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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 names They have been residing with me since Month to reside with me until Day. Year Signature Residential Address Phone Number s City State Zip Code and will continue Attach Proof of Residency see Verification of Residency on back of form Child s Parent/Legal Guardian I certify that the above information is true. Notarized Statement Subscribe and sworn to before me This day of Notary Public My commission expires State of Hawaii 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. Year Signature Residential Address Phone Number s City State Zip Code and will continue Attach Proof of Residency see Verification of Residency on back of form Child s Parent/Legal Guardian I certify that the above information is true. Notarized Statement Subscribe and sworn to before me This day of Notary Public My commission expires State of Hawaii 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. 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 the relative/friend relative/friend s proof of legal residence A copy of the relative/friend s proof of legal residence must be attached to the 4. Depending on a school s past experiences a school can request that one or more of the above be provided* 5. If none of the above is available then the school may use other documentation to verify residence. 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. Notarized Statement Subscribe and sworn to before me This day of Notary Public My commission expires State of Hawaii 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. 1. Rental/lease agreement mortgage document or current real property assessment document in the parent/guardian s name. .

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