New Brunswick:
F-1 International Student Financial Statement Fall 2021
International Students who are admitted into a degree program at Rutgers University will need to obtain a Certificate of Eligibility (Form I-20) in order
to enter and/or remain in the U.S. on an F-1 student visa. This requirement applies to both international students coming from abroad and students
transferring from another U.S. university or institution.
In order for Rutgers to issue you a Form I-20 you will need to submit:
1. This form with both Part A and Part B completed in its entirety, including the signatures of both you (the student) and your sponsor(s).
2. A copy of the picture page from your passport.
3. Bank statement(s) or letters(s) from you or your sponsor(s), issued no earlier than 9 months of the date you intend to begin your studies. For
students beginning in the Fall (September) semester, we cannot accept any bank statement issued before January 1. Account balance(s) must be
shown in an amount greater than or equal to $52,000 USD. If you submit a photocopy/scanned file of this document, please keep the original bank
statement/letter to bring to your visa interview.
Note: Bank statements must be for a checking, savings, or time deposit account. Brokerage (stock funds), real estate, or any other non-liquid assets
are NOT ACCEPTABLE. The name of the account holder printed on the document(s) must match the sponsor name(s) you provide on this form. Any
part of this form left blank or completed incorrectly may delay the issuing of your I-20.
ALL PARTS ON THIS FORM MUST BE COMPLETED. (Please write answers in Ink or Type)
Part A Student Information
Student’s Name (as it appears on passport): __________________________________________________________________________________
Last/Surname First/Given Middle
Rutgers ID# (RUID): _ _____________________(required) Email Address: _________________________________________________________
Permanent Overseas Address (Per government regulations, please list an address outside of the U.S.): ___________________________________
Country of Birth: _____________________ City of Birth: ________________________Country of Citizenship: ______________________________
Date of Birth (Month/Day/Year): ____________________ Sex: ___ Female ___ Male
Check one: _____I am NOT bringing any dependents
_____ I will be accompanied by dependents (Spouses or children only. Parents are NOT considered to be dependents.)
List names, relationships, dates of birth, and city and country of birth:
Part B Source(s) of Financial Support
Please indicate the source(s) of funding for each year needed to complete the degree program. Any combination of funds is acceptable, as long as you
demonstrate you can cover the full cost. Totals for Year 1 must be greater than or equal to $52,000 USD. For Years 2-4, please include a projected
increase of 5% each year. All sponsors must sign the same form.
Note: For dependents, please add additional funding of $5,000 USD for spouse and/or $3,750 USD for each child, per year.
Funding Source
Year 1 (Documented)
Year 2 (Projected)
Year 3 (Projected)
Year 4 (Projected)
Student’s Personal Savings
Scholarship or Loan
(must be > or = $52,000)
(must be > or = to $54,600)
(must be > or = to $57,330)
(must be > or = to $60,197)
**Sponsor (Family Member or Government Agency contributing funds for the student’s academic program and expenses)
Sponsor Name(s):_______________________________ Relationship to Student (ex. Mother, Uncle, Government Agency): ___________________
Sponsor Signature(s): ___________________________________________________ Date: _____________________
This will certify that the information given on this form is complete and accurate to the best of my knowledge. I am fully aware that any false or
misleading statement may result in denial of admission or cancellation of registration following enrollment. I/We pledge financial support to meet the
educational and living expenses of this student in the annual amounts cited above.
Scholarship/Loan: ____________________________________________ Awarded By: _________________________________________________
Applicant’s (Student’s) Signature (must be signed by student): __________________________________________ Date___________________
(Please note: Electronic signatures are not acceptable)