UHCL Sponsor's Affidavit and Declaration - Texas - Edit, Fill, Sign Online

I,____________________________, ______________________of_____________________________,

Name of Sponsor (Please Print) Relationship to Student Name of Student

Hereby solemnly promise and declare that I undertake to maintain the above-named student during his/her stay in the

United States of America, and to repatriate him/her to ________________________________ at my own

( St ude nt’ s Home C oun t r y )

cost, if and when necessary; also that in the event of his/her dying in the United States I promise to bear all costs

associated with burial or cremation and transport of remains to __________________________________.

(Student’s Home Country)

I further certify that I now possess the financial resources to provide not less the $24,273.00 USD (for undergraduates);

$23,403.00 USD (fo r gradu ate stud ent s) ;

$27,661.00 USD (for undergraduate HADM students); $27,441.00 USD (for MHA

or MHA/MBA students) for the duration of study

toward the edu cational and living expenses of the abov e-named student

while in the United States. I understand that the educational and living expenses will approximate the $24,273.00

USD

(for undergraduates); $23,403.00 USD (for graduate students); $27,661.00 USD (for undergraduate HADM students);

$27,441.00 USD (for MHA or MHA/MBA students) per year. This amount is based upon enrollment in 12 semester

credit hour s per sem est er, wh ich is fu ll-time for undergraduate students; 9 semester credit hours per semester, which is

full time for graduate students.

I have attached a Bank Statement indicating a minimum amount listed above in support of this affidavit.

Note: Graduate students may provide a bank statement showing a minimum of $30,000.00 USD available for their own

support, or sponsor’s bank statement showing a minimum of $24,273.00 USD. Additional dependents; add $5,000.00

USD for spouse & each additional dependent(s) add $4,500.00 USD.

________________________________________ _______________________________________

Sponsor’s Signature Sponsor’s Name (Please Print)

_________________________________________________________________ ___________________

Sponso r’ s Address Sponsor’s Country



This section is to be completed only if currently residing in the United States. NOTE: Persons in F1 or J1 sta tus ma y no t

sponso r anoth er stu den t!

Sponsor’s Place of Birth ___________________________ Sponsor’s Date of Birth______________________

1. Are you a U.S. Citizen?  Yes  No If no, answer item 2.

By Birth  Yes  No By Naturalization  Yes  No

(If naturalized, evidence of citizenship must be provided along with this document)

Naturalization Certificate Number________________Date and Place Issued___________________

2. If y ou are a permanent resident:

When did you come to the United States?_______________________________________________

Proof of residency must be submitted with this document. Please provide a copy of documentation.

_________________________________________________________________________________

Name and Address of Employer

_________________________________________________________________________________

Job Title Dates of Em ploym ent

UHCL SPONSOR’S AFFIDAVIT AND DECLARATION

FOR INTERNATIONAL STUDENTS

Fillable Printable UHCL Sponsor's Affidavit and Declaration - Texas