7/27/2019 Osu Affidavit

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Apply online: apply.osu.

Undergraduate studyAfdavit o fnancial support or international students

The Ohio State University is required by U.S. government regulations to check the availability o adequate unding or your tuition, ees,and living expenses or the duration o your studies. Complete this orm i you are requesting F-1 or J-1 status. Please note that we willnot be able to issue a notice of admission until funding documentation is completed.

Important:The total unds on the afdavit(s) you submitrom personal sources, unding agencies, or bothmust equal the total undsneeded or the duration o your studies at Ohio State (at least our years). However, you only need to submit evidence (bank statements,fnancial awards, etc.) to support your frst year o study in the United States. See estimated annual expenses on this page.

A separate copy o this afdavit orm is required rom each personal or agency sponsor. Please read the instructions in each section.

Mail, e-mail, or ax the required fnancial documentation to: Undergraduate Admissions, P.O. Box 182646,Columbus, OH 43218-2646 USA. [Express mail address: Undergraduate Admissions, 1354 Lincoln Tower, 1800Cannon Dr., Columbus, OH 43210 USA] E-mail: int.undergrad@osu.edu. Fax: +1-614-292-4818.

Section 1: Student inormation and declaration (required)

Name in ull as it appears on your passport:

Family name/surname

First/given name Middle name

_____________________________________________________ ______________________________________________OSU ID (*see note at bottom right) Date o birth (month/day/year)

Country o citizenship

City and country o birth

Country o residence

Do you presently hold an F1 or J1 student status? h Yes h No

I yes, what institution issued the Form I-20 or DS-2019: _________________________________________

Student declaration

I hereby promise that the inormation provided on this orm is correct and complete. I understand that I amultimately responsible or all expenses associated with my stay in the United States.

________________________________________________________________________ _____________________________Students Signature Date (month/day/year)

Estimated annual expenses or sinstudent living alone (withoutamily) in the United States

The amounts below represent ees ineect autumn 2013 through summer or most programs; costs are subject change without notice.

Costs listed are for an academic year

(two semesters/nine months).Average tuition and ees1 $26,4

Room and board2 $10,3

Books and supplies $1,2

Health insurance3 $2,1

Living expenses $3,1

Total estimatedexpenses $43,3

Tuition and ees may vary by major, college, aarea o study. The university reserves the righassess ees or special services and programsapplicable to students. In 20142015 and be y

students should plan or a 5 to 10 percent anincrease or all costs.

1 Includes an International UndergraduateStudent Fee o $500 per semester, assessprovide academic and support services ointernational students.

2 Health insurance is required or internatistudents (see the health insurance sectiopage 5 or more inormation).

3 Cost o the most popular room and meal combination; your cost will range betwee$9,810 and $11,790.

Additional estimated annual expeor amily member(s) accompanyin

the student to the U.S.

Living expenses (nine months)

For spouse only $8,125

For each child $4,062

Health insurance (nine months)

For spouse only $4,238

For all children $4,388

For spouse and children $6,784

*The OSU ID number is provided to

applicants by e-mail 15 days ater the

application has been submitted. I you have

not yet applied to Ohio State, please leave

this space blank.

Section 2 continued on other side

Section 2: Afdavit or personal sponsors

Use this afdavit i ull or partial unding is coming rom a personal source (amily, riend, or sel).

1. Ask each sponsor to (a) complete the Afdavit o Support rom Personal Sources (other side) indicatingull or partial support o your studies and (b) attach an ofcial bank statement(s). The name on the afdavitmust match the account holder on the bank statement(s).

2. Bank statements must be in English. English translations must be signed and sealed by the appropriatebank or government ofcial.

3. Each bank statement submitted must include the ollowing details:

Sponsors namethe translated name must be on the original document (not handwritten in)

Datedocuments must be dated no more than one year (12 months) prior to the date classes beginor the desired term o enrollment (see class start dates at go.osu.edu/bigcal)

Amount o available unds and the type o currency

7/27/2019 Osu Affidavit

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Afdavit o Support rom Personal Sources

Please check ONE:

h I will provide FULL FINANCIAL SUPPORT or the students educational and living expenses or the entire length o study at Ohio State.

h I will provide PARTIAL FINANCIAL SUPPORT or the students education and living expenses or the entire length o study at Ohio State

inthe amount o USD$ _____________ per year.

h I am sel-sponsored; I will provide my own unds. I have attached a bank statement(s) veriying that unding is available.

Check i appropriate:

h I will provide ull fnancial support or a spouse and/or children accompanying the student to the United States (see expenses on ront page).

Sponsors amily name/surname First/given name Middle name

Relationship to student

________________________________________________________________________ _____________________________Sponsors signature Date (month/day/year)

Section 3: Afdavit or agency sponsors

Use this afdavit i unding is coming rom a unding agency (government, organization, or institution/school).

Ask each unding agency to either complete the orm below OR attach a letter including the details o the award.

Afdavit o Support rom a Funding Agency

We, ________________________________________ (name o sponsor), hereby certiy that we will provide ull fnancial support associated

with tuition, ees, books, health insurance, and living expenses or ________________________________________ (students name) and, i

applicable, health insurance and living expenses or spouse and children or the entire length o study at Ohio State.

Study is approved or ___________________________________ (degree) in ___________________________________ (feld o study) at

The Ohio State University. Funding is eective or the entire length o study starting _____________________________ (Term: e.g., Autumn 2013

Ofcial title

Ofce or division

Address where tuition/ees will be billed, i applicable:

________________________________________________________________________ _____________________________Signature Date (month/day/year)

Ofcial seal/stamp o

unding institution

REQUIRED

Section 2 ,continued