STATEMENT

OF HAVING FINANCIAL SUPPORT

*Please fill with CAPITAL letters

I, the undersigned below:

Complete name :

Sex : □ Male □ Female

Place, date of birth :

Nationality :

Passport number :

Marital status : □ Married □ Unmarried

Major/Department :

Duration of Study : ………………*days/months/year

understand that students under self-funding program are responsible for any cost incurred for studying at
Universitas Sebelas Maret (UNS) Surakarta, while students under scholarship program provided by the
university will be given financial assistance with certain limit.

I hereby state that I will follow the university regulations regarding the education fee and scholarship
provision, and that I have financial support and I am responsible for any additional cost for living,
travelling to Indonesia and back, and other personal expenses during my study at UNS.

……………., ………………………… *place, date of letter

*sign here

(………………………………………..)*name