Lease Verification Form printable pdf download

LEASE VERIFICATION FORM

Dear Residence Manager, Landlord, or Agent:

KIPP WAYS Primary/Academy received a lease from the below name person(s) and they have specified you and/or your

company as the present landlord. We would appreciate your response to the following questions below at your earliest

convenience. If you have additional information that may help in our decision, please feel free to comment or give us a call

at 404-475-1941.

RESIDENT(S) NAME:

OTHER OCCUPANT(S):

Address:_________________________________________________________________________________________________

Phone #: ________________________ Fax:

Manager, Landlord or Agent Name:,

I do hereby authorize the Manager, Landlord or Agent, to release the requested information to Atlanta Public Schools for their

review. I also understand that representatives of Atlanta Public Schools may visit my home to verify residency. I understand and

agree that this information may include names, addresses, or dates of birth of any/all lessees/occupants, move-in and/or move-out

dates and dates of the Lease.

I certify under penalty of perjury that I am a resident of the above stated address and the information I submitted in support

of my child's enrollment is complete and accurate. I understand that my child may be withdrawn from his or her assigned school

if incomplete, inaccurate or false information is provided. I also understand that I must notify the school office within 10 days if my

residence changes.

Signature

Date

Signature

Date

============================================================================================================

To be completed by Authorized Manager, Landlord, or Agent Responding

Residency Status:

______Current resident

______Not a current resident

_____Has never been a resident

Month to Month______________

Lease Expired:

or Lease Expires:,

Comment:

Signature (Authorized Manager, Landlord, or Agent Responding)

Date

Lease Verification Form