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Filing A Statement In Lieu

On March 16, 2004, the CDE wrote to CHN and said that the state's attorneys had accepted CHN's in lieu of statement. If the state forms are not available for any reason, you can rest easy knowing that you always have the option to file your own Statement In Lieu (SIL). The SIL is created on your own computer and mailed in, so no online access is required.

Filing a Statement In Lieu is quite simple. Proceeding through the affidavit law (Ed. Code Section 33190-33191) one paragraph at a time, you provide the required information, confirm you are in compliance with cited law, make a statement of certification, and then sign it and send it in. (Don't forget to keep a copy for yourself!) Using the exact text of the affidavit law, CHN's Legal Committee has created the Guide to Filing a Statement In Lieu below to help you along.

Below is a sample Statement in Lieu form. You can print it out, fill in the blanks and mail to the address listed at the bottom of the form.

Below are 2 sample copies of a SIL

Statement In Lieu sample 1

Statement In Lieu sample 2

Mail your SIL to this address:

Title II Leadership Office - Private Schools
California Department of Education
1430 N Street, Suite 4309
Sacramento, CA 95814

[This guide is provided as a courtesy to those seeking information about filing a Statement in Lieu of the state form R-4/Private School Affidavit (PSA). Please consult your attorney if you have legal issues. This is not intended to serve as legal advice.]

Guide to Filing a Statement In Lieu

General information:
As with all official documents relating to your private school, a businesslike presentation is preferable.

(The text of the California Education Code is in bold italics. You can also find it here.)

33190. Every person, firm, association, partnership, or corporation offering or conducting private school instruction on the elementary or high school level shall between the first and 15th day of October of each year, commencing on October 1, 1967, file with the Superintendent of Public Instruction an affidavit or statement, under penalty of perjury, by the owner or other head setting forth the following information for the current year:

Make sure you file between October 1 and October 15 of every school year. If you are establishing your private school mid-year, go ahead and file your Statement In Lieu at the time you establish your school. At the close of your Statement In Lieu you will make your "under penalty of perjury" certification, followed by your signature.

(a) All names, whether real or fictitious, of the person, firm, association, partnership, or corporation under which it has done and is doing business.

(Step 1) List the name of your private school, and any previous names you may have used.

(b) The address, including city and street, of every place of doing business of the person, firm, association, partnership, or corporation within the State of California.

(Step 2) List the complete address for the location of your private school; if you plan to receive school mail at a different address (such as a post office box), list this complete address as well.

(c) The address, including city and street, of the location of the records of the person, firm, association, partnership, or corporation, and the name and address, including city and street, of the custodian of such records.

(Step 3) List the complete address for the location of the records of your private school. You might choose to use "same as above" or to fully repeat the address information if it has already been provided for (b) above. List also the name and complete address of the person in charge of the school records. You can have one parent listed by name for all the required positions (there are more to follow), or you can switch back and forth; this is completely at your discretion.

(d) The names and addresses, including city and street, of the directors, if any, and principal officers of the person, firm, association, partnership, or corporation.

(Step 4) For each listed director or principal officer provide the full name and address.

(e) The school enrollment, by grades, number of teachers, coeducational or enrollment limited to boys or girls and boarding facilities.

(Step 5a) School enrollment, by grades: For grades 1-12, list the total number of students in each grade. Remember that kindergarten is not compulsory and should not be reported on this form.

(Step 5b) Number of teachers: You should have at least one teacher.

(Step 5c) Co-ed, boys-only or girls-only: "Co-educational" covers all three possibilities and gives you the most flexibility.

(Step 5d) Boarding facilities: List "day only". Even though your kids sleep at the same address as your school, you don't want to characterize your school as a boarding school; boarding schools have additional legal requirements for operation.

(f) That the following records are maintained at the address stated, and are true and accurate:
(1) The records required to be kept by Section 48222.
(2) The courses of study offered by the institution.
(3) The names and addresses, including city and street, of its faculty, together with a record of the educational qualifications of each.

(Step 6) You should rephrase this as a positive statement; you can list out the individual records in (f)(1)-(3) above (Section 48222 refers to attendance records), or you could simply state that "the records required by Section 33190(f) are maintained at the address stated and are true and accurate". You do not need to submit any of these records with your affidavit.

(g) Criminal record summary information has been obtained pursuant to Section 44237.

(Step 7) Review Section 44237; then you can put this in word for word, or amend it if you prefer. In our experience, bureaucrats get nervous when legal language is modified; however, their anxiety levels needn't direct your actions.

Whenever two or more private schools are under the effective control or supervision of a single administrative unit, such administrative unit may comply with the provisions of this section on behalf of each of the schools under its control or supervision by submitting one report.
Filing pursuant to this section shall not be interpreted to mean, and it shall be unlawful for any school to expressly or impliedly represent by any means whatsoever, that the State of California, the Superintendent of Public Instruction, the State Board of Education, the State Department of Education, or any division or bureau of the department, or any accrediting agency has made any evaluation, recognition, approval, or endorsement of the school or course unless this is an actual fact.
The Superintendent of Public Instruction shall prepare and publish a list of private elementary and high schools to include the name and address of the school and the name of the school owner or administrator.

These paragraphs require no action in your Statement In Lieu.

33191.
(a) Commencing October 1, 1985, the affidavit or statement filed with the Superintendent of Public Instruction pursuant to Section 33190 shall, under penalty of perjury, include a statement manifesting compliance with the provisions of Section 44237.

(Step 8) The last part of your Statement In Lieu will be your certification statement. Starting with the statement, "I hereby certify under penalty of perjury" you need to confirm that the information you've provided for Section 33190(a) through (f) is true and correct, and also include an explicit statement per Section 33191(a) above that you are in "compliance with the provisions of Section 44237".

Make sure you review the provisions of Section 44237 prior to certifying your compliance; background checks do not apply to the parent or legal guardian "working exclusively with his or her own children" per Section 44237(b)(4).

(Step 9) Retain a copy for your own files and mail the signed original to:

Title II Leadership Office - Private Schools
California Department of Education
1430 N Street, Suite 4309
Sacramento, CA 95814
(b) In the case of any private school where the instructor also serves as the administrator of the school, the affidavit or statement shall be made available upon request to the parents or guardians of all pupils currently enrolled in the school and to any parent or guardian considering whether to enroll his or her child in the school.

This paragraph requires no action in your Statement In Lieu.

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