Fillable Printable Affidavit of Financial Support Form - California

Affidavit of Financial Support Form - California

Office of Admissions and Records_____

International Admissions

AFFIDAVI T OF FINANCIAL SUPPORT

All F-1 students are required to provide documentation of financial support before an I-20 document can be issued.

If the student will use his/her own personal funds as the source of financial support, the student MUST PROVIDE A BANK STATEMENT

showing the availability of at least $ 35,000 (undergraduates) or $34,000 ( graduat es) in liqu id ass ets. Bank statements and financial

affidavits s hould be dated no EARLIER than June 1

for Spring applications or October 1

for Fall applications.

If the student will be supported by a private sponsor (family member, friend, or private institution), the sponsor must sign the Stat ement o f Financial

Obligation below. In addition, sponsors MUST PROVIDE A BANK STATEMENT showing the availability of at least $35,000 (undergraduates)

or $34,000 (graduates) in liquid assets.

If the student will be sponsored by a public agency (embassy, home government, public institution, religious organization, etc.), the agency must

provide written verification that the costs will be covered. Sponsorship statements should reflect the semester and year of the applicat io n.

Estimated Student Expenses For One School Year (2 semesters)

(Th ese am o unts are est imates and are subject to change without not ice. Actual expenses may vary.)

Undergraduate

Graduate

Expenses

24 unit s / 2 semesters

18 unit s / 2 semester s

Tuition -- at $3 72 per unit

$ 8928.00

$ 6696.00

Fees

6544.00

7810.00

Book s and Su pplies

1826.00

Room and Meals

13050.00

Insurance ( 12 month co ver age)

1725.00

Other expenses (including transportation and personal expenses)

2927.00

2893.00

TOTAL

$35,000.00

$34,000.00

Family Membe rs. Students who will be accompanied by a spouse and/or children will need to submit additional

documentation of financial support ($5000 for spous e and $3000 for each c hild).

Note: MBA and MSA students pay an additional amount of $254.00 per unit.

State ment o f Financial O blig a ti on

Students requiring a form I-20 must complete this Statement of Financial Obligation and supply all appropriate documentation of financial support.

If the student will be supported by funds other than his/her personal funds, the sponsor must sign below. If more than one sponsor will provide

financial support, each sponsor must sign our Financial Affidavit form, and each sponsor must provide an official bank statement showing the

availability of the necessary funds (please see Estimated Student Expenses above).

Spons or ’ s na me (Print) __ __ _________ ______________ ________ _________ _________________ Relationship to student ____ _______ ________

Sponsor’s signature ________________________________________________________________________ Date ____ ________ _______ ______

Student’s name (Print) _________________________________________________________________

Student’s sig na t ure ________ ________ ________ ________ _________ _________________________________ Date ________ _____ _______ ____

By signing above, the student and sponsor, if applicable, certify that sufficient financial resources will be available to cover all expens es (please see

stimated Student Expenses above) for the duration of studies at CSU Northridge. Further, by signing above, the student agrees to obtain and

maintain adequate health insurance through out the du ration of studies.

If a spouse and/or children will be included on the I-20, please provide the following information (If necessary, use an extra sheet of paper).

Spouse Date of Birth ___________________________________

(Family or Surname), (Given Name)

Country of Birth Countr y of Citizenship Gender: Female ____ Male ______

Child Date of Birth ___________________________________

(Fami ly or Surn ame), (Given N ame)

Country of Birth Countr y of Citizenship Gender: Female ____ Male ______

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Financial Affidavit Page 2 of 2

CSUN ID Number or last 4 digits of US Social Security Number (if available) ____________ ______ ______ _ _______

Name as it appears on Passport _____________________________________ _______________________________

(Family Name or Sur name ), (First Name or Given N ame)

Date of Birth (Month Day, Year) _________________________ Gender: Female ________ or Male ______

Country of BIRTH __________________________ Country of CITIZENSHIP ____________________________

If you are currently in the United States, what type of visa do you hold? (For example, F1, F2, B1, J1, A2, etc.) _______

  

Permanent Address in your HOME COUNTRY: Please print clearly

Street Address

City

Province or State _______________________ Postal Code Country________________________________

Phone number in HOME COUNTRY

Email Address

1. Are you transferring to CSUN from a US school (including language school, high school, college, university)?

__________ YES __________ NO

If you answered YES, please provide the following information:

Name of School

City and State of School

Month and Year you ended, or plan to end, your enrollment at that school

2. Are you on OPT? YES NO

If you answered YES, please provide the following information:

Name of School that authorized your OPT

Month, Day and Year your OPT began and ending date

    

Please complete both pages of this form and mail or email it to the address below. Your I-20 cannot be issued until we

have received this completed form and all required documentation of financial support. If you are transferring from a

school in the US, that school must first transfer your I-20 record to us in the SEVIS database.

California State University, Northridge

International Admissions, Bayramian Hall 150

18111 Nordhoff Street

Northridge, CA 91330-8207 USA

intladm@csun.edu

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