Fillable Printable Affidavit of Financial Support Form - The Ohio State University

Affidavit of Financial Support Form - The Ohio State University

Undergraduate study

Afﬁdavit of ﬁnancial support for international students

The Ohio State University is required by U.S. government regulations to check the availability of adequate funding for your tuition, fees

and living expenses for the duration of your studies. Complete this form if you are requesting F-1 or J-1 status. Please note that we will

not be able to issue a notice of admission until funding documentation is completed.

Important: The total funds on the afﬁdavit(s) you submit—from personal sources, funding agencies or both—must equal the total funds

needed for the duration of your studies at Ohio State (at least four years). However, you only need to submit evidence (bank statements,

ﬁnancial awards, etc.) to support your ﬁrst year of study in the United States. See estimated annual expenses on this page.

A separate copy of this afﬁdavit form is required from each personal or agency sponsor. Please read the instructions in each section.

To submit the required ﬁnancial documentation, we highly recommend using our Admissions Uploader

at admissions.osu.edu/secure/docus. Or, you may email to [email protected] or mail via courier to

Undergraduate Admissions, SAS Building – Rm. 621, 281 W. Lane Ave., Columbus, OH 43210 USA.

Section 1: Student information and declaration (required)

Name in full as it appears on your passport:

Family name/surname

First/given name Middle name

_____________________________________________________ ______________________________________________

OSU ID (*see note at bottom right) Date of birth (month/day/year)

Country of citizenship

City and country of birth

Country of residence

Do you presently hold an F1 or J1 student status? h Yes h No

If yes, what institution issued the Form I-20 or DS-2019: _________________________________________

Student declaration

I hereby promise that the information provided on this form is correct and complete. I understand that I am

ultimately responsible for all expenses associated with my stay in the United States.

________________________________________________________________________ _____________________________

Student’s Signature Date (month/day/year)

Estimated annual expenses for single

student living alone (without

family) in the United States

The amounts below represent estimated

fees in effect autumn 2015 through spring

2016 for most programs; costs are subject

to change without notice.

Costs listed are for an academic year

(two semesters/nine months).

Average tuition and fees

$28,365

Room and board

$11,666

Books and supplies $1,234

Health insurance

$2,374

Living expenses $2,900

Total estimated

expenses $46,539

Tuition and fees may vary by major, college, and

area of study. The university reserves the right to

assess fees for special services and programs

applicable to students. In 2016–2017 and beyond,

students should plan for a 5 to 10 percent annual

increase for all costs.

1 Includes an International Undergraduate

Student Fee of $500 per semester, assessed to

provide academic and support services for

international students.

2 Health insurance is required for international

students.

3 Cost of the most popular room and meal plan

combination; your cost will depend on the plans

you select.

Additional estimated annual expenses

for family member(s) accompanying

the student to the U.S.

Living expenses (nine months)

For spouse only $8,628

For each child $4,314

Health insurance (nine months)

For spouse only $2,374

For all children $4,748

For spouse and children $7,122

*The OSU ID number is provided to

applicants by email 1–5 days after the

application has been submitted. If you have

not yet applied to Ohio State, please leave

this space blank.

Section 2 continued on other side

Section 2: Afﬁdavit for personal sponsors

Use this afﬁdavit if full or partial funding is coming from a personal source (family, friend, or self).

1. Ask each sponsor to (a) complete the “Afﬁdavit of Support from Personal Sources” (other side) indicating

full or partial support of your studies and (b) attach an ofﬁcial bank statement(s). The name on the afﬁdavit

must match the account holder on the bank statement(s).

2. Bank statements must be in English. English translations must be signed and sealed by the appropriate

bank or government ofﬁcial.

3. Each bank statement submitted must include the following details:

• Sponsor’s name—the translated name must be on the original document (not handwritten in)

• Date—documents must be dated no more than one year (12 months) prior to the date classes begin

for the desired term of enrollment (see class start dates at go.osu.edu/bigcal)

• Amount of available funds and the type of currency

Afﬁdavit of Support from Personal Sources

Please check ONE:

h I will provide FULL FINANCIAL SUPPORT for the student’s educational and living expenses for the entire length of study at Ohio State.

h I will provide PARTIAL FINANCIAL SUPPORT for the student’s education and living expenses for the entire length of study at Ohio State

in the amount of USD$ _____________ per year.

h I am self-sponsored; I will provide FULL FINANCIAL SUPPORT for my educational and living expenses for the entire length of study at

Ohio State. I have attached a bank statement(s) verifying that funding is available.

Check if appropriate:

h I will provide full ﬁnancial support for a spouse and/or children accompanying the student to the United States (see expenses on front page).

Sponsor’s family name/surname First/given name Middle name

Relationship to student

________________________________________________________________________ _____________________________

Sponsor’s signature Date (month/day/year)

Section 3: Afﬁdavit for agency sponsors

Use this afﬁdavit if funding is coming from a funding agency (government, organization, or institution/school).

Ask each funding agency to either complete the form below OR attach a letter including the details of the award.

Afﬁdavit of Support from a Funding Agency

We, ________________________________________ (name of sponsor), hereby certify that we will provide full ﬁnancial support associated

with tuition, fees, books, health insurance and living expenses for ________________________________________ (student’s name) and, if

applicable, health insurance and living expenses for spouse and children for the entire length of study at Ohio State.

Study is approved for ___________________________________ (degree) in ___________________________________ (ﬁeld of study) at

The Ohio State University. Funding is effective for the entire length of study starting _____________________________ (Term: e.g., Autumn 2014)

Ofﬁcial title

Ofﬁce or division

Address where tuition/fees will be billed, if applicable:

________________________________________________________________________ _____________________________

Signature Date (month/day/year)

Ofﬁcial seal/stamp of

funding institution

REQUIRED

Section 2 ,continued

UAP160021 rev. 7/15