U.S. citizens and resident aliens who have a foreign bank account with at least $10,000 in it must file Form 4709 to report the existence of the account. The form is also used to report any income earned on the account and to disclose information about the foreign financial institution that holds the account. Penalties for failing to file Form 4709 can be significant, so it's important to understand your obligations and file the form on time. This article will provide an overview of Form 4709 and explain how to complete it.
| Question | Answer |
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| Form Name | Form 4709 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | NHW, DPC, ZZ, Broward |
THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA
STUDENT REGISTRATION FORM
(If the information below changes, it is the parent’s/guardian’s (F.S. 1002.21(5)
responsibility to notify the school within 10 school days.)
I understand that students whose parents are found, after appropriate investigation, to have submitted fraudulent information in an effort to enroll a student in a school to which the student is not assigned shall be immediately withdrawn by the school and the parent must enroll the student in the appropriate boundaried school. I have read and understand the Providing Proof of Residence: Important Information for Parents (SBP.5.1) and understand that if I have provided fraudulent information, I may be referred to law enforcement for prosecution.
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Student (Legal Name) __________________________________________________________________________________________________ |
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Middle |
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Address ______________________________________ |
Bldg. _____ |
Apt. _____ City _____________________ Zip Code ______________ |
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3. |
Parent/Guardian Name _____________________________________________ |
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Home Phone __________________________________ |
Cell Phone__________________________ |
Email_______________________ |
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Parent/Guardian Name _____________________________________________ |
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Home Phone __________________________________ |
Cell Phone__________________________ |
Email_______________________ |
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F.S.I. __________________________________ 5. Student S.S.N.________________________(F.S. 1008.386 requires SBBC to request this |
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information for the student’s permanent record) |
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Ethnicity: |
Is the student of Hispanic, Latino or Spanish origin Yes______No______ |
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Race: W _____ |
B _____ |
A _____ |
NA or AN _____ |
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NHW or PI______ |
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(White) |
(Black or African American) |
(Asian) |
(Native American or Alaskan Native) |
(Native Hawaiian or Pacific Islander) |
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8.Sex: Male _____ Female _____ 9. Current Grade Level ______ 10. Birth Date ______/______/______ Verified with____________________
11.Birthplace: City __________________________ State or Country ___________________
12. Has the student previously attended a: |
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Broward Public School? |
Yes ______ No _____ If yes, School ___________________________________________________ |
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Yes ______ No ______ If yes, School ___________________________________________________ |
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Private School? |
Yes______ No ______ If yes, School __________________________________________________ |
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Florida Public? |
Yes ______ No _____ If yes, School ________________________ County ____________________ |
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Outside of Florida? |
Yes ______ No _____ If yes, School ________________________ City_____________State_______ |
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Country____________________Check One: Public ____ Private ____ Other _____ |
13. Has the student ever been: |
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retained? |
Yes _____ No _____ Grade (s) ________ |
•in a Home Education Program? Yes _____ No _____ If yes, name of county/state/country ________________________________
Dates of attendance: From _____/_____/______ To _____/_____/_____
•in Exceptional Student Education (ESE)? Yes ______ No _____ Program _____________________________________________
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• in a Magnet Program? |
Yes _____No _____ If yes, name of Magnet Program ____________________________________ |
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• expelled from school? |
Yes_____ No_______ |
convicted of a felony? |
Yes_____No______ |
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14. |
Is a language other than English used in the Home? Yes _____ No ______ If yes, language used: _________________________________ |
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Would you like to receive information sent home in this language? Yes ____ No ____ |
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Does the student have a first language other than English? |
Yes _____ |
No _____ |
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Does the student most frequently speak a language other than English? |
Yes ____No ____If yes, language spoken: __________________ |
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17.Student lives with: Both Parents _____ Father _____ Mother _____ Other (relationship to student) _______________________________
18.Marital Status of parents: (optional) Married _____ Divorced _____ Separated _____ Widow(er) _____ Other _____
Parent Signature ______________________________Date: _________Parent Signature_____________________________Date: ____________
Enrollment Date______/_____/______ |
Proof of Residence__________________________ Review Dates ______/______/______ |
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Statement of Bonafide Residence Form Provided |
Temporary Custody |
Reassignment (must enter code) |
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ELL |
ELL Codes (Circle One) |
LY |
LF |
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LZ |
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ZZ |
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Health Exam Certificate (for students entering a Florida school for the first time, a health exam must be done within one (1) year prior to the day of registration) |
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Florida Certificate of Immunization (680) Form |
Overall Immunization Status ________________________________________ |
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Temporary Exemption (if checked, enter expiration date: |
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Medical Exemption |
Religious Exemption |
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Registrar: |
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Date: |
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FOR SCHOOL USE ONLY: |
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Copies given to: Registrar |
Guidance |
DPC |
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Other (specify) _________________________ |
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Form 4709 (Rev. 10/13/10) |
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PS18614 |
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School Name________________________________________Teacher_____________________________________Current Grade_________Enrollment Date___________________________