Northeastern University - Extension Of Ds-2019 For J-1 International Scholars (Form C) Page 2
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1
2Extension of DS-2019 for J-1
International Scholars (Form C)
Funds
Name of Source
Amount (U.S. Dollars)
Required Financial Documents
Northeastern Salary,
$
Appointment Letter
Stipend, Honorarium,
etc.*Prorate annual salary
to reflect exact time period
of DS-2019 if it is less or
more than one year.
Northeastern
$
Appointment Letter or Accounts
Reimbursements
Payable Forms
U.S. Government Agency
$
Letter of Funding
International Organization
$
Letter of Funding
Home Country Government
$
Letter of Funding
Bi-national Commission of
$
Letter of Funding
Home Country
Other Organizations
$
Letter of Funding
Personal Funds
$
Bank Statements
Total
-
$
Please note that the minimum funding required per annum for a J Scholar is $28,000; for a spouse, an additional $14,000 is needed,
and for each child, an additional $7,000. The total of financial support declared above should match or exceed the estimated living
costs of the J Scholar, and their dependents, if applicable.
Minimum Funding Requirement/per
Program Duration
Total Amounts of Requirement
annum
Scholar/$28,000
Year(s)
Month(s)
$
Spouse/$14,000
Year(s)
Month(s)
$
Children/$7,000 x
(number)
Year(s)
Month(s)
$
Total
-
$
Explanation of Non-Northeastern Funding for J-1 Sponsorship (Read carefully):
Funding from sources other than Northeastern (private sponsor, government funding, scholarships, personal funds, etc.) will be
considered towards meeting the NU minimum funding requirements, with the following restrictions:
1) All documentation must be translated into English; currency must be clearly referenced and converted into USD.
2) Documentation must be originals or copies of originals (note that the U.S. Consulate requires original documentation
during the visa process).
3) Financial institution documentation, such as bank statements or letters, must include the name of the scholar, must be
recent, and cannot be older than 9 months upon receipt by the OGS.
Note: The scholar is permitted to use financial support by family members provided that the following is submitted:
a) Financial institution documentation, such as bank statements or letters, including name of the financial sponsor;
documentation must be recent, and not older than 9 months upon receipt by the OGS.
b) A letter signed by the financial sponsor attesting that the scholar is entitled to the funds in the sponsor’s account
4) In cases in which the documentation reflects a range in funding, the OGS will use the lowest figure in the range unless
the scholar provides a letter from the funding source indicating otherwise.
Note: The OGS retains the right to request original documentation or other means of clarification.
I certify that the above information is complete, accurate, and true. I take full financial responsibility for all of my and my
dependents’ expenses.
Scholar’s Signature: __________________________________________________________________
Date: _________________
Department Head or Dean: _____________________________________________________________________________________
Name
Signature
Date
Faculty Host: _________________________________________________________________________________________________
Name
Signature
Date
SEVIS Contact: _______________________________________________________________________________________________
Name
Signature
Date
Office of Global Services, 405 Ell Hall, 360 Huntington Ave, Boston, MA 02115
northeastern.edu/ogs | ogs@northeastern.edu | (p) 617.373.2310 | (f) 617.373.8788
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