FINANCIAL STATEMENT FORM
This form is not an application for financial assistance. The Immigration and Naturalization Service requires an international student
to show funds are available for the first year of study, and that adequate funding will also be available for subsequent years. An
official letter from a banking institution showing the amount of funds available must accompany this form. Your
financial information will be used to ensure compliance with U.S. immigration policy and is necessary to create your
immigration document.
Annual Expenses for 2019/2020 Academic Year (9 months)/Source of Funding Available to Student
Note: These are approximate costs and are subject to change.
IELP
City College
(Must be completed by the applicant)
Organizational Support:
MSU Billings: $
Employer: $
Government: $
Other: $
Personal Funds:
Student: $
Family: $
Sponsor: $
Total Funds:
$11,732.00 $9,010.00 $19,550.00 $17,450.00
$350.00 $1,000.00 $1,000.00 $1,000.00
$1,000.00
$7,240.00 $7,240.00 $7,240.00 $7,240.00
Dependent
$5,000.00*
(Add to total
c
ost if
(Add to total
cost if
total cost if
applicable)
(Add to total
cost if
COST
$20,322.00 $18,250.00 $28,790.00 $26,690.00
Family/Sponsor Certification
This is to certify that I have agreed to provide the amount of funds stated above to the student for the purpose of full-time study at MSU
Billings. This commitment will continue for the duration of the student’s course of study.
The evidence of my resources in the form of
an official bank letter accompanies this statement.
I also understand that it is not the responsibility of MSU Billings to provide
financial assistance to the student.
Name of Sponsor_______________________________________ Relationship to Student ___________________________________
Address of Sponsor_______________________________________________________________________________________________
Signature of Sponsor_________________________________________________ Date_______________________________________
* Dependents Planning to Accompany Student (This information will be listed on the I-20 or DS-2019 form)
Complete Name
(Family Name in Caps)
Date of Birth (MM/DD/YYYY)
Relationship to Applicant
I certify that the above information provided is a correct statement of my arrangements for financing my studies and I
understand that I am responsible for any debts incurred while attending Montana State University Billings.
Name o
f Student______________________ Student’s Signature______________________________ Date________________
Return this form to: International Studies, MSU Billings, 1500 University Drive, Billings, Montana 59101 USA
internationaladmissions@msubillings.edu
