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Form – Arizona Residency Documentation
Arizona Residency Documentation
Please fill out the form below.
Under Arizona State Law (A.R.S. § 15-823J), as part of the annual registration process, school districts are required to obtain and keep on file documentation of the residency of the parent or guardian with whom each student lives. This documentation must be provided each time a student enrolls in a school district in Arizona, and reaffirmed during the annual registration process.
This Arizona Residency Documentation Form must be completed for all students by the parent or legal guardian. A photocopy of one of the documents listed below-which clearly shows the parent or legal guardian's full name and residential address (no P.O. boxes)-must be provided to the school or district with this completed and signed form. Personal information other than name and address (such as Social Security Number, account numbers, etc.) should be blacked out on the document before providing it to the school or district.
Those who cannot document their own residence because of extenuating circumstances must complete both this form (checking the last box) and the "Affidavit of Shared Residence" also available from the school.
Parent/Legal Guardian Name
As the Parent/Legal Guardian of the Student, I attest that I am a resident of the State of Arizona and submit in support of this attestation a copy of the following document that displays my name and residential address or physical description of the property where the student resides:
Valid Arizona driver's license, Arizona identification card or motor vehicle registration
Valid U.S. passport
Real estate deed or mortgage documents
Property tax bill
Residential lease or rental agreement
Water, electric, gas, cable, or phone bill
Bank or credit card statement
W-2 wage statement
Certificate of tribal enrollment or other identification issued by a recognized Indian tribe that contains an Arizona address
Documentation from a state, tribal or federal government agency (Social Security Administration, Veteran's Administration, Arizona Department of Economic Security)
I am currently unable to provide any of the foregoing documents. Therefore, I have provided an original affidavit signed and notarized by an Arizona resident who attests that I have established residence in Arizona with the person signing the affidavit. (Note: Please also complete the "Affidavit of Shared Residence.")
Signature of Parent/Legal Guardian
This field is for validation purposes and should be left unchanged.
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Heritage Academy Mesa: 32 S. Center, Mesa, AZ 85210
Phone: (480) 969-5641
Fax: (480) 969-6972
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