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California R4 Private School Affidavit
California R4 Private School
Affidavit Form Sample
Make a copy of this form and then go online to fill out a similar
form for your California homeschool. New form for 2007-8 is currently
available. Though it is available before October 1, it is recommended
that you do not complete or send it in until October 1, 2007,
and DO complete it on or by October 15, 2007. If you decide to
homeschool later in the school year, you may also send it on
at that time, until the state takes the affidavit off its site
during the summer vacation months. Even if you file for the first
time in, say, March, you must file again the October of the same
year if you will be continuing to homeschool.
Private
School Affidavit Form (The R4)
The California Department of Education makes the R4 form available
from about October 1 (or earlier) through May every year. This
link will probably be "dead" over the summer. Read
the instructions below and look at the sample before attempting
to fill it out. Some questions are trickier than others, and
you will need to think about how you will answer some ahead of
time.
How to Start a Private School in Your
Home
In California, families can legally homeschool their children
by establishing a private school in their home and complying
with the private school requirements of the California Education
Code. Parents who have established a home-based private school
cannot be prosecuted for truancy.
This page is not intended to be legal advice and is distributed
for information purposes only. Consult a lawyer, such as the
HSC Legal Team, if you have special circumstances precluding
following these directions.
The provisions of Education
Code Section 48222 provide for the exception of children
from public school by reason of being instructed in a private
full-time school.
The R4 Affidavit
Excemptions under this section are valid only after verification
by the attendance supervisor of the district that the private
school has complied with the provisions of Education
Code Section 33190 requiring the annual filing by the "owner
or other head of a private school" of an affidavit of prescribed
information with the Superintendent of Public Instruction. This
affidavit does not act as a license. The Department of Education
does not license, evaluate, recognize, approve, or endorse any
private school course. The affidavit is necessary to effect public
exemption from other schools and for the school to be eligible
to receive the appropriate pupil records from pupil last school
of attendance.
What if you can't get an affidavit?
Submit written requests to:
Private Schools Affidavit
California Department of Education
1430 N Street, Fourth Floor
Sacramento, CA 95814
I recommend that you use the
web-based application even if you have to borrow a friend's
access or use a public terminal such as at a library or cybercafe.
It would probaby be best NOT to file on October 1st, the first
day of filing, nor on October 15th, the deadline, as the server
could get too much traffic. File instead between October 2 and
14, and at an "odd" hour such as early in the morning
or late at night.
We remain as convinced as ever that there is clear statutory
authority for people to start private schools in their homes
and to educate their children there. The state doesn't agree,
but we think they're wrong. We just have to get a LOT smarter
about how to play the game with the government. Don't lie, but
don't give them a handle to hassle us, either.
Debbie Schwarzer, HSC.
Should you wish to double check this information, visit the
HSC page: Homeschooling
Legally and Confidently.
What if you can't print it out?
It is the information on the form that is wanted. You may
carefully hand write or type it out (recommended) it out.
Statement/Letters-in-Lieu
Statement/Letters-in-Lieu must be postmarked no earlier than
October1st. The certification statment from the Private School
Affidavit is available for your reference. Private schools filing
a statment in lieu of the affidavit are not required to use this
specific wording. However, an acceptable certification makes
substantially the same statement.
Filling out the R4 Affidavit
The CDE has put up an R4
form online with the exact same questions in a web-based
form that is formated only slightly differently. My instructions
below would not change. Do NOT under any circumstances use an
affidavit from a privious year as it will not be valid for the
coming year.
The R4 does not need to be mailed in this year. It requires
an electronic signature instead. Do make two printed copies for
yourself, and keep in your "homeschool" folder."

California
R4 Private School Affidavit Form Sample 2007
Some parts always bring forth questions. Here's the reasoning
behind some of the data provided:
-
- School Information
- Is this a new school?
- If you have been homeschooling since birth, so to speak,
but this is the first year you have been required to fill out
the R4, select the "Yes" radio button.
-
- If your school has six or more students, have you filed
an affidavit in the past?
- What if you have less than 6 children but did file in the
past? Put 'No," as the first phrase disqualifies you.
-
- Present Name of School
- A fun thing to do in September is to decide on a name for
your school. I have written another
article about doing this. You will mostly use the name in
formal documents such as the R4, so select one that sounds "professional."
-
- Street Address
- For those in hiding (seriously, from an abuser or in the
Victims Witness program), the street address of the school and
the mailing address can be different. You can use a P.O. Box
for the mailing address, but then use for the street address
some public place where you regularly conduct school. Do you
go to your local library a lot? Use that. A church basement?
Use that. The woman with whom I (Debbie) spoke said that the
CDE does not try to verify these school addresses.
Debbie Schwarzer
HSC Legal Team
- Type of School
- Coeducational
- Put this even if you have all boys or all girls. You may
decide to form co-operative classes in your home with children
of both genders. You could have more children. This leaves the
option open.
