Graduate International Student Affidavit of Financial Support
Students must show funding for their first year of study at minimum prior to immigration documents being issued by a school. IUP also needs to have adequate information regarding an international student’s financial resources. The purpose of this Affidavit of
Financial Support is to demonstrate that you or your sponsor are capable of full financial responsibility for your tuition, fees, books, housing, etc., occurring during your undergraduate studies at IUP. IUP will not contact sponsors to pay for student bills. Students are ultimately responsible for all bills they incur while at IUP. This information will be kept confidential. Please convert all sums to
U.S. dollars and provide exchange rates for any additional documents provided.
1.

Your name: Mr./Mrs./Miss ____________________________________ Birth Date: __/__/__ (month/day/year)
Country of Citizenship: _____________ Country of Birth: ___________________

City of Birth: ______________

2.

Are you presently in the U.S.? Yes No

If yes, what visa type do you currently have ?_____________________

3.

Are you financially independent? ____________ YES (continue with question 3a) ________NO (skip to question 4a)
a. What is your annual income (after taxes)? US$ ___________________
b. What is the TOTAL amount of your (student’s) personal savings? US$ ____________________
Skip to question 5

4.

5.

6.

a.
b.
c.
d.

Father’s name ______________________________
Mother’s name _______________________________
Father’s occupation _________________________
Mother’s occupation ___________________________
Father’s annual income (after taxes) US$ ________
Mother’s annual income (after taxes) US$ __________
If you are a dependent, how many other dependents does your family have who are currently attending a college or university? _______
a. Name of your sponsor (if parent is not sponsor) ___________________________________________
In addition to signing this form, please ask your sponsor to provide a letter and bank statement showing support.
b. Sponsor’s occupation ___________________________________________________________
c. Sponsor’s annual income (after taxes) US$ __________________________________________
How much money will you have for your FIRST YEAR of study from all sources:
Personal savings US$
Family US$
Other (specify source) US$
Sponsor US$
TOTAL FOR FIRST YEAR US$

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