Berkeley, CA · Alameda County
Residential Preferential Parking Program Child Care Permit Affidavit
Parents or custodians complete this affidavit to support a child care permit for parking in a designated Residential Preferential Parking area.
What this form is
This affidavit supports a Residential Preferential Parking Program child care permit for a provider caring for children age 12 or younger at the listed address. It asks for the parent or custodian’s name, the address, each child’s name and birthdate, and declarations about property ownership, permit use, and the accuracy of the information. Attach a copy of each child’s birth certificate.
Who needs it
A parent or custodian seeking a child care permit for a provider serving children age 12 or younger at the listed address needs to complete this affidavit.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This affidavit is signed without a notary; the resident signs and dates declarations made under penalty of perjury and attaches each child’s birth certificate.
How to submit this form
- 1
Download the Affidavit
Download the Residential Preferential Parking Program Child Care Permit Affidavit PDF.
- 2
Complete the Form
Enter the parent or custodian’s name, childcare address, and each child’s name and birthdate.
- 3
Gather Attachments
Attach a copy of the birth certificate for each child listed.
- 4
Sign and Submit
Sign and date the declarations, then submit the affidavit to the city department named on the form.
Frequently asked questions
- What is the Child Care Permit Affidavit for?
- It supports a Residential Preferential Parking Program child care permit for a provider parking in the designated area while caring for the listed children.
- What attachments does the affidavit require?
- Attach a copy of the birth certificate for each child listed on the affidavit.
- Do I need a notary for the Child Care Permit Affidavit?
- No. The document has no notary block; the resident signs and dates declarations made under penalty of perjury and attaches each child’s birth certificate.
- How do I submit the Child Care Permit Affidavit?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Residential Preferential Parking Program Child Care Permit Affidavit doesn’t need a notary — but if you have another Berkeley form that does, a commissioned online notary can help.