Residency Requirements

Change of Address Form


Proof of Residency Documentation

Please provide one (1) mandatory item from Category A and one (1) from Category B. If unable to
provide from Category B, two items from Category C are required. Account numbers and amounts may
be redacted from forms. In addition, a photo ID is required.

***DOCUMENTS IN CATEGORIES B & C ARE REQUIRED TO BE LESS THAN 60 DAYS OLD AND MUST REFLECT YOUR CURRENT LEDYARD ADDRESS ***

Rev 10/2021


Links to Policy Forms:

 5111.3(a) Residency Verification Notice 
 5111.3(b) Ledyard Residency Questionnaire
 5111.3(c) Ledyard Residency Affidavit
 5111.3(d) Required Residency Documentation Table
 5111.3(e) Ledyard Change of Address Form
 5111.3(f) Transportation Emergency Contact
 5111.3(g) Authorization for Emergency & Custodial Decisions
 5111.3(h) Release of Information