-
- School Accomodations
- Day only
- Yes, I know your children are most likely with you over night.
Selecting "Residential boarding only" or "both"
could open you up for a demand for inspection not required by
day schools.
-
- Grades Offered
- This is for the grades OFFERED by your school, not the grade
level work actually attempted by your children, so put the grade
your child would be in because of his or her age and birthdate.
Do NOT offer kindergarten; regulations for kindergartens are
more detailed than those for private elementary and secondary
schools, and marking this box will open you up to additional
bureaucratic regulation. Since kindergarten is not compulsory,
it is not necessary to offer it even if you have kindergarten-aged
children. You should also NOT say that you operate a preschool,
because of strict licensing and other regulations.
-
- High School Diploma Offered
- Even if you just have small children, some day you may want
to give them a diploma, so sure, YES, you offer one!
-
- Classification of School
- Select "Non-religious" even if you are. The "Church-affiliated"
option would only be for churches running a private school. Only
someone starting up a cottage school under church auspices would
check "Religious."
-
- Statistical Information
- Range of students' ages
- Put current ages of your youngest (6 by December 2) and oldest
child (under 18 by December 2) in the homeschool. If you are
homeschooling only one child, put their age in both fields, as
the form will bounce if you put the age in only one field.
-
- Enrollment on a single date
- Note that the form even says that you do not need to include
any preschoolers. As Kindergarten is also not required in California,
feel free to not include any child who will not
be 6 by December 2 in your count. Do not include any teenager
who turns 18 on December 2 or earlier, even if they will be concluding
their high school studies at home.
-
- Put the number of children you have at each grade level.
In most circumstances, you would put your children according
to their ages. Do not be tempted to put bright kids ahead or
slow kids behind grade levels. This isn't a transcript. You may
also be "ungraded" and just lump the number of your
children into "Ungraded Elementary" or "Ungraded
Secondary."
-
- Number of School Staff
- I advise you to put one each in "Full-Time Teachers"
and "Administrators." You do not need to discuss who
does which job with your spouse. They are only asking for numbers,
and this is a reasonable number of people to run a private school.
Even if all sorts of relatives, friends and neighbors may pitch
in and help with your children's education, it is not necessary
nor advisible to list them here. If you are a single parent,
put "1" in the "Full time Teachers" block.
-
- Directors and Principal Officers
- Decide which parent is most tolerant of filling out forms
and doing the paper work. Let them be the "Director"
of your private school. While there is room to list two directors,
it is only necessary to list one.
-
- Tax Status of School
- Check only "None of the above." There is no way you can
claim any of these tax exemptions for any of the expenses associated
with homeschooling your own children.
-
- NDSL Loan Cancellation
- Select "no"
- If you real feel you may qualify, seek legal advice.
-
- School Records
- The attendance records required by Education Code
Section 48222 and the records of courses of study, names, addresses,
and educational qualifications of the faculty, as required by
subdivisions (f)(2) and (3) of Education Code Section
33190, are maintained by the person and at the place listed here
and are true and accurate.
-
- Who will be keeping the records? Required records include
immunization
records, course of study for each child, and a list of educational
qualifications of teachers, as well as attendance records. You
need only record days absent. You may wish to send for
your child's "Cumulative Folder" from their last school.
You probably keep your own old transcripts and the children's
immunizations records anyways. If you have no faith in immunizations,
you need to get a Waiver
of Health Examination for School Entry available here online.
More information on this below.
-
- Neither you nor your children need to meet any special health
requirements in order to homeschool. Health requirements are
required for those taking in the children of others on a regular,
paying basis.
Fingerprinting Not
Required AN A TO Z
RESOURCE
California homeschoolers do not need to allow themselves to be
fingerprinted in order to file the R-4.
- Acknowledgements
Check all boxes. No, you do not need concern yourself with city ordinances as long as you are only educating your own children in your home. Do plan how you will safely store your children's records for many years to come. I advise you to make at least two copies of the final document: one to store away safely in a fire-proof box, and the other to be available to show when needed. Keep copies for 3 years.You understand that filing the PSA does not mean your homeschool is accredited. You only need to show a background check for non-family members you employ (pay) to instruct your children in your home.
- Electronic Signature
This is a legal document. You would be committing perjury should you lie on it. The information should be true, accurate, and complete. The advice here on how to answer some questions comes from legal advisors to HSC.
Other Questions
What is an "R4" and is it different from a "PSA?"
The Private School Affidavit (PSA) used to be in print form, and, like most forms, had a form number printed at the bottom. The state labeled this their "R4" form. Older homeschool families still refer to the R4. They are the same thing. Probably the term "R4" will fade away.
Do I need to file an PSA if we intend to purchase the services
of a distance learning program?
