MULTIPLE OCCUPANCY AFFIDAVIT



2020-2021 Multiple Occupancy PacketINTERBORO SCHOOL DISTRICTLiving in a Multiple Occupancy situation means, that you live with a tax payer/home owner who resides in the Interboro School District. Families in this situation will complete the attached forms and have them notarized and bring in all the necessary documents. Due to Covid-19, we are only requiring the guardian to be present if an appointment is necessary. We are permitting them to supply the tax payers paperwork this year. An appointment is only needed if you can not send required documents via email or fax or drop box. This packet is required to be completed annually.2020-2021 Multiple Occupancy PacketINTERBORO SCHOOL DISTRICTMultiple Occupancy InformationLiving in a Multiple Occupancy situation means, that you live with a tax payer/home owner who resides in the Interboro School District. Families in this situation will complete the attached forms and have them notarized and bring in all the necessary documents. Things to bring with you:Tax Payer/Home Owner:Fill out the Multiple Occupancy Owner Form and have it NotarizedProof of Residency ( Mortgage Statement, or Property/School Tax Bill)1 Current Utility Bill (in owner’s name) (Gas, Electric, Water, or Cable/Satellite) and an additional piece of mail.Photo ID presented at the time of Registration Parent/Guardian:Fill out the Multiple Occupancy Parent/Guardian Form and have it NotarizedPicture ID with matching address (update card / internet receipt is acceptable if change has been made.)Total of 2 pieces of mail: 1 current Utility Bill (Gas, Electric, Water, or Cable/Satellite) and an additional piece of mail. If all utilities are in the tax payers name, you will be required to bring in 2 pieces of mail (bank statement, credit card statements, etc)INTERBORO SCHOOL DISTRICTMultiple Occupancy Affidavit(TAX PAYER/HOME OWNER) I, ____________________________________________, hereby state that I am the Owner of the residence located at ________________________________________________________________________________________________ and that__________________________________________________ (Parent/Guardian 1)________________________ (Role)__________________________________________________ (Parent/Guardian 2)________________________ (Role)__________________________________________________ (Student)________________________ (DOB)__________________________________________________ (Student)________________________ (DOB)__________________________________________________ (Student)________________________ (DOB)are sharing this residence with me. Should the parent(s)/guardian(s) and student(s) listed above move from my residence, whether within the Interboro School District or not, I shall notify the School District. Resident and Interboro School District further agree that if, at any time, the facts as set forth in the Affidavit are found to be incorrect, Interboro School District, shall have no obligation to continue to educate the student(s) listed above in its school system either on a free or tuition basis. I understand that if the above residency is questionable, the District will conduct a residency investigation. I further understand and agree that, should the student(s) listed above be found to be attending Interboro School District’s schools illegally, the District will immediately dis enroll the student(s) and may file suit against the parent(s) / guardian(s) and myself (as the owner of the residence) in a court of law to recoup tuition costs. * Period covered by this affidavit is for the 2020-2021 school year in the Interboro School District.RELATIONSHIP TO PARENT/GUARDIAN:____________________________ TAX PAYER/HOME OWNER ___________________________________________________________Print namePhone #SIGNATURE:___________________________________________DATE:_____________________*NOTE:right15748000Estimated tuition rates for 2020-2021 Academic Year are:Elementary: $11,971.42Sworn to and subscribed before me, aSecondary: $15,072.28 Notary Public, on this _______day of _______________, 20__________________________________________Notary PublicINTERBORO SCHOOL DISTRICTMultiple Occupancy Affidavit(PARENT / GUARDIAN)I, ____________________________________________, hereby state that I am the Parent/Guardian or have legal custody of __________________________________________________ (Student)________________________ (DOB)__________________________________________________ (Student)________________________ (DOB)__________________________________________________ (Student)________________________ (DOB)__________________________________________________ (Student)________________________ (DOB)and that we reside at: _________________________________________________________with_____________________________________Address Tax Payer’s NameShould we move to another location, whether within the Interboro School District or not, I shall notify the School District. I further agree that if, at any time, the facts as set forth in the Affidavit are found to be incorrect, Interboro School District, shall have no obligation to continue to educate the above student(s) in its school system either on a free or tuition basis. I understand that if the above residency is questionable, the District will conduct a residency investigation. I further understand and agree that, should the above student(s) be found to be attending Interboro School District’s schools illegally, the District will immediately dis enroll the student (s) and may file suit against myself (as parent(s)/guardian(s)) and the owner of the residence in a court of law to recoup tuition costs. * Period covered by this affidavit is for the 2020-2021 school year in the Interboro School District.RELATIONSHIP TO TAX PAYER/HOME OWNER:__________________PARENT/GUARDIAN _____________________________________________________________________________Print NameSIGNATURE:___________________________________________DATE:_____________________*NOTE:right15748000Estimated tuition rates for 2020-2021 Academic Year are:Elementary: $11,971.42Secondary: $15,072.28Sworn to and subscribed before me, aNotary Public, on this _______day of___________________, 20_______ _____________________________Notary Public ................
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