Orange, CT · New Haven County
Conversion of a Single-Family Dwelling Certification
This yearly certification is for dwelling owners who certify that a converted or primary unit will be occupied by someone age 55 or older and agree to recertify annually.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The owner certifies that either the converted unit or the primary unit will be occupied by an elderly person age 55 or older, and agrees to recertify by January 31 each year. Orange residents use this form for the conversion of a single-family dwelling; the owner signs and swears to the certification before a notary.
Who needs it
An owner of a dwelling being converted into a single-family home must complete this certification if either unit will be occupied by someone age 55 or older.
Why it needs a notary
The form has a jurat stating it was subscribed and sworn to before the notary; the dwelling owner signs the certification before the notary.
How to get this notarized
- 1
Download the Form
Get Orange’s Conversion of a Single-Family Dwelling Certification.
- 2
Fill In the Certification
Enter the owner’s name and dwelling address, and review the occupancy and annual recertification statements.
- 3
Book an Online Notary
Schedule a session with a commissioned online notary.
- 4
Sign on Video
Sign and swear to the certification during the online notary session.
- 5
Submit to the City
Submit the notarized form to the City of Orange; contact the city if you need submission instructions.
Preview the form
The blank PDF straight from Orange. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the yearly certification?
- Fill in the owner and dwelling details, then sign and swear to the certification before a notary. The form says to recertify on or before January 31 each year.
- Do I need to sign this form in front of a notary?
- Yes. The form includes a subscribed-and-sworn-to block for a notary, so the owner should sign before the notary.
- Can I notarize the certification online?
- Connecticut authorizes remote online notarization by its own notaries under Public Act 23-28, codified at Conn. Gen. Stat. §3-95b, effective October 1, 2023. Book a commissioned online notary to sign on video.
- Where do I submit the completed certification?
- The form does not specify where to submit it. Contact the Town of Orange or confirm with the town clerk if unsure.