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The completion of this form is needed if your child is living with one parent, or is shared jointly between both parents living in two different households.

If custody is joint, name of who joint custody is shared with:

Do you as the custodial or joint custodial parent have legal custody through a court order?
If there is a court order, does it permit the child to be released to the non-custodial parent?
Does the court order allow the non-custodial parent to access school records?
Parent/Guardian Signature
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