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UG I-20 Request Form

The document is a financial certification form required by Brown University for international students to obtain a Certificate of Eligibility (I-20) for a student visa. It requires personal data, sources of funds, and certifications from bank officials and sponsors. Students must complete and upload the form to the OISSS Gateway as soon as possible.

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15 views1 page

UG I-20 Request Form

The document is a financial certification form required by Brown University for international students to obtain a Certificate of Eligibility (I-20) for a student visa. It requires personal data, sources of funds, and certifications from bank officials and sponsors. Students must complete and upload the form to the OISSS Gateway as soon as possible.

Uploaded by

bayannotvsani
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

BROWN UNIVERSITY Financial Certification

Please upload to OISSS Gateway, as indicated in your instructions.


Read carefully, complete as appropriate, and upload as soon as possible. When we receive this form and other applicable
materials, we will be able to issue the Certificate of Eligibility (I-20), which will enable you to obtain a student visa.

PERSONAL DATA: (Please print)

NAME (As It Appears on Your Passport):


Family Name (Surname) First (Given) Name Middle Name (in full)

DATE OF BIRTH: COUNTRY OF BIRTH: CITY OF BIRTH


Month Day Year

COUNTRY OF CITIZENSHIP: *
*If you are a citizen of more than one country, please indicate the country which issued the passport you will be using for your student visa application.

SOURCES OF FUNDS: ASSURED PROJECTED SUPPORT


SUPPORT (Include 5% cost increase per year)
First Year Second Year Third Year Fourth Year
SELF-SUPPORT

Name of Bank
A bank official’s signature is required on the certification below.
PARENTS OR INDIVIDUAL SPONSORS

Name

Bank
Parent’s or sponsor’s signature and a bank official’s signature are
required on the certification below.
YOUR GOVERNMENT OR OTHER SPONSORING AGENCY

Name of Agency

Enclose with this form a signed copy of your letter or award.


UNIVERSITY JOB
This information may be obtained from your
financial aid award letter. LOAN

GRANT

OTHER (SPECIFY):

Enclose with this form a signed and stamped affidavit from an


authorized person to certify the accuracy of this entry.
Each of these totals should equal the institution’s estimate of
expenses for one year. TOTAL
OFFICIAL CERTIFICATION OF SOURCES OF FUNDS AND AMOUNTS
This is to certify that I have read the information furnished by the applicant on This is to certify that I have read the information furnished by the applicant on
this form, that it is a true and accurate statement, and that the funds are this form, that it is a true and accurate statement, and that the funds are
available. available.
SIGNATURE AND STAMP SIGNATURE OF
OF BANK OFFICIAL GUARANTOR
Parent or Sponsor
NAME & TITLE NAME & RELATIONSHIP
TO STUDENT
BANK ADDRESS
ADDRESS
DATE
DATE
I certify that the information provided here is correct and complete.

SIGNATURE OF STUDENT DATE

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