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Hermiston School District
Residency Verification
The Hermiston School District has a responsibility to the State of Oregon to ensure that
student residency information is accurate and in accordance with State guidelines. The
Hermiston School District’s Residency Verification form must be signed by
parents/guardians upon initial student enrollment and whenever residence information
changes. Listed below is a series of documents that are acceptable to properly verify
residence, proper residency verification requires at least ONE of the following:
PLEASE CIRCLE AND ATTACH COPIES
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Letter on apartment complex letterhead
Mortgage booklet, escrow papers, homeowners association receipt, property tax
form
Rental agreement and current rent receipt
Residence insurance statements
Utility bills (Electric, Gas, Trash, Water)
Driver’s License
Bank Statement
Mail addressed to you with a current postmark
We would like to inform you that a person who knowingly submits a false declaration may
subject the signer to responsibility to pay tuition for the dates of attendance in which their
student did not legally reside within the Hermiston School District boundaries. The
student will be ineligible to continue to attend any school within the Hermiston School
District until residency is confirmed within Hermiston School District boundaries.
Student’s Name
Grade Level
Signature of Parent/Guardian
Date