Declaration of finances: f-1 Visa Applicants Student Name: as given on passport First Name Middle Name Family Name Country of Birth


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DECLARATION OF FINANCES: F-1 Visa Applicants 
 
Student Name:
as given on passport 
First Name 
Middle Name 
Family Name 
 
Country of Birth
Country of Citizenship
Mailing Address
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


____________________________________'>AFFIRMATION OF AVAILABILITY OF PERSONAL FUNDS 
Certification by bank official
Official bank seal or stamp 
I verify that ___________________________________ (
account owner

has funds on deposit or available in the amount of $______________ in 
U.S. dollars to support the above-named student’s expenses.
_____________________________________ 
____________________ 
Signature of bank official
Date 
Name of bank official (please print):_____________________________________ 
Name of bank ________________________________ _________________ 
Address of bank __________________ _____________________________ 
I hereby state that I am willing and able to provide the funds stated for the educational expenses of the above
-named student. I understand that the tuition and fees are subject to change yearly without prior notice.
Signature:
Date: 
Title or relationship to the student applicant: 
AFFIRMATION BY STUDENT 
I certify that the information on this form and in any other supporting documentation, bank statements, letters etc. are true and correct. 
I
 understan d that any false information, willful or negligent misrepresentation, or failure to disclose any requested information will 
constitute grounds for 
California Lutheran University revoking my acceptance and may jeopardize my visa status.
Date 
Student signature

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