Get Landlord Living Agreement Form

PUBLIC SCHOOLS OF BROOKLINE BROOKLINE MASSACHUSETTS LANDLORD LIVING AGREEMENT This form is required to be filled out and notarized by your landlord if you are leasing your home and have recently moved. YOU DO NOT NEED TO COMPLETE THIS IF YOU HAVEN T MOVED AND YOUR ADDRESS IS UP TO DATE WITH THE SCHOOL. I swear under oath that the following Landlord s Name- Please print information is true List all applicable children Parent s name s Property Address of which I am the owner of said property on record. I understand that the Public Schools of Brookline reserves the right to investigate residency if they feel that temporary residency was established for the sole purpose of attending the Public Schools of Brookline. I further understand that according to Massachusetts General Law Chapter 76 Section 5 Any person who violates or assists in the violation of this provision may be required to remit full restitution to the town of the improperly-attended public schools. Signed under the pain and penalties of perjury on this day of 201 Landlord s Signature Date Print name --------------------------------------------------------------------------------------------------------------------Statement of Notary Public Commonwealth of Massachusetts Norfolk County ss. On this day of 20 before me the undersigned notary public personally appeared name of document signer proved to me through satisfactory evidence of identification which were to be the person whose name is signed on the preceding or attached document and acknowledged to me that he/she signed it voluntarily for its stated purpose. I understand that the Public Schools of Brookline reserves the right to investigate residency if they feel that temporary residency was established for the sole purpose of attending the Public Schools of Brookline. I further understand that according to Massachusetts General Law Chapter 76 Section 5 Any person who violates or assists in the violation of this provision may be required to remit full restitution to the town of the improperly-attended public schools. I further understand that according to Massachusetts General Law Chapter 76 Section 5 Any person who violates or assists in the violation of this provision may be required to remit full restitution to the town of the improperly-attended public schools. Signed under the pain and penalties of perjury on this day of 201 Landlord s Signature Date Print name --------------------------------------------------------------------------------------------------------------------Statement of Notary Public Commonwealth of Massachusetts Norfolk County ss. Signed under the pain and penalties of perjury on this day of 201 Landlord s Signature Date Print name --------------------------------------------------------------------------------------------------------------------Statement of Notary Public Commonwealth of Massachusetts Norfolk County ss. On this day of 20 before me the undersigned notary public personally appeared name of document signer proved to me through satisfactory evidence of identification which were to be the person whose name is signed on the preceding or attached document and acknowledged to me that he/she signed it voluntarily for its stated purpose.