Editing previous response:

Please fix the highlighted areas below before submitting.

McKinney-Vento Residency Attestation Form

Please complete the form below. Required fields marked with an asterisk *

This form should be completed by the owner or tenant of the property at which the student(s) and their custodians are living.

First and Last Name*

Answer Required

Street Address*

Answer Required

City*

Answer Required

State*

Answer Required

Zip/Postal*

Answer Required

I am...*

of the residence above

Answer Required

Owner

Tenant

In order to comply with Homewood School District's proof of residency requirement, I verfiy the following information for the following students:*

Please list the first and last names of all students at residence

Answer Required

First and Last Names of Custodial Parent/Guardians at residence*

Answer Required

I attest that student(s) named above and his/her custodians have been living at the address above since*

Answer Required

To the best of my knowledge, the student(s) named above and his/her custodians will continue to reside at this address until*

Answer Required

By providing my name below, I affirm that the information presented in this form is true, complete and accurate.

Signature of Owner/Tenant*

Answer Required

It is against the law to falsely register McKinney-Vento.