Yes, if the program's headquarters is in another state. Yes,
if you are just purchasing curriculum. No, if the school is located
in the State Of California and your children are considered enrolled
in that school. Check with the program. Some are specifically
set up as "cover schools"
for homeschool families in California and even though headquartered
out of state, have R4's on file in California. Clonlara is an
example of a program that does this.
When is the PSA due to be turned in? What if I miss that
date?
The PSA must be postmarked no later than October 15th each
school year your decide to homeschool. If you decide
to homeschool after October 15th, it is OK to acquire and turn
in the form at any time, except the summer, when the form for
the new school year is not available. You should do this within
two weeks of taking your child out of school to avoid truancy
accusations. I was told to file between October 1st and 15th
as this is when all the big private schools file. The state then
has so many PSA's to handle, yours is not likely to be examined
too closely. [The School of Sardines strategy.]
- In a nutshell, what do we have to do to comply with private
school regulations?
- You need to keep a record of attendance showing only days
absent. [48222].
(Note: mark only days your children are ABSENT from being educated.
They'd have to be comatose!) Calendar to print out and use for 2007-8.
- You need to have transcripts or diplomas of the instructors
on record, at least for one of parent, for the highest level
of achievement they attained. A job or experience resumé
would also do.[48222].
- While you need to cover specific subject areas [51210],
you do not need to show anyone your "curriculum" in
order to prove you are doing so. Maintain a record of the
courses of study you offer. This does not imply a daily record,
just a general outline. Again, it is unlikely anyone will ever
ask to see this. It might be your goals and general plans for
the year. Here is a sample
course catalog from a fancy California private school which
puts theirs up online each year. You may want to use it as a
sample for the grade levels of your children, revising it to
fit your goals.
- You need to instruct in English [48222].
However, there are exceptions. 50% of the time you may instruct
in a language other than English in order to learn or practice
that language. If you are recent immigrants, you could make the
effort to learn English as a family, resorting to your native
language for some subjects. Again, it is highly unlikely any
official will ever check to see how much of your homeschool program
is in English, but you could be challenged if your children did
not appear to be in the process of learning English.
- California state law (section
120335 of the California Health and Safety Code) require
that all private schools keep two health forms on file:
Form PM
286, the "California School Immunization Record,"
and form PM
171A, the "Report of Health Examination for School Entry,"
OR form PM
171B, the "Waiver of Health Check-up for School Entry."
(section
120365) Place these records in your child's cumulative file.
These records will need to be sent to a new school if he/she
ever transfers. Parents may choose to exempt their children from
immunization. The back side of Form PM 286 contains the two possible
exemptions: a.) Medical and b.) Personal beliefs against immunization.
Both forms can be obtained from your local County Health Department.
I have a teaching credential. Do I need to file an PSA?
Is your credential from the state of California? Is it for
the grades your children are in? If you answer "yes"
to both these questions, you may homeschool under the "Tutor
Provision" and do not need to file the R4. Be aware
that by high school level you will most likely have to file the
R4, as most high school credentials are subject-specific rather
than grade-specific.
A friend has a teaching credential and has agreed to tutor
our children. Do I need to file an PSA?
Yes, file the PSA, then hire your friend as an instructor in
your private school. That is the easiest way. You could hire
the friend even if she didn't have a credential. Homeschooling
families regularly outsource for a wide variety of subjects they
can't easily do at home. (For example, piano lessons, soccer
coaching, computer camp, etc. Hiring a tutor for the 3 Rs is
the same.) Some teachers do form an independent study service
if they plan on tutoring a large number of students as a home
business. See For Teachers
Who Want to Tutor.
- While I believe you, what are some other sources of this
information?
The Private School
(R-4) Affidavit
R4 interpretation from the HomeSchool
Association of California.
How
should I fill out my private school affidavit (R-4) form?
Following is a line-by-line description of the online private
school affidavit form with some helpful hints in filling it out
from HSC.
How
to establish Your Private School: The R4 Affidavit
From the California
Homeschool Network.
There is another website claiming to represent a state association
that I shall not deem to link. It is listed by some homeschooling
sites unfamiliar with California homeschooling. It says the R4
is not legal, which is contrary to the statements of all three
California homeschool associations and even HSLDA. Should you
run into this site, ignore it. It has no credibility from the
majority of California homeschoolers, religious or secular.
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A step-by-step manual written for the new and inexperienced homeschooler.
The explanations, resources, and recommendations apply to families
homeschooling for a wide variety of reasons and to families who
"afterschool" their children.
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- Homeschooling: The Early Years: Your Complete
Guide to Successfully Homeschooling the 3- to 8- Year-Old Child
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The formative years are the most critical to a child's education.
They lay the foundation for developing learning skills that last
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- The Teenage Liberation Handbook
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by Llewellyn, Grace
Written primarily for teens who need to convince their parents
they can teach themselves. 1998 Paperback
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The Unschooling Handbook : How to Use the Whole World
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Unschooling, a homeschooling method based on the belief that
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