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Affidavit Of Support

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Affidavit of Support

This form must be completed by the person (sponsor) who will provide the student with full or partial support and/or

room and board during the student's ourse of study at the City University of New York.

Instructions: Complete items 1 through 6 if you are a sponsor providing financial support; Complete items 1 and 7 if you are a

sponsor providing room and/or board.

If the financial sponsor is different than room/board sponsor, please fill out two different forms.

Sponsor Information

I, ______________________________________________, citizen of ______________________________________,

sponsor (family name, given name)

country/ies

and residing at __________________________________________________________________________________

street

city/state

country

postal code

___________________________________________________________________________________

telephone number/s

I am employed with

______________________________________________________________________________

name of employer

employer's telephone number

located at _____________________________________________________________________________________

street

city/state

country

postal code

I receive an annual income of $

(in U.S. dollars) from this employment.*

*Attach a current salary confirmation statement written by that employer or verification of annual income for self-employed or retired

ndividuals. The employer statement or verification of annual income must be written in English or come with a certified translation.

Certify the following:

I have $

(in U.S. dollars) on deposit with:______________________

name of bank

Bank address: _______________________________________________________________________________________

street

city/state

country

postal

code

Attach bank officer's statement of account history.

I currently support # _____________________ persons

(number of people including myself).

4a.

Our total annual income is

(in U.S. dollars).

Our total family expenses are

(in U.S. dollars) .

I sponsor # ___________ individuals for immigration in addition to this affidavit.

4b.

Affidavit Of Support

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