Fillable Printable Affidavit of Support - Utah

Affidavit of Support - Utah

Sponsors of students planning to attend the University of Utah should complete the following form.

Students request the University of Utah to issue the I-20 Certificate of Eligibility in order to obtain his/her student visa. Before the

University of Utah can issue the I-20, the student must provide proof of financial responsibility. With this statement of support, the

sponsor assumes this financial responsibility.

In addition to this form, sponsors should also send a financial statement showing

sufficient funds to cover the students schooling and other expenses to the International Admissions Office.

Signature of Sponsor ____________________________________ *Date (mm/dd/yyyy)

*I hereby attest that I (Name of Sponsor)

*Indicates required fields.

*currently reside at (mailing address)

*Amount subject to change

If checking partial financial responsibility, this includes:

Room and board in the amount of (US$) Tuition in the amount of (US$)

Other expenses in the amount of (US$) If other expenses, please explain

for: *Student Last Name Middle name

Student’s date of birth (mm/dd/yyyy) *Relationship to student

*Student First name

Student’s birthplace

*Term the student plans to attend the University of Utah beginning

I assume full financial responsibility

I assume partial financial responsibility

*City ZipcodeState *Country

The University of Utah

Affidavit of Support

The University of Utah • Office of Admissions • 201 S 1460 E RM 250 S • Salt Lake City UT 84112 • 801-581-8761 • 801-585-7864 fax

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