PROOF OF RESIDENCY I, ____________________________________, residing at ___________________________________________, RESIDENCE OWNER
ACTUAL PHYSICAL ADDRESS OF RESIDENCE
hereby certify that _______________________________________________________ and his/her/their children, PARENT/GUARDIAN NAME _______________________________________________________ are living with me at my residence. NAME OF CHILD(REN) They have made my residence their permanent residence as of ________________________________. INSERT DATE I understand signing this affidavit certifies their residency for the purpose of attending school in the Brenham Independent School District. The attendance officer may, on occasion, verify their residence. I also understand, if their residency should change, it will be my responsibility to notify the proper authorities in the Brenham Independent School District as to the date they will be moving from my home. IN WITNESS WHEREOF, I have hereunto set my hand this __________ day of _________________________ in DAY OF MONTH
MONTH _____________________________, Texas. CITY _____________________________________________________________________________________________ SIGNATURE OF PARENT/GUARDIAN
SIGNATURE OF CUSTODIAN/ATTORNEY­IN­FACT ADDRESS: _______________________________
_______________________________
ADDRESS: ________________________________ ________________________________ STATE OF TEXAS COUNTY OF _____________________________________ BEFORE ME, the undersigned authority, on this day personally appeared _____________________________ PARENT/GUARDIAN NAME and __________________________, known to me to be the person whose name is subscribed to the foregoing RESIDENCE OWNER NAME instrument and acknowledged to me that he/she executed the same for the purposes therein expressed. GIVEN under my hand and seal of office on this the ________ day of ___________________, 20______. __________________________________________________
(SEAL) Notary Public’s Signature UPDATED FEBRUARY 2016