F-1 INTERNATIONAL STUDENT GENERAL AFFIDAVIT OF

F-1 INTERNATIONAL STUDENT GENERAL AFFIDAVIT OF SUPPORT

January 2025 – General - Updated: 08/03/2024 - Page 1 of 4

Directions

READ all information and then complete the form in its entirety for each sponsor including self-funded students.

This form must be completed individually for each student sponsor. If the student is self-funded, the student must also complete

this form individually. The financial statements must match the submitted affidavit of support. This form must be completed

electronically. Please download Adobe Acrobat Reader DC (free version) and complete form by using the pen function in the toolbar.

The “IAb” button will allow you to type in the space provided and the “Sign Yourself” button will allow you to provide the necessary

electronic signatures. The X and ✓ will allow you to mark appropriate boxes. Please download the form to your desktop, right click, and

“open with” Adobe Acrobat Reader DC. Opening in a web browser extension does not allow for the functionality to complete the form

electronically. INCOMPLETE AND/OR HANDWRITTEN AFFIDAVITS WILL NOT BE ACCEPTED.

Statement of Purpose of this Document

International students must provide financial evidence showing the student or sponsor(s) have sufficient funds to cover full tuition and

expenses for their first year of study before UMSL can issue an I-20 or DS-2019. Though the requirement of evidence is only for one

academic year, funding from the student or the sponsor must be available during the entire period of intended study. This form

is intended to accompany the financial statements for the first year of study as evidence that the student and/or sponsor(s) are aware of

the financial and legal obligations during and beyond the first year of study until the completion of the student’s program of study.

1. STUDENT LEGAL BIOGRAPHICAL INFORMATION – PLEASE COMPLETE ALL FIELDS

For living address, please provide as many details as possible, including house number, flat/apt number, street name, zone, province, postal code etc.

Family/Last/Surname(s) (if the student has 1 name, please type here)

Given/First/Forename(s) (if the student has 1 name, please type FNU)

Permanent Living Address in Home Country (cannot be a PO BOX)

City, County, Province/State, Country, Postal Code - Permanent Address

TRANSFER STUDENTS – US Living Address (cannot be a PO BOX)

TRANSFER STUDENTS – US City, State, Zip

Student Personal Email Address (email the student checks personally)

Student Personal Phone Number with Country Code

+( ) -

Passport Country of Issuance

Passport Number

Country of Citizenship

Country of Birth

City of Birth

Date of Birth - MM/DD/YYYY

Planned Level of Program

Bachelor Only (choose one)

Bachelor

Master

Doctor/Professional

Freshman

Transfer

I currently have an active SEVIS

Record with another institution (for

students transferring their SEVIS

Record to UMSL)

I currently have an initial status

SEVIS Record with UMSL (for

students deferring to a new

semester)

Planned Major of Program

Planned Semester to Start

YES NO

FALL SPRING 20_________

2. DEPENDENTS

Does the student plan to bring dependents with them? YES NO

• If yes, Number of Dependents: ___________

• If yes, check all that apply: SPOUSE CHILD <unmarried, under 21 years of age>

$4000 for EACH dependent must be added the total amount shown on financial documents.

Additional documents are required for each planned dependent, these should be declared in the Triton Portal as part of the application

and uploaded accordingly.

Dependents who are not added to the student's application at the time of admission will only be eligible for addition during the student's

second semester at the university. No exceptions will be made to this policy.

F-1 INTERNATIONAL STUDENT GENERAL AFFIDAVIT OF SUPPORT

January 2025 – General - Updated: 08/03/2024 - Page 2 of 4

3. FUNDING

I __________________________________________________________am funding my educational and living expenses in the US by:

Choose ONE Only

 Self-Funding OR  Sponsor-Funding OR  Both Self-Funding AND Sponsor-Funding

Please complete an affidavit of support for each person and/or organization funding the student’s program of study and expenses including

those students who are self-funded. Each sponsor must have an individual affidavit to accompany the submitted documents.

4. DOCUMENTS PROVIDED (COMPLETE ALL COLUMNS FOR FUNDING SOURCE)

An affidavit of support for each sponsor must be completed. If one sponsor has multiple documents the same affidavit may be completed.

Please complete this area for the documents being submitted by the sponsor associated with this specific affidavit of support. If there is

a different sponsor named on different documents, an affidavit must be completed for each individual sponsor or sponsor organization

including self-funding by the student. UMSL Global recommends https://www.xe.com/ for currency conversion.

