OUT-OF-STATE Fin Statement Undergraduate Intl Student

International Financial Statement UNDERGRADUATE ADMISSIONS Florida Agricultural and Mechanical University 1700 Lee Hall Drive FHAC, Suite G-9 Tallahassee FL 32307-3200 Phone: 850 ● 599 ● 3796 Fax: 850 ● 412 ● 6604 This International Financial Statement is for use by international undergraduate student applicants who have completed the Florida A&M University application for admissions This form is not an application for admissions; it is required supplementary information needed for your immigration document (called an “I-20” for F-1 visa applicants) US immigration law requires the University to verify that any student seeking an F-1 Visa has sufficient funds to finance their studies for the duration of their program The Office of International Education and Development will issue you the appropriate immigration document only AFTER you have 1) competed this form and submitted acceptable financial documents to the Office of Undergraduate Admissions AND 2) Been formally admitted to Florida A&M University Failure to read the instructions and complete the form correctly will result in delays in the processing of your application and issuance of your immigration document Instructions: • Complete the International Financial Statement for Undergraduates • The International Financial Statement is a form fillable file, allowing you to type information on the form directly If you cannot so, print this form and write by hand Print legibly in BLOCK letters Note that physical signatures are required on page 2, not typed names alone NOTE: You will need original copies of your financial documents for your visa appointment at the U.S Consulate It is recommended that you request several original signatures/copies from your bank for future use Also, copy the International Financial Statement for your records 2014-2015 Estimated Fees Out of State Tuition and Fees (30 credits) Living Expenses Books and Supplies Other personal expenses TOTAL $17,940 $16,984 $1,000 $4,000 $39,924 These figures are estimated costs for the calendar year (12 months) and are subject to increase without notice Annual increases in tuition and fees are anticipated Tuition covers two semesters (15 hours per semester) Summer enrollment requirements Undergraduate students attending the summer session will need an estimated additional amount of $6,278 for tuition and fees Note: You are required to earn at least nine (9) hours prior to graduation by attendance in one or more summer terms to complete university requirements for graduation Dependents: If bringing a spouse and/or children, you must show an additional $3,000 for your spouse and $4,500 for each child who will be in the U.S as your dependents This does not include dependents with U.S citizenship Individuals other than your spouse or child cannot be considered dependents for immigration purposes If purchasing insurance in the U.S for dependents, actual costs for dependents could increase Note: All J2 dependents are required to carry insurance coverage at all times during their stay in the U.S Important Information about Financial Documents: • Proof of funds must be current when the I-20 is processed • Only official, original statements in English are accepted • Account holder name must be listed in English • All proof must be stated in U.S dollars and clearly state the date that the documents was written or printed • Original signed documentations are required by mail only, with the exception of copies of award letters • Funds must be available in the form of liquid assets that can easily be converted into cash • Printouts from on-line bank accounts are not accepted without an official signature and stamp from the bank Acceptable account examples for I-20 issuance: • Checking • Deposits with no withdrawal restrictions or maturity dates • Savings • Scholarship or Grant award letter from U.S government, foreign government, or international agency specifying what expenses are covered and any upper limits on those expenses Unacceptable account examples for I-20 issuance: • Art or commodity holdings • Business accounts without an individual account holder name • Credit card limits or balances • Funds from another F-1 or J-1 visa holder • Investment accounts (stocks, bonds) • Life insurance policies • Real estate holdings • Retirement accounts or pension funds • Salary verification letters • Time deposits or Certificates of Deposit that have withdrawal restrictions or have not matured Shipment of your Immigration Document: When your I-20 is in process, you will receive an e-mail from the Office of International Education and Development with further instructions about arranging for the shipment Additional Information • Tuition and fees are subject to change without notification • Health insurance is mandatory for all international students The student health insurance policy must be purchased from an American based company on an annual basis prior to registration, unless proof of comparable insurance is