Letter of Residency

LETTER OF RESIDENCY

Complete only if the parent/guardian does not have a utility bill in his/her name.
NC Pre-K Child's 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.*

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

Street Address

Street Address Line 2

CityState / 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
DATE*

MonthDayYear
Date
PARENT/GUARDIAN SIGNATURE*

Clear
Date*

MonthDayYear
Date
Should be Empty: