PARISH OF EAST BATON ROUGE
BEFORE ME, the undersigned notary, personally came and appeared:
__________________________________ (full name), called “Affiant,” a person of the age of majority whose permanent mailing address is: (legal custodian of student)
Affiant has been advised and is aware that this Affidavit is being provided to officials of the East Baton Rouge School Board for purposes of admitting a student to the East Baton Rouge Parish School System.
Affiant is advised and is aware that the making of intentionally false statements in this Affidavit may expose him/her and the residency owner to prosecution for false swearing under R.S. 14:125 or other applicable laws of the State of Louisiana.
Sworn to and subscribed before me, upon oath or affirmation, on this ______________day of __________.