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Undergraduate Declaration and Certification of Finances

To Be Completed By Undergraduate Applicant

You are required to certify that you will have adequate financial support to cover your cost of education and living expenses for the entire period of study at Polytechnic Institute of NYU. A Certificate of Eligibility (Form I-20 or Form DS2019) for obtaining a student visa will not be issued until you have completed this form satisfactorily and submitted it with the official documents which verify your assets. Please read and fill out the form as per the instructions below.

Be sure to keep copies of all documents submitted as you will need this information when you apply to the United States Citizenship and Immigration Services for a visa.

Please have the following documents ready in electronic form before you start filling out this form.

  1. Affidavit of Support (This is a declaration which has to be filled by the applicant’s sponsor. Applicants who are sponsoring themselves need to fill out the affidavit of support as well).
  2. Proof of availability of funds such as bank statements indicating available funds, loan approval letters or any other demonstration of assets.
    1. All documents submitted as proof of availability of funds must be in the name(s) of those signing affidavits of support.  
    2. Certificate of Finance and Bank Statements must be dated within six (6) months of the start of classes for the incoming semester. Please submit the required documents as soon as possible, but not before March 1st (August 1st for Spring Admission).
  3. Copy of Applicant’s Passport and dependents’ passport(s), if any.
Biographic Information

As per passport

According to passport

According to passport

According to passport

Address where I20 should be sent.

#

Address where I20 should be sent.

Address where I20 should be sent.

Address where I20 should be sent.

According to passport

According to passport

According to passport

Upload a scan of your passport.

7 digit NYU-Poly ID number; 0######

Dependents

Enter details of any dependents (ex; spouse, children) if they are accompanying you.

According to his/her passport

According to his/her passport

Relation to the applicant

Upload a scan of dependent’s passport.

According to his/her passport

According to his/her passport

Relation to the applicant

Upload a scan of dependent’s passport.

According to his/her passport

According to his/her passport

Relation to the applicant

Upload a scan of dependent’s passport.

If more than three dependents are accompanying you, please upload their details in a single document.

Financial Information

Applicants must fill out either section I or section II or both.

You must be able to show adequate funds for your tuition fees (after deducting your scholarship, if any), living, and other expenses (minimum of USD 53,894 for a year. For every dependent, an additional USD 4000 must be shown).

Section I

To be filled by applicants who are self sponsored or are being sponsored by family.

Full name of the sponsor

Relationship to the applicant

Section II

To be filled out by applicants who are being sponsored by their government, employer, or some private agency.

$

Total amount available to cover applicant's tuition and living expense, a minimum of $53,894

Bank letters or government sponsored letters or employer letters or private agency letters or others

Affidavit of Support

This is a declaration which has to be filled by the applicant’s sponsor and should be notarized. Applicants who are sponsoring themselves need to fill out the affidavit of support as well.

Additional Document(s)
Applicant's Agreement

By checking this box, I certify that the information above is an accurate statement of my arrangements for financing my studies at Polytechnic Institute of NYU.