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University of Pittsburgh Office of Admissions and Financial Aid___________________________________

Office of Admissions and Financial Aid Alumni Hall, 4227 Fifth Ave Pittsburgh, PA 15260-6601 U.S.A. Phone: 412-624-7488 Fax: 412-648-8815 www.oafa.pitt.edu

Information Regarding Financial Support Requirements & Certification of Financial Responsibility 2013-2014
You MUST review the following instructions before completing and signing this form. Failure to read the instructions and complete the form correctly will result in delays in the processing of your application and issuance of your visa document.
1. 2. Review the estimated tuition and fees and estimated living costs (including transportation, boarding, personal and books) and the estimated length of the degree program to which you are applying. Complete the certification indicating the amount of support that will be provided from each source for each year of the program. You MUST show immediately available liquid assets for the first year only. (NOTE: Liquid assets include money in a banking account, stocks, bonds, or other investments with cash value. Retirement accounts cannot be used as a source of financial support unless the sponsor can provide evidence that he/she is, in fact, retired and able to access those funds without penalty for early withdrawal. Real estate or other non-liquid asset such as automobiles, jewelry, or other personal property cannot be used as a source of financial support under any circumstances). For the following years beyond year one, you must document the availability of finances as well, but they do not have to be in immediately available liquid assets. Financing for the subsequent years can be demonstrated by providing letters or other documentation verifying ongoing anticipated earnings such as salary or investment income, or other assets that will demonstrate your ability to fund your program for the entire duration of the program. All proof of financial support must be submitted in English. All proof of financial support must be stated in U.S. dollars and clearly state the date that the documentation was written or printed. All proof of financial support must be an original document. Please be aware that evidence of financial support must also be shown to the U.S. Embassy or Consulate when applying for a visa. Therefore, you will need to have two sets of financial support documents—one to submit to the University of Pittsburgh and one for the U.S. Embassy or Consulate. More than one sponsor may be used. More than one sponsor may copy this form for use. Mail the completed form(s) to the address in the upper right corner of this document.

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Undergraduate Cost and Length of Study Figures for 2012-2013
The figures below are for Academic Year 2012-13, effective Fall Term 2012. The costs for Academic Year 2013-14 were not available at the time of printing. For immigration purposes, providing evidence of financial support to meet the costs outlined below is sufficient; however, please note that actual costs will likely increase for 2013-14.

Pittsburgh Campus: ▪ Kenneth P. Dietrich School of Arts and Sciences ▪ College of Business Administration ▪ School of Engineering ▪ College of General Studies ▪ School of Nursing Pittsburgh Campus -Upper-Level Undergraduate: ▪ School of Education ▪ School of Information Sciences ▪ School of Health & Rehabilitation Sciences ▪ School of Social Work Regional Campuses: ▪ Bradford Campus (except) Nursing ▪ Greensburg Campus ▪ Johnstown Campus (except) Engineering Technology (except) Nursing (except) Respiratory Care ▪ Titusville Campus (except) Nursing

Tuition/Fees $26,280.00 $29,498.00 $28,636.00 $26,280.00 $33,168.00 $26,280.00 $28,322.00 $33,168.00 $26,280.00 $23,286.00 $29,442.00 $23,286.00 $23,288.00 $25,394.00 $29,444.00 $24,826.00 $20,698.00 $29,302.00

Living $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00 $14,124.00

Insurance $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00 $1,703.00

Total/year $42,107.00 $45,325.00 $44,463.00 $42,107.00 $48,995.00 $42,107.00 $44,149.00 $48,995.00 $42,107.00 $39,113.00 $45,269.00 $39,113.00 $39,115.00 $41,221.00 $45,271.00 $40,653.00 $36,525.00 $45,129.00

Length 4 years 4 years 4 years 4 years 4 years 2 years 2 years 2 years 2 years 4 years 4 years 4 years 4 years 4 years 4 years 4 years 2 years 2 years

Provided each year from annual salary/income. I/we will provide funds from the following sources: Year One 1 1. Phone: 412-624-7488 Fax: 412-648-8815 www.Office of Admissions and Financial Aid Alumni Hall.pitt. . or other assets that will demonstrate your ability to fund your program for the entire duration of the program. Total annual salary in $US _________________ You MUST attach documentation annual salary/income. Total Available from All Sources: _________ _________ _________ _________ Signature of Sponsor Date Signed 1 Support for the first year must be in immediately available liquid assets. Provided from other sources. 3. Subsequent years can be demonstrated by providing letters or other documentation verifying ongoing anticipated earnings such as salary or investment income.oafa. You MUST identify source(s) and attach documentation. Provided from bank account with a total in $US _____________________. You MUST attach an Official Bank Statement. 4227 Fifth Ave Pittsburgh.S.A. _________ Year Two _________ Year Three _________ Year Four _________ to _________ _________ _________ _________ _________ _________ _________ _________ 4.edu Certification of Financial Responsibility Student’s Name Family Name Department/School Given Name Middle Name Sponsor’s Name Family Name Sponsor’s Address (Number and Street): Given Name Middle Name City: State/Province: Country: Postal Code: Phone: / E-Mail: Relationship of Sponsor to Student: Certification of Financial Responsibility I/we hereby certify that I/we will provide financial support for engage in a program of study at the University of Pittsburgh. PA 15260-6601 U. 2.