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Fillable Printable Affidavit of Financial Support Form - California State University, Northridge

Fillable Printable Affidavit of Financial Support Form - California State University, Northridge

Affidavit of Financial Support Form - California State University, Northridge

Affidavit of Financial Support Form - California State University, Northridge

Revised7/30/2015PLEASECOMPLETEBOTHPAGES
AdmissionsandRecords
InternationalAdmissions
AFFIDAVITOFFIN A NCIALSUPPOR T
AllF1studentsarerequiredtoprovidedocumentationoffinancialsupportbeforeanI20documentcanbeissued.
Ifthestudentwillusehis/herownpersonalfundsasthesourceoffinancialsupport,thestudentMUSTPROVIDEABANKSTATEMENTshowingthe
availabilityofatleast$35,000(undergraduates)or
$34,000(graduates)inliquidassets.Bankstatementsandfinancialaffidavitsshouldbedated
noearlierthanJUNE1
st
forSpringapplicationsorOCTOBER1
st
forFallapplications.
Ifthestudentwillbesupportedbyaprivatesponsor(familymember,friend,orprivateinstitution),thesponsormustsigntheStatementof
FinancialObligationbelow.Inaddition,sponsorsMUSTPROVIDEABANKSTATEMENTshowingtheavailabilityofatleast$35,000
(undergraduates)or$34,000(graduates)inliquid
assets.
Ifthestudentwillbesponsoredbyapublicagency(embassy,homegovernment,publicinstitution,religiousorganization,etc.),theagencymust
providewrittenverificationthatthecostswillbecovered.Sponsorshipstatementsshouldreflectthesemesterandyearoftheapplication.
EstimatedStudentExpensesForOneSchoolYear(2 semesters)
(Theseamountsareestimatesandaresubjecttochangewithoutnotice.Actualexpensesmayvary.)
UndergraduateGraduate
Expenses
24units/2semesters
18units/2semesters
Tuition‐‐at$372perunit$8928.00$6696.00
Fees6564.007830.00
BooksandSupplies1826.001826.00
RoomandMeals13050.0013050.00
Insurance(12monthcove rage)1725.001725.00
Otherexpenses(includingtransportationandpersonalexpenses)2907.002873.00
TOTAL
$35,000.00$34,000.00


FamilyMembers.Studentswhowillbeaccompaniedbyaspouseand/orchildrenwillneedtosubmitadditional
documentationoffinancialsupport($5000forspouseand$3000foreachchild).
Note.MBAandMSAstudentspayanadditionalamountof$254.00perunit.
StatementofFinancialObligation
StudentsrequiringaformI20mustcompletethisStatementofFinancialObligationandsupplyallappropriatedocumentationoffinancialsupport.
Ifthestudentwillbesupportedbyfundsotherthanhis/herperso nalfunds,thesponsormustsignbelow.Ifmorethanonesponsorwillprovide
financialsupport,eachsponsormustsignourFinancialAffidavitform,andeachsponsormustprovideanofficialbankstatementshowingthe
availabilityofthenecessaryfunds(pleaseseeEstimatedStudentExpensesabove).

Sponsor’sname(Print)_____________________________________________________________Relationshiptostudent___________________
Sponsor’ssignature________________________________________________________________________Date_________________________
Student’sname(Print)_____________________________________________________________
Student’ssignature__________________________________________________________________________Date________________________

Bysigningabove,thestudentandsponsorcertifythatsufficientfinancialresourceswillbeavailabletocoverallexpensesforthedurationof
studiesatCSUNorthridge.Further,bysigningabove,thestudentagreestomaintainadequatehealthinsuranceforthedurationofstudies.
Ifaspouseand/orchildrenwillbeincludedontheI20,pleaseprovidethefollowinginformation(Ifnecessary,useanextrasheetofpaper).

SpouseDateofBirth___________________________________
(FamilyorSurname)(GivenName)
CountryofBirthCountryofCitizenshipGender:Female____Male______
ChildDateofBirth___________________________________
(FamilyorSurname) (GivenName)
CountryofBirthCountryofCitizenshipGender:Female____Male______
Revised7/30/2015PLEASECOMPLETEBOTHPAGES
CSUNAffidavitofFinancialSupportPage2of 2
CSUNIDNumberorlast4digitsofUSSocialSecurityNumber(ifavailable)___________________________________
NameasitappearsonPassport______________________ ______________________________________________
(FamilyNameorSurname)(FirstNameorGivenName)
DateofBirth(MonthDay,Year)__________ _______________Gender:Female________orMale________
CountryofBIRTH__________________________CountryofCITIZENSHIP____________________________
IfyouarecurrentlyintheUnitedStates,whattypeofvisadoyouhold?(Forexample,F1,F2,B1,J1,A2,etc.)_______
PermanentaddressinyourHOMECOUNTRY:Pleaseprintclearly
StreetAddress

City
ProvinceorState_______________________PostalCode______Country________________________________
Phonenu mberinHOMECOUNTRY
EmailAddress____________________
1.AreyoutransferringtoCSUNfromaUSschool(incl udinglanguageschool,highschool,college,university)?
__________YES__________NO
IfyouansweredYES,pleaseprovidethefollowinginformation:
NameofSchool
CityandStateofSchool
Monthand Yearyouended,orplantoend,yourenrollmentatthatschool
2.AreyouonOPT?YESNO
IfyouansweredYES,pleaseprovidethefollowinginformation:
NameofSchoolthatauthorizedyourOPT
Month,DayandYearyourOPTbeganandendingdate
Pleasecompletebothpagesofthisformandmailoremailittotheaddressbelow.YourI20cannotbeissued untilwe
havereceivedthiscompletedformandallrequireddocumentationoffinancialsupport.Ifyouaretransferringfroma
schoolintheUS,thatschoolmustfirst
transferyourI20recordtousintheSEVISdatabase.
CaliforniaStateUniversity,Northridge
InternationalAdmissions,BayramianHall150
18111NordhoffStreet
Northridge,CA913308207
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