Type of Document

Full Legal Name of Account

Holder OR Organization on

Document

Name of Financial Institution

OR Organization on

Document

Date of

Document

MM/DD/YYYY

Amount in

$USD$

on Document

Bank Statement of Student

Bank Statement of Sponsor

External Scholarship

Government / Employer

Loan Statement - Student

Loan Statement - Sponsor

UMSL Assistantship

Total Amount of Funds Provided for this affidavit for this sponsor on all Documents in $USD$ for Year 1

5. SPONSOR-FUNDED: PLEASE PROVIDE SPONSOR INFORMATION AND SIGNATURE

A separate affidavit is required from each sponsor providing support. If one sponsor has multiple documents the same affidavit may be

completed. However, if there is a different sponsor named on different documents, an affidavit must be completed for each individual

sponsor or sponsor organization including self-funding by the student and UMSL Assistantship. Self-Funding Attestation is on Page 3.

Sponsor Legal Biographical Information – Please complete ALL fields as applicable

Legal Relationship to Student: Parent Spouse Grandparent Sibling Aunt/Uncle

Sponsor Organization: _____________________________________________________________________________________

Other (explain):

Family/Last/Surname(s) (if the sponsor has 1 name, please type here)

Given/First/Forename(s) (if the sponsor has 1 name, please type FNU)

Permanent Living Address in Home Country (cannot be a PO BOX)

City, County, Province/State, Country, Postal Code - Permanent Address

Sponsor Personal Email Address (email the sponsor checks personally)

Sponsor Personal Phone Number with Country Code

+( ) -

Organization Name (if sponsor is not an individual) (UMSL Assistantship)

Full Name of Contact at Organization (if sponsor is not an individual)

Organization Contact - Email Address (if sponsor is not an individual)

Organization Contact - Phone Number with Country Code

+( ) -

Sponsor Attestation

This is to certify that I, the undersigned, have agreed to provide the funds indicated above to fund the financial expenses of the above-

mentioned student for the purpose of full-time study at the University of Missouri-Saint Louis (UMSL). I am submitting financial statements

verifying the availability of these funds. I understand that the applicant is not eligible for financial aid and that UMSL cannot provide need-

based financial assistance or a guarantee of on-campus employment. I further understand that I must provide these funds for the duration

of the applicant's course of study and that if the commitment is not met, the student is subject to dismissal from UMSL for non-payment.

- (UMSL Assistantship Department does not need to sign) -

___________________________________________________________________________________________________________

Full Legal Signature of Sponsor or Organization Designee Date: DD/MONTH/YYYY <ex: 23/January/2018>

F-1 INTERNATIONAL STUDENT GENERAL AFFIDAVIT OF SUPPORT

January 2025 – General - Updated: 08/03/2024 - Page 3 of 4

Required Documentation

All financial statements must be less than 6 months old from the date of submission of affidavit of support and statement. All

documents older than 6 months will be rejected. Please note that advisors reserve the right to request updated statements or additional

documentation. If student defers admission, updated financial statements will be required.

Bank Statement

• Bank statements must clearly indicate the financial institution's name, the account holder's name, the account balance, and type of

currency. Statements must show liquid assets only. Bank letters must be on letterhead with bank address.

Government / Employer Funding

• An official award letter on letterhead that clearly indicates the provider, the student’s name, the amount of the award, the duration

of the award, and that the award is valid for study at UMSL.

Loans

• An official letter on letterhead from the financial institution that clearly indicates the student’s name and amount of award.

• Conditional loan approvals will be accepted only if the condition is the receipt of your I-20 or DS-2019 and is clearly stated

External Scholarship

• An official award letter on letterhead that clearly indicates the scholarship provider, the student’s name, the amount of the award,

the duration of the award, and that the award is valid for study at UMSL.

UMSL Assistantship

• If you have earned or been awarded a Graduate or Teaching Assistantship prior to arrival to UMSL that will cover all or most of

your tuition and expenses, please ensure that you have the final letter of award in your file for inspection

• Please list individual who signed the letter as the person of contact

The following types of funding are NOT accepted:

• Documents older than 6 months from the date of submission

• Income statements, tax documents, and promissory notes

• Assets not in liquidated form (house, car, etc.)

• Documents not on official letterhead indicating the financial institution and the location of the institution

• Investments, pensions, and provident funds, unless it is clearly stated that funds can be withdrawn at any time

6. SELF-FUNDING ATTESTATION: PLEASE PROVIDE NAME, INITIALS, AND SIGNATURE

The student must complete this section of the form if the student is either completely or partially self-funded. Sponsor-Funding

attestation is on Page 2. This section may be left blank if the student is NOT self-funding their own financial expenses.

I _____________________________________________am funding my own educational and living expenses either fully or partially.

I, the student, have declared I am fully funding or partially funding my own program of study. By placing my initials in each line and

signing below, I acknowledge the following:

I understand:

• the United States’ federal government strictly limits work opportunities available to international

students.

• should not plan to subsidize my expenses through legal or illegal employment.

TYPE Initials Here

I understand:

• international students are not eligible for federal financial aid nor domestic scholarship programs.

• there are no need-based scholarship programs for international students at UMSL.

