Exchange Visitor Financial Support And Budget Form Page 2
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1
2Exchange Visitor Financial Support and Budget
Government regulations for J-1 visa programs require sufficient the exchange visitor have sufficient financial support to
cover the costs of travel and living expenses while participating on the training program. Financial support can be derived
from various sources; however, in no case can the exchange visitor be paid for on-the-job training in an amount less than
that paid a similarly situation American resident.
Income & trainee personal resources:
Approximate total gross income provided by U.S. company
$____________
Total gross income is for the entire stay. Please note that trainees staying for 18 months should calculate the gross income for 78 weeks.
Is the U.S. company providing sickness & accident insurance?
Yes
No
Financial Support provided by U.S. Government, if any
Name of U.S. Government Agency________________________
$____________
Financial support provided by trainee’s government, if any
$____________
All other financial support ______________________________________
$____________
Fill in whom is providing and amount, including income provided by foreign company
Exchange visitor’s personal funds:
$____________
0.00
Approximate total net income
$________
Subtract 15% for payroll withholding tax from the total gross income.
Total Financial Support
$
_______________
0.00
Anticipated Exchange Visitor Expenses:
Calculate for total stay in the U.S.
180.00
U.S. Visa application fee
$______________
Provided by U.S. host __
U.S. Visa reciprocity fee, if any
$______________
Provided by U.S. host __
International airfare
$______________
Provided by U.S. host __
Temporary housing upon arrival in U.S., if any
$______________
Provided by U.S. host __
Transportation to host site from port of entry
$______________
Provided by U.S. host __
Security deposit for housing
$______________
Provided by U.S. host __
0.00
Housing rent: monthly________ x number of months____
$______________
Provided by U.S. host __
0.00
Utilities: monthly________ x number of months____
$______________
Provided by U.S. host __
(Gas, electric, water, telephone, cable, etc.)
0.00
Commuting expense: monthly________ x number of months____
$______________
Provided by U.S. host __
Miscellaneous expenses not included in rent
$______________
Provided by U.S. host __
(Sheets, towels, pots, pans, etc..)
0.00
Food: monthly________ x number of months____
$______________
Provided by U.S. host __
(Budget $75-100 per week if cooking own meals. Budget more to eat out)
0
0.00
$ 57.00
Sickness & Accident Insurance: monthly______ x number of months____
$______________
Provided by U.S. host __
Entertainment
$______________ Provided by U.S. host __
(Movies, museums, sporting events, car rentals, etc.)
Personal/Other
$______________
Provided by U.S. host __
(Stamps, clothing, etc.)
180.00
Total anticipated expenses:
$______________
Remaining money for travel:
$
_______________
-180.00
(Subtract total expected expenses from total net & personal financial support)
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