Form IS-50, Financial Certification

Form IS-50, Financial Certification
Part I. Requirements and Expenses
Requirements:
United States (US) Universities are required by law to verify that students entering the US with temporary student visas have adequate
financial resources to meet the expenses of their program of study. You must complete this form in order to receive a Certificate of
Eligibility (Form I-20 or DS-2019) from Clemson University (CU), which you will use to apply for your US student visa. All
signatures and documentation provided must be originals and must be less than six months old. Support may come from any
combination of sources, including personal, family, or sponsored funds. Be sure to provide documentation for each source of funding.
If you have more than one sponsor, print or copy this form as many times as necessary and then upload all documents to the portal.
Annual Expenses (Minimum amount you must show available to you):
Tuition and Fees (includes Health Insurance)
Living Expenses
Undergraduate
$31662.00
$12250.00
Graduate
*$17758.00
$12250.00
$1100.00
$42950.00
$1100.00
$31108.00
Books and Supplies
TOTAL
Dependent
$6000.00 for spouse
$4380.00 per child
*For exact tuition and fees for your program, please see: http://www.clemson.edu/cfo/student-financials/tuition-fees/index.html
Additional Information:
University tuition, fees and health insurance costs are subject to change without notice. You should not plan to obtain a graduate
student assistantship or other financial aid after your arrival if you have not already been offered such assistance. If you are offered an
assistantship, a portion of your tuition will be waived by the university. In lieu of tuition, the Graduate Assistant will be required to
certify the amount for fees ($2100.00 per year), living expenses ($12,250 per year), and books & supplies ($1100 per year).
Part II. Student Information: Please type in information
1. Family Name
First Name
Middle Name
2. ☐ Male ☐ Female Date of Birth (mm/dd/yyyy)______________________ Country of Birth
City of Birth ____________Country of Citizenship________________ Country of Lawful Permanent Residency______________
3. Mailing Address (this is where your Form I-20/DS2019 will be sent)___________________________________________________
______________________________________________________ Email Address_______________________________________
Degree Level ☐Bachelors ☐Masters ☐Ph.D.
Program Start Date ☐Fall
Degree Program (major)_________________________________
☐Spring ☐Summer I ☐Summer II
4. Please Check the Appropriate Response:
☐I request a Form I-20 to apply for an F-1 Visa
☐I request a Form DS-2019 to apply for a J-1 Visa
☐I will be transferring my F-1/J-1 SEVIS record to CU from: ___________________________________(name of current US school)
I currently hold a valid ☐F-1 Status
☐J-1 Status ☐Other: _____________________________________
5. Provide the following information and proof of relationship for each dependent you plan to bring to the US:
Full Legal Name
Relationship (spouse/child)
Date of Birth (mm/dd/yyyy)
City of Birth
Country of Birth
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(864) 656-3614
www.clemson.edu/ia
is@clemson.edu
4/28/2015
Page 1 of 2
Form IS-50, Financial Certification
Part III. Funding Sources
You will need to prepare sufficient financial support for the entire period of study. The usual amounts of time to complete degrees at Clemson are:
Doctorate-72 months (6 years), Master’s-24 months (2 years), Bachelor’s-48 months (4 years). Monetary support may come from any combination of
sources (sponsor, family, personal, graduate assistantship-but only if you have already been notified that you are receiving one). You must provide a
certified bank statement or other certified financial documentation showing you have immediate access to funds for at least one academic
year or duration of your stay if your program is shorter than one academic year.
Part IV. Sponsor Information
Note: Government-sponsored or scholarship recipients must provide a copy of the official award letter. The letter should include the
US dollar amount (per year) of the award. Scholarship letters must state that the scholarship has been awarded for study at Clemson
University and should list the expenses covered by the award as well as the maximum amounts available to cover each expense (fees,
books, housing, etc.). Letters for transfer students must also specifically state that funds will be available for study at Clemson
University. If the financial document is not in your name, the account holder is your sponsor. A sponsor refers to the individual(s) who
will support and pay for your stay. The sponsor must complete and sign the following section of this form.
I certify that I have read the information furnished by the student on this form, that it is true and accurate, and that the funds are
available to the student for expenses while studying at Clemson University. I guarantee that the funds are available to the student for
the first academic year at Clemson University (including funds for dependents that will accompany or join the student).
TOTAL Funds Available to the student $______________________________________ (United States Dollar)
1.
Sponsor’s Name _________________________________ Sponsor’s Visa Status, if in the US ________________________
2.
Sponsor’s Address_____________________________________________________________________________________
3.
Sponsor’s Telephone Number ________________________________ Email Address _______________________________
4.
Relationship of Sponsor to Student _______________________________________________________________________
5.
Sponsor’s Signature ____________________________________ Date ___________________________________________
By signing, I certify that the funds are available for at least one academic year at Clemson University for the student and dependents.
Part V. Student Statement
I, _________________________________________ (student name), certify that the information furnished is true and accurate. I
guarantee that the funds available for my first academic year at Clemson University (including funds for dependents who will
accompany me) TOTAL: $________________________ (United States Dollar)
Student Signature ______________________________________________ Date ________________________________________
Please upload this form along with your supporting financial documents to the iStart Student Portal under the E-Form: Financial
Certification
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(864) 656-3614
www.clemson.edu/ia
is@clemson.edu
4/28/2015
Page 2 of 2