TYPE Initials Here

I understand

• I must demonstrate remaining tuition and living expenses after being awarded any internal UMSL

Global Scholarships (if applicable)

• I must provide the full amount of tuition and expenses after sponsoring financial are applied (if

applicable)

• I must provide these funds for the duration of my program and that if the commitment is not met, I am

subject to dismissal from UMSL for non-payment.

TYPE Initials Here

___________________________________________________________________________________________________________

Full Legal Signature of Student Date: DD/MONTH/YYYY <ex: 23/January/2018>

F-1 INTERNATIONAL STUDENT GENERAL AFFIDAVIT OF SUPPORT

January 2025 – General - Updated: 08/03/2024 - Page 4 of 4

7. FINAL STUDENT ACKNOWLEDGEMENT AND SIGNATURE

STUDENT MUST READ AND SIGN HERE OR FORM WILL BE INCOMPLETE. If there are multiple sponsors, including a

combination of self-funding and sponsor-funding, the student must complete and sign every affidavit submitted.

• I certify that the information on this form is complete and accurate to the best of my knowledge.

• I am aware that false information will result in denial or cancelation of my I-20 / DS-2019 and enrollment.

• I understand that international students are not eligible for federal financial aid, need-based scholarship programs, or domestic

scholarship programs.

• I acknowledge that the United States’ federal government limits work opportunities available to international students and that I

should not plan to subsidize my studies through employment.

• If I receive a merit-based scholarship from UMSL Global, I understand that the amount of my award cannot be increased and if

guidelines of the scholarship are not followed, I will no longer be eligible for the scholarship.

• I understand that UMSL reserves the right to cancel the registrations in all my courses if the University has not received and

processed the required minimum payment for my assessed fees by announced deadlines, which has implications for my ability to

maintain my legal non-immigrant status.

___________________________________________________________________________________________________________

Full Legal Signature of Student Date: DD/MONTH/YYYY <ex: 23/January/2018>

___________________________________________________________________________________________________________

Type Full Legal Name of Student Birthdate of Student: DD/MONTH/YYYY <ex: 23/January/2018

Program

Months

per

Academic

Year

24/25

Tuition per

Credit

Hour

Credit

Hours per

Academic

Year

Estimated

Tuition

Total

Estimated

Intl Fees

Total

24/25

Tuition +

Fees Total

Estimated

Living

Expenses

Estimated

Health

Insurance

Estimated

Bo oks,

Supplies, &

Incidentals

24/25

Expenses

Total

24/25

Total

Financial

for I-20

Undergraduate

Arts & Sciences; Education; Social

Work

9 $1,253 30 $37,590 $200 $37,790 $12,778 $2,842 $4,346 $19,966 $57,756

Business 9 $1,317 30 $39,510 $200 $39,710 $12,778 $2,842 $4,346 $19,966 $59,676

Nursing (BSN) 9 $1,362 30 $40,860 $200 $41,060 $12,778 $2,842 $4,346 $19,966 $61,026

Engineering

(BSCIE, BSEE, BSME)

9 $1,372 30 $41,160 $200 $41,360 $12,778 $2,842 $4,346 $19,966 $61,326

Graduate (Master and Doctorate)

Arts & Sciences; Social Work 9 $1,533 18 $27,594 $200 $27,794 $15,811 $2,842 $1,313 $19,966 $47,760

Education 9 $1,582 18 $28,476 $200 $28,676 $15,811 $2,842 $1,313 $19,966 $48,642

Business 9 $1,695 18 $30,510 $200 $30,710 $15,811 $2,842 $1,313 $19,966 $50,676

Nursing 9 $1,821 18 $32,778 $200 $32,978 $15,811 $2,842 $1,313 $19,966 $52,944

Graduate (Special Tuition Rates)

IMBA 1+1 12 $1,695 27 $45,765 $200 $45,965 $15,811 $2,842 $1,313 $19,966 $65,931

IMBA 3+2 - UNDG Year 1 12 $1,317 30 $39,510 $200 $39,710 $15,811 $2,842 $1,313 $19,966 $59,676

IMBA 3+2 - GRAD Year 2 12 $1,695 21 $35,595 $200 $35,795 $15,811 $2,842 $1,313 $19,966 $55,761

DBA 12 $1,764 24 $42,336 $200 $42,536 $15,811 $2,842 $1,313 $19,966 $62,502

Optometry OD 9 $1,502 32 $48,064 $2,000 $50,064 $15,811 $2,842 $1,313 $19,966 $70,030

Dependents

Spouse $4,000

for spouse

Child $4,000

for each child

Estimates are based on minimum required credit hours per federal regulations and/or specific academic program requirements.

Minimum credit hour requirements for scholarship recipients and academic programs may differ from minimum regulation requirements.

Oak Hall + 200

Notes

Tuition, fees, and expenses are based on projected estimates for the 2024/2025 academic year and are subject to increase.

All projections are estimated.