Fillable Printable Affidavit of Financial Support Form - California State University

Affidavit of Financial Support Form - California State University

Affidavit of Financial Support Form

Applicant Information (type or print clearly):

Name (as it appears in your passport). All students must include a copy of your passport biographical page.

Last First Middle

Email: CIN:

Term applying for:

Fall Winter Spring Summer 20

Mailing Address for I-20: If you want to pick up the I-20, please check this box:

Financial Sponsor Information:

By signing below, the sponsor certifies that sufficient financial resources will be available to cover the

student’s expenses for the duration of his/her studies at Cal State L.A. Attach copy of the bank statement.

Sponsor’s Name (print)

Relationship to Applicant Sponsor’s Signature/Date

Address of sponsor City/State Country

Amount of sponsorship (US Dollars)

Check the appropriate program level you are applying to. *Fees are subject to change without notice.

ESTIMATED

EXPENSES*

Undergraduate

(36 units / 3 quarters)

Graduate

(24 units / 3 quarters)

Credential

(24 units / 3 quarters)

MA/MS/MBA in

Business

(24 units / 3 quarters)

Doctorate

(24 units / 12 months)

TOTAL

$38,340*

$36,670*

$36,210*

$41,580*

$54,100*

Dependent Information: Attach a copy of passport for each dependent listed below. Additional financial support required: $4500 for spouse

and $3000 for each child. Attach additional sheets if necessary.

Relationship

Family Name

(as listed in passport)

First Name Gender

Date of Birth

(MM/DD/YYYY)

City/Country of Birth

Country of Permanent

Resident/Citizenship

Spouse

Child 1

Child 2

If you are currently inside the U.S., please submit the following:



Copy of your current visa stamp



Copy of your I-94 form



Copy of your I-20 or DS-2019, and Employment Authorization Document (EAD) if any

School currently attending:

SEVIS ID: Last Date of Attendance:

If you currently hold F-1 or J-1 status, contact your International Student Advisor for transfer out procedures. See attached instructions for more

information.

Applicant’s Signature:

I certify that all information given above is true and correct. I certify that sufficient financial resources will be available to cover all

expenses for the duration of my studies at Cal State L.A. Further, I agree to be responsible for all expenses not covered by the sponsor

and to obtain and maintain adequate health insurance coverage throughout enrollment at Cal State L.A.

Signature _________________

______________________________ Date: _________________________

California State University, Los Angeles

International Office

Revised 07/2014

Instructions for Completing the Affidavit of Financial Support Form

Applicants holding or applying for an F-1 or J-1visa must complete and submit the Affidavit of Financial Support form with

signatures and appropriate documentation to show proof of funding. Attach the appropriate financial statements, following the

guidelines given below.

Attach a copy of your passport (biographical page only) and for all dependents who will accompany you.

Write your name and/or CIN on all pages being submitted.

Once you receive admission to Cal State L.A., submit the Affidavit of Financial Support form and all required items directly to the

following address:

California State University, Los Angeles

International Office

5151 State University Drive

Los Angeles, CA 90032

OR email scanned copies to intladmission@calstatela.edu

If you send documents via email, please follow this format on the subject line:

Last name, First name; CIN; term applying for (ie: Fall 2014)

Guidelines for Completing Section B (Financial Sponsor Information)

You must submit official copies of at least one of the documents described below to substantiate that you have the financial means to cover your

expenses and those of your dependents (if any) while in the U.S. in accordance with these estimated expenses.

ESTIMATED

EXPENSES

Undergraduate

(36 units / 3 quarters)

Graduate

24 units / 3 quarters)

Credential

(24 units / 3 quarters)

MA/MS/MBA in

Business

24 units / 3 quarters)

Doctorate

(24 units / 12

months*)

Tuition and Fees

$17,160

$15,490

$15,030

$20,400

$26,200*

Living Expenses

$20,180

$36,900*

Health Insurance

$1000

Total $38,340 $36,670 $36,210 $41,580 $54,100

Acceptable financial documents may be any of the following, so long as they show that you have the necessary funds available. If the

document(s) you are submitting is not in English, a certified English translation must be attached to the original.



An official bank statement for a savings, checking or time deposit accounts in your or your sponsor’s name. Bank statements must clearly

show the account holder’s name, name of banking institution and must be dated within 6 months from the date of submission. We do not

consider investment or retirement accounts.



If you will be supported by a private sponsor (family member, friend, or private institution), the sponsor must complete and sign the

Sponsor Information on page 2. We do not consider investment or retirement accounts.



Letter of financial support or financial guarantee document from government sponsor or foreign embassy which specify Cal State L.A. as the

student’s school, the validity period of financial support and the amount provided.



An official scholarship award letter addressed to you or Cal State L.A. and specifying the amount and validity period of financial support.

Dependents

A student who will be accompanied by a spouse and/or children must submit additional support of $4,500 for a spouse and $3,000 for each

child. Please complete Dependent Information section of the Affidavit of Financial Support form. You must also include copies of marriage

and/or birth certificates. If the certificates are issued in a language other than English, you must attach a certified English translation.

Methods of Mailing

If you reside within the U.S., we will mail your acceptance packet, including the Form I-20, to you via regular United States Postal Service

(USPS) mail. If you reside outside the U.S., you must use a courier service to ensure delivery and tracking of the acceptance packet. The cost

for the courier service will be borne by you. Once we have issued the Form I-20, we will provide the courier service information so that you can

create an account with them. Please do

not open an account until you receive instructions from us to do so.

Transfer to Cal State L.A.

If you currently has F-1 or J-1 visa status, contact your International Student Advisor for transfer out procedures. Cal State L.A. is unable to

issue an I-20/DS-2019 without access to your SEVIS record. Once you receive admission to Cal State L.A., complete and submit the Transfer to

Cal State L.A. form to the International Office to facilitate the transfer in process (www.calstatela.edu/international).

Change of Status

If you are currently in the U.S. with a non-immigrant status and wish to change to F-1 international student, please contact the International

Office for instructions upon being admitted to Cal State L.A. Depending on your status, you may be prohibited from enrolling in classes until

U.S. Department of Homeland Security has approved your change of status application.

Revised 07/2014