INTERNATIONAL STUDENT FINANCIAL STATEMENT
The State University of New York
NAME OF STUDENT: FAMILY/LAST NAME FIRST/GIVEN MIDDLE
PERMANENT ADDRESS STREET
IN HOME COUNTRY:
CITY PROVINCE, IF APPLICABLE OR STATE COUNTRY POSTAL CODE
DEPENDENTS:
■
I plan to come without dependents
■
The following dependents will accompany me
(list names and relationships):
___________________________________________________________
___________________________________________________________
PART I. (Type directly into the form or print and write clearly in ink)
EMAIL TELEPHONE NUMBER
COUNTRY OF CITIZENSHIP COUNTRY OF BIRTH DATE OF BIRTH (MONTH/DAY/YEAR)
CAMPUS TO WHICH YOU ARE APPLYING DEGREE FOR WHICH YOU ARE APPLYING MAJOR FIELD/DEPARTMENT
FUNDING:
Does your country restrict dollar exchange?
■
Yes
■
No
What is the maximum dollar amount permitted for a student? $____________
Do you have a source within the U.S. for emergency
funds once you arrive in this country?
■
Yes
■
No
If YES, name source____________________________________________
Amount available in U.S.: $_____________________
This is a two-page form. Be sure to read all information before completing this form.
International students must document their ability to meet all educational and living expenses for the first year of their intended study
b
efore this University can issue a Certificate of Visa Eligibility (form I-20 or DS-2019) per immigration regulations. Although you must only
show proof for the first year of study, funding must be available for your entire course of study from your personal or sponsored funding
sources. International students are NOT eligible for financial aid and U.S. Federal immigration regulations severely restrict international
student employment so students should not expect to subsidize their studies by earning income in the United States.
INSTRUCTIONS:
Part I: Answer all questions in Part I completely.
Part II: I
n the first column, indicate the source(s) of your funding. In the column headed Year 1, indicate the amount (in U.S. dollars)
available for each year of study. Each sponsor must verify these amounts by signing the form. Be sure to include supplementary documents
as indicated and provide official documentation of funding. Please note that if you send originals by mail, you must retain a set of originals
for your visa interview. The originals sent to the campus will not be returned.
All documentation must be dated within six (6) months of the date of initial enrollment at the SUNY campus to which you are applying.
A more current version may be requested by the individual SUNY campus to verify funding. The SUNY campus has provided you with an
estimate of their annual education and living costs for international students. You must document financial support equal to or greater than
this amount. Tuition and fee estimates, as well as cost of living expenses, are subject to change without notice and will usually increase
each year. Students must be prepared to meet these increases.
SOURCE OF FUNDS – REQUIRED DOCUMENTATION: **Please provide in English and in US dollars.
Personal/Family: Signatures of sponsors on this form. Bank verification on both this form and in a separate bank statement.
Scholarship: Official scholarship letter from the institution awarding the scholarship. The award letter must contain the name of the
student, the amount of money available for each year of study, the duration of the award (including beginning and ending dates), the degree
and major field of study for the award, and the name of the SUNY campus to which the award is applicable.
Government or Employer: Official letter indicating amount of support and containing the same information as for “Scholarship”
described above.
Loans: Official letter from credit institution indicating approval of the loan and the amount approved.
Dependent Support: A student wishing to have his/her family member(s) accompany him/her must document additional funding for each
family member per calendar year of intended study. Each campus will provide you with the required spouse/child documentation. The
costs may vary based on campus and regional area and are estimated living costs.
The SUNY campus to which you are applying reserves the right to require additional financial documentation and/or pre-payment from
students whose countries impose currency exchange restrictions or other obstacles to the transfer of currency. Students from such
countries will be notified of specific requirements when they have submitted a completed application.
FSA-4
