#2803440
Arizona Department of Education
Arizona Residency Documentation Form
Student School
School District or Charter Holder
Parent/Legal Guardian
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 Arizona Address Confidentiality Program authorization card
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
Payroll stub
Certificate of tribal enrollment (506 Form) or other identification issued by a recognized
Indian tribe in Arizona
Documentation from a state, tribal or federal government agency (Social Security Administration,
Veteran’s Administration, Arizona Department of Economic Security)
___ Temporary on-base billeting facility (for military families)
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.
Signature of Parent/Legal Guardian Date
*For members of the armed services, the provision of verifiable documentation does not serve as a declaration of
official residency for income tax or other legal purposes. Armed service members may utilize a temporary on-
base billeting facility as the address for proof of residency.
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