Letter of Residency

LETTER OF RESIDENCY

Complete only if the parent/guardian does not have a utility bill in his/her name.
I Property Owner's Name* DO HEARBY ATTEST THAT NC Pre-K Child's Name* IS A CURRENT RESIDENT AT MY HOME/PROPERTY. A COPY OF MY LEASE OR UTILITY BILL (ELECTRIC, WATER, CABLE) IS UPLOADED. (CELL PHONE BILLS NOT ACCEPTED)
Please upload a copy of the property owner's current utility bill or lease.

Cancel of
Property Address (Utility bill must match name & address provided on this form.) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
PLEASE LIST ALL INDIVIDUALS LIVING AT RESIDENCE AND RELATIONSHIP TO CHILD LISTED ABOVE.
Name & Relationship to child
Name & Relationship to child
Name & Relationship to child
Name & Relationship to child
Name & Relationship to child
Name & Relationship to child
PROPERTY OWNER'S SIGNATURE *

Clear
PARENT/GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
Date *

Month Day Year
Date
Should be Empty: