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Fillable Printable Affidavit of Financial Support Form - Ohio

Fillable Printable Affidavit of Financial Support Form - Ohio

Affidavit of Financial Support Form - Ohio

Affidavit of Financial Support Form - Ohio

The Ohio State University Affidavit of Financial Support Form
For International Applicants requesting Form I-20 or DS-2019
Required Documentation & Estimating your Annual Expenses
To receive a Form I-20 (F-1 visa) or DS-2019 (J-1 visa) from The Ohio State University, international applicants are required by U.S. law to show:
~
Proof that guaranteed funding for tuition, fees, living expenses, health insurance, books and supplies is immediately available for the student’s
first year of study;
~
Proof that guaranteed funding for living expenses and health insurance is immediately available for the first year for any accompanying dependents; and
~
Assurance that adequate funding will continue to be available for the entire length of study for the student and any accompanying dependents.
A Form I-20 or DS-2019 will be issued only when these requirements have been satisfied by submission of:
~
Certification as described below of funds sufficient to meet estimated Annual Expenses;
~
A completed Affidavit of Financial Support Form; and
~
The required documents from each sponsor if you have more than one sponsor.
Individual Sponsors and/or Self-Support
In addition to the completed Affidavit of Financial Support Form, each individual sponsor and/or self-sponsoring student must submit bank statement(s) or
personalized bank letter(s) verifying that funds to cover the estimated Annual Expenses are immediately accessible for the first year of study.
Bank Statement Guidelines: Personalized bank letter in lieu of bank statement:
Must be on bank stationery Bank letters verifying amounts on deposit must be signed and dated by a
Must be dated within 12 months of the date of enrollment bank official in addition to the Bank Statement Guidelines stated at left.
Must specify amount of money on deposit
Must specify currency type We cannot accept the following:
Must be translated into English* Certified chartered accountant statements
Must include the name of the account holder* Real estate or jewelry holdings
(*Handwritten translations will not be accepted) Charge accounts
Pending or provisional educational loans
Salary or payroll statements
1.
Parent or Other individual Sponsor: Your parent or any other individual sponsoring all or part of your expenses must complete the Personal Sponsor
Certification section of the affidavit and submit bank certification. The bank certification must indicate your sponsor is the account holder and must show
funds at least equal to the amount promised by that person in Part 3.
2.
Self-Support: If you intend to use personal savings for all or part of your financial support, complete the Student Certification section of the affidavit and
submit your own bank certification. The bank certification must indicate that you are the account holder and show funds at least equal to the amount
promised by you in Part 3.
Government or Other Sponsoring Agency
If a government or an agency (i.e. organization, institution, or employer) will provide funding, indicate the name of the agency on the affidavit and submit a letter from
the agency detailing the terms and amount of your award. The letter of award should indicate payment toward expenses associated with tuition, fees, living
expenses, health insurance, books and supplies as well any additional dependent living and health expenses.
Additional Government or Sponsoring Agency Letter Guidelines
Must be on agency stationery Must include your name as the recipient
Must specify the length of the agency support Must be signed and dated by an authorized representative of the agency
Must be dated within 12 months of your first day of enrollment Should indicate The Ohio State University as the institution you will attend
Annual Expenses
refers to the estimated amount needed for each academic year of study. An academic year is defined as August through May. If you will begin
your studies during the summer term prior to your first academic year, you are required to include expenses for that additional term of study in your bank certification
and on the affidavit. To calculate your estimated First Year Expenses, refer to the International Graduate Student Budget or the International Professional Student
Budget. Find the student expenses for your intended program and add expenses for dependents for whom you are requesting a visa document.
$ Student Expenses. (If beginning enrollment Autumn or Spring term of your first year.)
+ $ Spouse / Children Expenses. (Must include living expenses and health insurance expenses for 9 months.)
= $ First Year Expenses
+ $ Student Expenses. (If beginning enrollment Summer term of your first year.)
+ $ Spouse / Children Expense (Must include living expenses and health insurance expenses for 12 months.)
= $ First Year Expenses
Note: When you enroll, plan to have approximately $3,000 in addition to your program’s estimated budget amount to cover one-time costs such as the
$50 OIA Orientation Fee, program fees for specific courses and yearly increases in expenses.
Interna
expens
study i
suppor
Part 1
Name
Family
Date o
Count
The O
Part 2
Are yo
Do you
Are yo
If you
If you
Are the
passpo
Part 3
You ar
the Inte
your ac
Self-su
Parent
Govern
Ohio S
ational applicants
ses, health insura
s also required. T
rt to cover all educ
1 - Applicant’s
in full as it appea
y Name (surname
of Birth (month / d
try of Birth _____
hio State Univers
2 - Current Vis
ou currently living
u plan to enroll in
ou requesting:
are presently an
What is the la
If you are pre
are presently a J
ere dependents fo
ort ID pages for al
3 - Identify yo
re required to indic
ernational Profess
cademic program
upporting
(LOANS
t or Personal Indiv
nment or Sponsor
State Scholarship/A
requesting a Form
nce, books and su
The immigration do
cational and living
s Personal Inf
ars on passport:
e) _____________
PRINT name EXACT
day / year) ______
_______________
sity ID Number __
sa Status
g in the U.S.?
n another progra
Form I-20 (fo
F-1 or J-1 stude
ast day of your en
esently on OPT, w
J-1 scholar, traine
or whom you are re
l dependents.)
ur Sources of
cate who will spon
sional Student Bud
as well as expens
S are considered sel
vidual Sponsors
ring Agency (e.g. I
Associateship/Aw
m I-20 (F-1 visa) or
upplies for their firs
ocument (Form I-2
expenses for the
formation
_______________
TLY as it appears on pa
_______________
__________ City o
_______________
yes no If
am in the U.S. pri
or F-1 visa) F
nt, where are you
rollment? _______
hen will it expire?
ee or researcher,
equesting a visa d
f Support
nsor you and the a
dget to determine
ses for dependent
f-support)________
(name ______
(name ______
(name ______
IE, LAUSPAU, Fo
ard: (name of dep
University
r DS-2019 (J-1 vis
st year of study. A
20 or DS-2019) wi
duration of your s
_____________Gi
assport
.
____ Country of C
of Birth________
_________
yes, what is your
or to your enrollm
Form DS-2019 (fo
u enrolled? _____
_______________
______________
, what institution
document? Ye
amount you expect
your expenses. T
ts accompanying y
_________________
_______________
_______________
_______________
ord Foundation __
partment/organizat
stipends are usually
The Oh
For Inte
sa) are required by
Assurance that ade
ill be issued only w
studies for you and
iven (first) ______
Citizenship_____
_____________ C
current visa statu
ment at Ohio Sta
or J-1 visa) N
_______________
_______________
_______________
n issued your DS-
es No (If ye
t to receive from e
The Combined To
you to Ohio State.
_________________
_______________
_______________
_______________
_______________
tion ___________
y not sufficient to cov
hio State Unive
ernational Ap
y U.S. law to show
equate funding wi
when the universit
d any dependents
_______________
_______________
ountry of Legal P
us? F-1 J
ate? If so where?
No - I plan to atten
_______________
_______________
_______________
-2019? ________
es, complete the D
each sponsor. Re
otal below must eq
.
________________
_______________
_______________
_______________
_______________
_______________
ver dependents’ exp
C
ersity Affidavi
pplicants reque
w proof of guarante
ll continue to be a
ty is satisfied you
s who accompany
____________ Mi
_________ Occup
Permanent Resid
J-1 H-1
______________
nd OSU using my c
_______________
______________
______________
_______________
Dependent Informa
efer to the Internat
qual the estimated
______
Amount $_
_____) Amount $
_____) Amount $
_____) Amount $
_____) Amount $
_____) Amount $
penses.
ombined Total $
it of Financial
esting Form I-
eed funding for tu
available for all sub
will receive adequ
you to the U.S.
iddle__________
pation__________
dence__________
If different from yo
PR Other___
_______________
current visa status
_______________
_______________
ation form and atta
tional Graduate St
d Total Expenses
_______________
$______________
$______________
$______________
$______________
$______________
$______________
Support Form
-20 or DS-2019
ition, fees, living
bsequent years of
uate financial
_______________
_______________
_______________
ur country of citizenshi
______________
______________
s.
_______________
_______________
ach copies of
tudent Budget or
on the budget for
__________USD
___________USD
___________USD
___________USD
___________USD
___________USD
___________USD
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D
The Ohio State University Affidavit of Financial Support Form
For International Applicants requesting Form I-20 or DS-2019
Name _____________________________________________________________________ Ohio State University ID Number ____________________________
Part 4 - Certification of Support:
If you have more than one personal sponsor you must include a separate page for each.
1.
Contingency plans have been made such that any unexpected financial difficulties created by unfavorable exchange rates, increases
in educational costs, or other business or economic conditions will not reduce or stop the flow of monies to the student.
2.
The student must have adequate emergency support in the unlikely event of an accident or illness, excessive medical expenses,
and/or repatriation expenses (return of student to home country) while at The Ohio State University.
Personal Sponsor Certification
I have read and understood items 1 and 2 (above) of this Certification of Support. I certify I will make available the amount specified in Part 3 of this
Affidavit of Financial Support Form for the first year of study as well as each subsequent year the student remains in the program.
I have included bank certification of the financial support promised by me in Part 3.
Name of personal sponsor (Please print): ________________________________________________ Date: ______________________________
month / day / year
Signature of sponsor: __________________________________________Relationship to applicant: _____________________________________
Please complete all fields. Incomplete forms will not be processed.
Student Certification
I, ________________________________________ (applicant’s printed name), have read and understand items 1 and 2 (above) of this Certification
of Support. I certify the information provided on this Affidavit of Financial Support Form is complete, all supporting documentation is true and
accurate, and I have available to me the amount specified as Combined Total in Part 3 of this Affidavit of Financial Support Form.
I also certify I am aware of the costs of attending The Ohio State University and agree I am ultimately responsible for the payment of all tuition, fees,
living expenses, health insurance, books, supplies and additional expenses that may arise throughout my entire stay in the United States.
Applicant’s signature ________________________________________________________________ Date: _______________________________
month / day / year
Please complete all fields. Incomplete forms will not be processed.
To expedite processing, please either: Fax your documents to 614‐247‐1886 OR
Scan and attach your documents to an email and send to grada[email protected].
If you must send your documents via postal mail, send to: The Ohio State University
Office of Graduate and Professional Admissions
Attn: Financial Review
281 W Lane Ave
Columbus OH 43210
Name
Depe
Please
sufficie
page 1
If you
If your s
Family
Count
Date o
---------
Family
Count
Date o
---------
Family
Count
Date o
---------
Family
Count
Date o
---------
______________
endent Informa
e complete all de
ent funds to meet a
1 of this document
are married, indi
spouse is currently a
y Name (surname
PR
try of Citizenship
of Birth (month / d
------------------------
y Name (surname
PR
try of Citizenship
of Birth (month / d
------------------------
y Name (surname
PR
try of Citizenship
of Birth (month / d
------------------------
y Name (surname
PR
try of Citizenship
of Birth (month / d
------------------------
_______________
ation – require
ependent informa
all of their expens
t. Attach a copy o
icate date of mar
at Ohio State, what i
e) _____________
RINT name EXACTLY a
p ______________
day / year) ______
-------------------------
e) _____________
RINT name EXACTLY a
p ______________
day / year) ______
-------------------------
e) _____________
RINT name EXACTLY a
p ______________
day / year) ______
-------------------------
e) _____________
RINT name EXACTLY a
p ______________
day / year) ______
-------------------------
_______________
ed for depend
ation in this secti
es while in the Un
of Passport ID pag
rriage __________
s his/her status?
_______________
as it appears on passpo
_______________
_______________
------------------------
_______________
as it appears on passpo
_______________
_______________
------------------------
_______________
as it appears on passpo
_______________
_______________
------------------------
_______________
as it appears on passpo
_______________
_______________
------------------------
_______________
dents accompa
on.
Students who
nited States. Depe
e for all dependen
_______________
not applicable
_____ Given (first)
ort.
____ Country of B
____ Relationshi
------------------------
_____ Given (first)
ort.
____ Country of B
____ Relationshi
------------------------
_____ Given (first)
ort.
____ Country of B
____ Relationshi
------------------------
_____ Given (first)
ort.
____ Country of B
____ Relationshi
------------------------
The Oh
For Inte
______________
anying studen
o request visas for
endent expenses a
nts
.
_.
faculty member
) ______________
Birth __________
p Spouse
------------------------
) ______________
Birth __________
p Spouse
------------------------
) ______________
Birth __________
p Spouse
------------------------
) ______________
Birth __________
p Spouse
------------------------
hio State Unive
ernational Ap
Ohio State Unive
nt to the U.S.
r their spouse or u
are calculated as
visiting scholar
_______________
_______________
Child
------------------------
_______________
_______________
Child
------------------------
_______________
_______________
Child
------------------------
_______________
_______________
Child
------------------------
ersity Affidavi
pplicants reque
ersity ID Number
unmarried minor c
part of student’s A
student
______ Middle ___
____ City of Birth
Gender M
------------------------
______ Middle ___
____ City of Birth
Gender M
------------------------
______ Middle ___
____ City of Birth
Gender M
------------------------
______ Middle ___
____ City of Birth
Gender M
------------------------
it of Financial
esting Form I-
r ______________
hildren must prove
Annual Expenses
______________
h _____________
Male Female
------------------------
______________
h _____________
Male Female
------------------------
______________
h _____________
Male Female
------------------------
______________
h _____________
Male Female
------------------------
Support Form
-20 or DS-2019
_______________
e they have
s. Please refer to
_______________
_______________
------------------------
_______________
_______________
------------------------
_______________
_______________
------------------------
_______________
_______________
------------------------
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