SPONSOR’S AFFIDAVIT OF FREE ROOM AND BOARD
AND PROOF OF FINANCIAL CAPABILITY
By completing this affidavit, you are swearing to the U.S. government that this student will live with
you free of any charge for room and food for every year he/she is going to study at Molloy College and
live in the U.S. (The student cannot be required to provide you with any services such as, babysitting,
cleaning, etc., in exchange for the room and food, as that is employment) You are also proving that you
are the person who owns or rents the property and can afford the support you are promising with the
documents you have attached.
Before signing the affidavit of support, you must understand that you are making a financial
commitment to the student that should not be broken. Do not expect that the student will be able to
help support the costs through employment. Employment is strictly controlled by the U.S. Citizenship
and Immigration and Services and very limited.
HOW TO COMPLETE THE AFFIDAVIT OF FREE ROOM and BOARD:
1. Fill the form out completely in English.
2. Attach proof of support-- financial sponsors must show proof that they are capable of
providing the support for every year of the student’s program by attaching the following
documents:

Proof of Income- This must be on your employer’s business stationery, on income tax returns
or receipts, or estimated by a bank or private accountant if you are self-employed. The income
of a company will not be accepted as proof of income. You must provide an official statement
of the salary paid to you or it must appear on tax returns.

Photocopy of your deed, lease or rent receipts to prove that you are the person who owns or
rents the property.
3. Sign the affidavit in front of a notary public or the appropriate official in your country
The Proof of Income and deed, lease or rent receipts must be Photocopies or Faxes and Current (less
than two months old).
The Affidavit of Free Room and Board and all required documents should be returned to:
Molloy College
Enrollment Management Office
1000 Hempstead Avenue
P.O. Box 5002
Rockville Centre, NY 11571-5002
(over)
SWORN PROMISE OF FREE ROOM AND BOARD
I, _______________________________________________________, promise that for each year of
(name of financial sponsor, please print)
of his or her program of study, ______________________________________________________
(full name of student)
will live free of charge with me in my home at:
__________________________________________________________________________________
(street address)
__________________________________________________
City
I  own
State
______________________________
Zip
Home Telephone
 rent the above listed property.
If presently in the U.S., does the student currently live with you?  Yes  No
 I will not require any type of service (babysitting, cleaning, etc.) in exchange for providing free
room and board to this student.
My relationship to the student is _______________________________________________________
(parent, spouse, brother, sister, friend)
Name of my employer _______________________________________________________________
Annual Salary __________________(U.S. dollars)
My proof of income is attached
 Yes
Other Income______________(U.S. dollars)
 No
A copy of my deed or lease is attached  Yes
 No
I swear that the information I have provided above is true and correct
________________________________________________
Signature of Sponsor
__________________________
Date
Sworn and subscribed before me this day _________________________________________________
__________________________________________________________________________________
Signature of Notary
Notary Stamp