annually furnished to the University’s insurance provider Failure to have such insurance during any semester shall result in a hold being placed on student’s registration and/or receipt of insurance provider • Expenses not include travel • Submit your financial documents and International Student Financial Statement as early as possible to ensure timely processing of your application You can submit documents with your application, or separately if necessary International Financial Statement UNDERGRADUATE ADMISSIONS Florida Agricultural and Mechanical University 1700 Lee Hall Drive FHAC, Suite G-9 Tallahassee FL 32307-3200 Phone: 850 ● 599 ● 3796 Fax: 850 ● 412 ● 6604 Student Information Name: (as it appears on passport) Last (Family Name First (Given) Name Middle Name Female Male Date of Birth (mm/dd/yyyy): _/ _/ Marital Status: Single Married Divorced Separated Widowed Major applied For: _ Country of Birth: Expected Start Term: Country of Citizenship: _ Spring 2015 Summer A/B/C 2015 Fall 2015 Country of Permanent Residence: _ City of Birth: PERMANENT FOREIGN ADDRESS (in your home country): Address is current until (mm/dd/yyyy): Address: City: _ Province/State: Country: Postal Code: E-mail: _ Phone Number: CURRENT ADDRESS: Address is current until (mm/dd/yyyy): Address: City: _ Province/State: Country: Postal Code: E-mail: _ Phone Number: DEPENDENT INFORMATION (Do not complete this section for any family member who will not be in the U.S.) If your spouse and child/children will accompany you to the U.S., or if they are already in the U.S as your F-2 or J-2 dependents, please provide the following biographical data for each person Use a separate sheet, if necessary Note: additional expenses for dependents Name Last, First, Middle: (as it appears on passport) Date of Birth (mm/dd/yyyy) Citizenship Country of Permanent Residence City and Country of Birth Gender Relationship to you _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ IF YOU ARE IN THE U.S., COMPLETE THIS SECTION: Visa Status: F-1 J-1 Other (please specify): If currently in F-1 or J-1 status, name of current or most recent school that issued your I-20 form: _ Dates Last attended school: from _ (mm/dd/yyyy) mm/dd/yyyy) Page to: _ Last (Family Name First (Given) Name Middle Name Date of Birth (mm/dd/yyyy) APPLICANT STATEMENT I certify that the information on the International Financial Statement is complete and accurate I have read the instructions and guidelines provided I understand that an incomplete form will result in a delay in processing my application, and that false or fraudulent statements made by me or my sponsor can result in a denial or cancellation of admission I certify that adequate financial resources are available to me for the first year and for all subsequent years of my degree program at Florida A&M University Applicant Signature Date SOURCES OF FUNDING All Applicants and Sponsors Must Complete This Section Use a separate page for yourself, for each sponsor and each bank or financial institution Refer to the Instruction Page of this form for the Estimated Cost of Attendance Personal and/or Family Savings Submit a bank statement or letter in English that includes: name of sponsor, date, amount and type of account, currency, and amount available in US dollars Government Sponsor A copy of the signed letter of sponsorship is required The letter must specify the total amount of the scholarship as well as list what is covered, such as the amount of the monthly stipend, health insurance or other benefits Print name of agency sponsor: Type of visa required by sponsoring agency: F-1 $ $ J-1 Scholarship A copy of the award letter is required $ Other: Specify: $ STUDENT/SPONSOR STATEMENT I certify that the above information is correct, and that the funding amount listed above will be available for the first year and each subsequent year of study for the duration of the student's academic program My bank/financial institution has completed the Certification below OR I have enclosed bank and/or other financial verification demonstrating availability of funds for the first year Name of Student/Sponsor: (please print) _ Relationship to Applicant: Student/Sponsor's signature: Date: _ Shipment of your Immigration Document: When your I-20 is in process, you will receive an e-mail from the Office of International Education and Development with further instructions about arranging for the shipment Page FORM #2100/Rev:9/10/14 ... being placed on student? ??s registration and/or receipt of insurance provider • Expenses not include travel • Submit your financial documents and International Student Financial Statement as early... can submit documents with your application, or separately if necessary International Financial Statement UNDERGRADUATE ADMISSIONS Florida Agricultural and Mechanical University 1700 Lee Hall... Middle Name Date of Birth (mm/dd/yyyy) APPLICANT STATEMENT I certify that the information on the International Financial Statement is complete and accurate I have read the instructions