Montgomery College
International Student Office
AFFIDAVIT OF FINANCIAL SUPPORT
(For Use Only by Sponsors from OUTSIDE of the United States)*
____________________________________________________________________________________________________________ , residing at
NAME OF SPONSOR
_________________________________________________________________________________________________________________ , agree
COMPLETE ADDRESS OF SPONSOR**
to sponsor___________________________________________________________________________________________________________ .
NAME OF STUDENT AND/OR STUDENT’S DEPENDENT
SPONSOR’S RELATIONSHIP TO STUDENT: ____________________________________________________________________________ .
I/We certify that I/we am/are able to support the student named above for a total time of________years (to support as long as
needed enter “D/S”). I/we will provide: (Please check what you will support):
________ Living expenses (room, board, medical insurance, transportation, personal expenses, other).
________ School expenses (tuition, fees, books and supplies, other).
I/we understand that the estimated cost for ONE year of full time study at Montgomery College (all living and school expenses)
is $28,000 (USD) for the Current Academic Year and is subject to change.
In addition to the student named above, I/we also support:
A spouse who is________completely________partially dependent upon me for support.
Children________(total #) who are completely_______(#) or partially_______(#) dependent upon me for support.
This affidavit assures that the student named above will not become a public charge of the United States.
________________________________________________ (Signature MUST be notarized)
SIGNATURE OF SPONSOR
Date: Month ____________________ day ____________________, Year 20 ______ NOTARY SEAL HERE
________________________________________________________________________________________________________________________
SIGNATURE AND SEAL OF AUTHORIZED NOTARY PUBLIC (official licensed by a government to verify the identity of the signer) .
The following evidence of ability to provide financial support must be submitted with this completed affidavit:
1. Sponsor Obligations Document SIGNED BY THE SPONSOR .
AND
2. An original letter from the sponsor's bank (personal saving or checking accounts ONLY) that indicates the current
available balance in United States Dollars. MINIMUM $28,000 total.
AND
3. An original letter from sponsor's employer that verifies annual salary, or, if self-employed , the sponsor's most recent
income tax return or other proof of the income of the individual person signing this Affidavit.
NOTE: Additional documentation may be required as evidence of sponsor’ s ability to provide financial support.
For any dependent accompanying the student, please list the full name, birthdate, country of birth, and relationship to student on
a separate paper along with a notarized statement indicating who will be providing the dependent's financial support.
* Sponsors who ARE US citizens, permanent residents OR with a valid non-immigrant visa: use USCIS form I-134 Affidavit of
Financial Support, see International webpage for Instructions.
** If the sponsor is residing inside the U.S.: What is the sponsor’s Immigration Status? _____________ , ending on ______________ .
THIS FORM IS VALID FOR A VISA/STATUS APPLICATION FOR UP TO SIX MONTHS. 12/18 .
