SECTION II (to be completed by the Columbus City School District resident with whom the family

is living, and signed before a Notary Public):

The student and his parent(s) live at the address listed above as Guests of:

Homeowner

Lessee

Homeowner/Lessee Name________________________________Phone________________________

According to Ohio Tuition Law, the resident of the school district who permits a non-resident student to

reside with them can be held responsible for paying all tuition due, during the time the student resides in

their home. It is understood that fraudulent reporting of residency for school attendance purposes is a

violation of state law and could result in prosecution of all related parties, in a court of law. Further, as the

resident of the Columbus City School District, I understand I can be held personally liable for any and all

tuition obligations for all days of fraudulent attendance left unpaid by the custodial/biological parent.

__________________________________________________________________________________

Signature (Affidavit) of Residence Owner/Lessee Date

Please attach 1 proof of residency (current utility bill (dated within the last 30 days) or purchase/

rental agreement in the name of homeowner/lessee).

Residency Affidavit - Imagine Columbus Primary Academy