Fillable Printable Financial Affidavit - Ohlone College

Financial Affidavit - Ohlone College

Reminder: you must also submit separate bank documentation, in addition to this Financial Affidavit form

FINANCIAL AFFIDAVIT

International students are required to provide documentation of financial support before a Form I-20 can be issued to them

by Ohlone College. Documentation of financial support includes 2 items: 1) this completed Financial Affidavit form; and

2) an official bank statement. Please submit BOTH of these items as part of your application.

SELF-SUPPORTING STUDENTS: If the student will use his/her own personal funds as the source of financial support, the

student must provide an official bank statement showing the availability of at least $21, 022 in liquid assets, and complete

the Statement of Financial Obligation below. ELI students must demonstrate $25,474 in liquid assets.

STUDENTS SUPPORTED BY A FINANCIAL GUARANTOR: If someone else will financially support the student

(examples: family member, friend, or private institution,) the Financial Guarantor must provide their official bank statement

showing the availability of at least $20,782 in liquid assets, and complete the Statement of Financial Obligation below. ELI

students must demonstrate $25,474 in liquid assets.

Bank statements and Financial Affidavits must be dated within the last 6 months

Estimated Expenses, one Academic Year

Ohlone Degree Studies

(24 credits, 2 semesters)

English Language

Institute (ELI) Studies

Tuition and Fees, at $264 per credit

$ 6632.00

$ 11,084.00

Books and Supplies

950.00

Health Insurance

950.00

Room and Meals

9590.00

Other expenses (transportation, personal expenses, etc.)

2900.00

TOTAL

$21,022.00

$25,474.00

Note: If a spouse and/or children will be accompanying the student as F-2 Visa holders (dependents of an F-1 Visa-holder,) an additional $6,000 must be

demonstrated for your spouse and an additional $5000 must be demonstrated for each child. On a separate sheet of paper, please provide the following

information: Full Name of Spouse/Child as it appears on the passport, Date of Birth, Country of Birth, Country of Citizenship, and Gender.

Statement of Financial Obligation

Check One:

I, the student, will be Self-Supporting (using my own funds to finance my education.)

I will be the student’s Financial Guarantor. I will support the student financially during his/her studies at Ohlone College

IMPORTANT: The student must sign below. AND, if someone else will financially support the student,

the Financial Guarantor must also sign below.

Student’s Name (Last Name, First Name) _______________________________ ______________________________________

Student’s Signature _________________________________________________ Date ________________________

Financial Guarantor’s Name (Last Name, First Name) _____________________________ _______________________________

Relationship to Student (check one) Parent Other relative Friend Other ________________

Financial Guarantor’s Signature ________________________________________________ Date _________________________

By signing above, the student and Guarantor(s), if applicable, certify that sufficient financial resources will be available to cover all expenses for the

duration of studies at Ohlone College, and that the student also agrees to obtain and maintain adequate health insurance throughout his/her studies.