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Fillable Printable International Student Financial Affidavit - Lake Land College

Fillable Printable International Student Financial Affidavit - Lake Land College

International Student Financial Affidavit - Lake Land College

International Student Financial Affidavit - Lake Land College

International Student Financial Affidavit
To All Prospective Lake Land College F-1 Students:
U.S. Citizenship and Immigration Services (USCIS) regulations require that Lake Land College
obtain reliable documentation that an F-1 applicant has sufficient funds to adequately pay all
expenses while studying. Lake Land may issue a form I-20 only after evaluating and
authenticating proof of financial capability. Students must prove that they have $18,000 of
available funds, either personally or through a sponsor, in order to attend at least one year of
school and that there is a likelihood that the finances will exist for subsequent years. The
sponsorship information given below will be stated on Form I-20.
PERSONAL INFORMATION (to be completed by applicant)
Name of applicant (family, first, middle): ____________________________________________
Address: ______________________________________________________________________
Do you intend to bring any family members with you? No Yes
If yes: Spouse Child(ren)
Name: _____________________ Birth Date: ____________ Relationship to you: ____________
Name: ________________ Birth Date: ____________ Relationship to you:____________
Name: ________________Birth Date: ____________ Relationship to you: ___________
SPONSOR INFORMATION (to be completed by sponsor)
Please provide the following information regarding your demographics and personal finances.
Name (family, first, middle): ______________________________________________________
Your relationship to applicant: _______________________________________
Address:_____________________________________________________
Telephone: _______________ Email: _________________________
Sponsor’s Employment Information:
Sponsor’s Place of Employment: ______________________________________________
Position: ________________________________________________
Annual salary of Sponsor in USD $________________ Years of employment: ___________
This section to be completed by sponsor’s employer: Date:__________
I certify that the information provided above is true and correct.
Name of Employer (print): ____________________________________________
Employer's signature: ________________________________________________
Position Title: ______________________________________________________
Employer’s contact information: _______________________________________
Annual Salary of Sponsor’s spouse in USD: ____________Years of Employment_________
Number of children receiving support: ______________________________________________
Other dependents: _______________________________________________
Sponsor’s Financial Information:
Bank Account(s):
Type of account: ______________________ Account number: __________________________
Date opened: _________________________
Deposits for the past year (USD): ___________ Current balance (USD) ______________
This section to be completed by bank official: Date:_____________
I certify that the information provided above is true and correct.
Bank official's signature: _____________________________________________
Name of bank official (print): _________________________________________
Bank official's position: ______________________________________________
Bank's address: ____________________________________________________
Stamp/seal:_________________________________________________________
Sponsor must also attach an original bank statement (not a bank letter) dated within the
past two months. Submission of income tax returns is also encouraged. If a sponsor has
more than one account, please provide the information required above for each account, if
necessary on a separate piece of paper.
SPONSORSHIP AGREEMENT
This section to be completed by person who is serving as the educational sponsor for the
applicant:
I hereby declare that the contents of this Financial Affidavit are true and correct. I understand
that, by signing this document, I am affirming that I intend to serve as the student’s educational
sponsor for the amount listed below. I understand that signing this document without intention
of providing support is considered fraud, and will negatively affect the applicant’s immigration
status in the future if it becomes clear that the Financial Affidavit was falsified.
I will provide (applicant's name) _____________________________with
U.S. $ __________ yearly beginning ______________ until _________________.
I certify that the information provided above is true and correct.
Name of Sponsor (print): _________________________________________
Signature: _____________________________________ Date:____________________
PROSPECTIVE STUDENT: Please read and sign this statement:
I have read this Financial Affidavit and understand that my sponsor and I are responsible for
paying the educational expenses while at Lake Land College, and that federal and state financial
aid will not be available. I further understand that I may not work without USCIS approval. I
will be responsible for meeting educational expenses, for knowing my government's regulations
on foreign exchange (if any), and for requesting, completing, and submitting appropriate
documents which are needed to enable transfer of funds from my country to the United States.
I have read this statement of responsibilities and I agree to do what is required.
Applicant's name (print): _________________________________________
Signature: _________________________________________Date: ____________________
Please send this Financial Affidavit and attached International Studies
original* financial documents to: 5001 Lake Land Blvd.
Mattoon, IL 61938
*scanned/faxed copies not accepted U.S.A.
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