Affidavit of Financial Support for
International (F-1) Applicant
(Please print legibly or use typewriter and answer all items below)
1. Na
me of Sponsor
: A
ddress:
(Street and Number)
(City) (State) (Zip Code if in U.S.) (Country)
2. This affidavit is executed in behalf of the following person:
Na
me of Student
: S
ex: Male Female
Date of Birth: Citizen of (Country):
Marital Status: Relationship to Sponsor:
Presently Resides At:
(Street and Number) (City) (State) (Country)
Name of spouse and children accompanying or following to join student:
Spouse or Child Name
Sex
DOB
Child Name
Sex
DOB
3. I make this affidavit for the purpose of assuring Vance-Granville Community College that the person(s)
nam
ed in item 2 will not become a public charge in the United States
.
4.
I
am willing and able to receive, maintain and support the person(s) named in item 2. I am ready
and
willing to deposit a bond, if necessary, to guarantee that such person(s) will not become a public charge
dur
ing his or her stay in the United States
.
5.
I unde
rstand this affidavit will be binding upon me for the duration of study of the person(s) named in ite
m
2.
6.
I
am employed as, or engaged in the business
of wit
h
at
(Street and Number) (City) (State) (Zip Code)
I derive an annual income of
I have on deposit in savings bank in the United States or
(Country)
$
$
7. The following other persons are dependent upon me for support: (Place an “X” in the appropriate column
t
o indicate whether the person named is wholly or partially dependent upon you for support.
)
Name of Person
Wholly Dependent
Age
Relationship to Me
8. I have previously submitted affidavit(s) of support for the following person(s).
I
f none, state “None”
.
Na
me Date Submitted
9. Please specifically describe what support you intend to provide for the student. (For example: If you live in
the Henders
on area and are providing room and board, please state this.) Give many details of the
level of support you will be providing.
O
ATH OR AFFIRMATION OF SPONSOR
(Signature must be witnessed by Notary Public, Attorney,
or other Official authorized to administer oaths.)
I swear (affirm) that I know the contents of this affidavit signed by me and the statements are true and
correct.
Signature of Sponsor:
Subscribed and sworn to (affirmed) before me this day of .
(year:) , at .
My commission expires on .
Signature of Officer Administering Oath:
Title:
To complete the financial documentation this affidavit must be accompanied by an original bank letter
confirming that the sponsor has the financial means to support the applicant.