************* UNIVERSITY
AFFEDAVITOF FINANCIAL SUPPORT FOR INTERNATIONAL STUDENTS
________________________________________________beingduly sworn, hereby depose and affirm that I am a; (Name of Supporter)
- _____Citizen of the United States
_____Citizen of People’s Republic of China (Name of Country) _____U.S Permanent Resident-Alien RegistrationNo.______________________________________ B. That I was born in 城市, China and reside at (City and Country) 城市 省 People’s Republic of China (City) (State) (Country) C. That I am willing and able to financially support:
自己姓名 出生日期 Father and Son (Nameof Student) (BirthDate) (Relationship) During the period of his/her stay in the U.S. by providing the: (COMPLETE) 1. Stipendof $ 1,000 per month for living expenses. 2. Tuitionand fees of $ 10,206 per annum. 3. Roomand board with me in the U.S.at __________________________ at an estimated cost to me of $__________________per year. 4. Othersupport (Describe)______________________________________________________________ __________________________________________________________________________________
D. That thefollowing is a true and complete statement of my financial status:
1. Mymain occupation is: Plantation Owners 2. I amemployed by:___________________________________________________________________ (Name and Addressof Employer)
Oroperate a business: Zhang’s Family Grape Plantation (Name of Business) 3. Myannual income: (After taxes and business expenses) $ 35,000 Which consist of salary or wages: $15,000interest and dividends; $_______________rental income: $____________Family income; $20,000other sources, (describe)__________________________________________________________________________ 4. I ownthe following assets: Real Estate valued at $_______________; Stocks and Bondsvalued at $________________; and Bank Deposits in the amount of$____________________________.
Notary Public Only
Subscribed and shown to before me this ____________day of______________________, _______, at______________________________________________________________ (year) (County) (State)
____________________________ (Name of Notary)
麻烦过来人帮我看看,红色的部分怎么填?另外,空着的地方要不要填?最后的notary public 公证人那几行具体怎么填?
|