Student I-20 Acknowledgement

STUDENT I-20 ACKNOWLEDGEMENT

Student Information

Student Name:

Student ID:    SEVIS ID:

Date of Birth:    Country of Citizenship:

Major / Field of Study:    Level:

Program Start Date:    Program End Date:

I-20 Issue Date:    I-20 Program Begin:

Contact & Emergency Details

Relationship:    Phone:    Email:

Funding and Financial Responsibility

I acknowledge that I am responsible for maintaining sufficient funding for tuition, fees, living expenses, and health insurance for the duration of my studies. I certify that the following sources will cover my expenses (select all that apply):

Personal funds / savings
Scholarship or institutional award
Family or private sponsor
Loan
Other (describe below)

Student Obligations and Acknowledgements

By signing below I acknowledge and agree to the following obligations required to maintain F-1 status and the accuracy of my Form I-20. I have read each statement and indicate my acceptance by checking the box beside each item.

I will maintain full-time enrollment each academic term unless an authorized reduced load is approved by the Designated School Official (DSO). Failure to maintain full-time status without authorization may result in termination of SEVIS record.

I will report any change of U.S. address, legal name, program of study, or funding within 10 days to the DSO to ensure the I-20 and SEVIS records remain accurate.

I understand employment is restricted. I will obtain prior authorization from the appropriate office (DSO or authorized federal program) before beginning any on-campus or off-campus employment (including CPT/OPT). Unauthorized employment may result in loss of status.

I am responsible for maintaining a valid passport at all times while in the United States and for ensuring the passport expiration date allows required travel and immigration processing.

I understand that travel and re-entry to the United States require a valid I-20 with a recent travel endorsement by the DSO, a valid passport, and appropriate visa; it is my responsibility to obtain and carry these documents.

I will apply for a program extension or change of level before the I-20 end date if I require additional time to complete my program. I understand extensions are approved only for compelling academic reasons and require supporting documentation.

I understand that failure to comply with immigration or institutional requirements may result in termination of my SEVIS record and that reinstatement is not guaranteed.

Certification

I certify under penalty of perjury that the information I have provided on this acknowledgement and attached documents is true, complete, and accurate to the best of my knowledge. I acknowledge that knowingly providing false information to the school or to immigration authorities is a violation of federal law and may result in adverse immigration consequences, including denial of benefits, termination of status, and possible removal proceedings.

I further authorize the school to update my SEVIS record and take administrative action consistent with federal regulations when changes to my academic, financial, or personal status are reported or discovered. I understand that the DSO is the official school representative responsible for maintaining I-20 accuracy and reporting obligations to the appropriate immigration authorities.

Signature

If the student is under the age of majority in the state or jurisdiction of residence, a parent or legal guardian must also sign below.

By signing, the signer affirms that they have authority to sign on behalf of the student if signing as parent or legal guardian, and that they have read and understand the obligations set forth in this acknowledgement.

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