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This document serves as a declaration of residence and a confirmation of background checks required for adults who work with or come into contact with children in accordance with Pennsylvania Child Protective Services laws. It outlines the requirements for mandated reporters and the necessary criminal background clearances, including the FBI criminal background check for certain volunteers.
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How to fill out statement of residence

01
Obtain the statement of residence form from your local authority or relevant office.
02
Fill in your personal details, including your full name, address, and date of birth.
03
Provide proof of residence, such as utility bills or bank statements.
04
If required, have the form signed by a witness or a professional who can verify your identity.
05
Review the completed form for accuracy and completeness.
06
Submit the form to the appropriate authority as directed.

Who needs statement of residence?

01
Individuals applying for government services or benefits.
02
Students requiring proof of residence for school enrollment.
03
People applying for certain licenses or permits.
04
Residents needing to verify their address for legal documents.
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A statement of residence is a document that confirms an individual's primary address or residence for legal, tax, and administrative purposes.
Individuals who are residents for tax purposes and need to confirm their primary living address to governmental or legal entities are typically required to file a statement of residence.
To fill out a statement of residence, individuals must provide their full name, current address, date of birth, and possibly other identifying information such as a social security number or tax identification number, and then sign the document.
The purpose of a statement of residence is to establish and verify an individual's primary home address for various administrative, legal, and tax-related requirements.
The information that must typically be reported includes the individual's full name, physical address, date of residency, date of birth, and possibly other identifying personal information.
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