State Of Georgia County Of Fulton Affidavit Of Residence
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1State of Georgia
County of Fulton
Affidavit of Residence*
The undersigned, first being duly sworn, deposes and states that he/she is the parent/guardian of
_____________________________________, and said student lives with the undersigned, and that both
Student
the student and the undersigned are bona fide full time residents of Fulton County and that they reside at
___________________________________________________________________________________.
Street
City
Zip Code
Fulton County, Georgia with ____________________________________________________________
Name of homeowner/apartment lessee
The undersigned further agrees that he/she will notify the Fulton County Board of Education if the parent
and/or student ever terminate the above residence in Fulton County while the student is enrolled in a Fulton
County school. If it is determined that the student does not live in the appropriate school district,
he/she will be withdrawn from school immediately.
_________________________________________
____________________________________
Signature of Parent/Guardian
Signature of Homeowner/Apartment Lessee
_________________________________________
____________________________________
Print Name of Parent/Guardian
Print Name of Homeowner/Apartment Lessee
Sworn to and subscribed before this ______ day of _______, 200 ___.
_____________________________ (Notary Public)
My Commission expires ___________________________
*False swearing is a violation of the laws of the State of Georgia, punishable by a fine of not more than
$1,000, or be imprisonment for not less than one nor more than five years, or both. Georgia Code
(O.C.G.A. 16-1071).
When using this form you must bring two additional documents from the list below bearing the name
of the person who signed above as the owner of the house or lessee of the apartment in order to
register.
Acceptable Documentation
*Copy of home mortgage payment book
*Current bank statement
*Copy of home contract
*Current utility bill (gas, electric, or water)
*Current paycheck stub
*Apartment lease showing name of lessee
*Receipt to have utilities connected
*Homeowner’s/Renter’s insurance registration card
T:AffidavitofResidentceEnglish.doc
Rev. 07-21-05
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