We ask you to provide this confirmation as well as copies of the documents mentioned below!

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1 Nam: Matriculation numbr: W ask you to provid this confirmation as wll as copis of th documnts mntiond blow! Plas submit your documnts to th administration offic of th HTU Graz or by arrangmnt soztopf@htu.tugraz.at with an associat. Documnts rquird (copis only): VITAL prsonal documnts: Polic rgistration form Copy of visa(forign studnts only) Latst rcord of studis, nrollmnt/continuation confirmation Transcript of rcords, diploma crtificat(s) Prsonal and parntal proof of incom/wag slip Complt continous prsonal bank statmnts for th thr (3) months prior to application (original statmnt or stampd and signd by your bank) displaying your currnt account balanc Rntal contract Confirmation of paymnt of thr (3) past montly rnts, if not shown on bank statmnt Rcipts for all monthly (or ontim) xpnss and rvnu (xcpt food stuffs) - Th purpous of xpnss/slf-dposits/ cash withdrawal abov 100 must b statd! Dscription and tstamnt of hardships (.g. mdical crtificats, thft rport, proof of costs for thrapy and tratmnt, confirmation of back rnt or th lik) 1

2 Extras, if availabl: Copy of your crdit card bill All pags of th study assistanc notic (dclind notics as wll) Proof of othr scholarships notic for th social fund from th Austrian Fdral Studnt Council of Vinna latst confirmation for diploma thsis or dissrtation notic for lav of absnc from th dgr cours Support agrmnt, confirmation of advancs in maintnanc paymnts, confirmation of maintnanc paymnts Dclaration of costs for psychological thrapy: What kind of tratmnt ar you rciving? Sinc whn? Who is your thrapist (Is h/sh listd in th Austrian dirctory for authorizd thrapists? How oftn hav sssions bn carrid out? How much is bing rfundd by your halth insuranc?) Do you liv with your partnr/parnts/child(rn)? Crtificat of rgistration for: Your partnr Your child(rn) Proof of incom for: Your partnr Marriag crtificat Birth crtificat of child 2

3 Rqust for social bnfits from HTU-Graz Prsonal information Surnam: Nam: addrss (TU): Tlphon numbr: Strt nam: Postal cod & City: Nationality: Dat of birth: Plac of birth: Marital status: Sx: mal fmal Who livs with you in your collctiv houshold? Shard apartmnt Alon Parnts Siblings Dormitory Do you hav childrn? Ys No If so, how many? Cours of studis: What smstr ar you in? Matriculation numbr: Rcipiant of scholarship(s): Ys No and how old ar thy? Hav you vr rcivd funds from th social fund (HTU Graz)? No Ys Whn?: 3

4 Social fund of th Austrian National Union of Studnts of Vinna Hav you rcivd funds from th social fund of th Austrian National Union of Studnts in th past smstr? Ys No If so, how much? Dclaration of your monthly incom What is your sourc of incom? Plas stat your financial situation truthfully! Child bnfit: Scholarship(s): Pnsions, rtirmnt bnfits: Housing bnfit: Do you work? If so, what is your monthly incom: Unmploymnt bnfit / social bnfits: Support from family, rlativs & frinds: Support from govrnmnt, township or othr sourcs: Parntal lav allowanc / child bnfit: Othr (.g. donations, child support, and th lik): If you hav a cohabitant or a spous plas stat thir occupation and monthly incom: Occupation: Incom: 4

5 Dclaration of your monthly xpnss Blg notwndig! Rnt (incl. oprating costs): Houshold insuranc: Elctrical and. hating: Travl costs: Halth insuranc: Childcar allowanc: Othr: Tuition: Ys No Rqust for tuition rfund submittd: Ys No Rason If you hav currntly falln bhind on paying rnt plas stat your arrars: Dclaration for your parnts/partnr Partnr s nam, occupation & monthly incom: Partnr s addrss: Mothr s nam, occupation & monthly incom: Mothr s addrss: Fathr s nam, occupation & monthly incom: Fathr s addrss: 5

6 Dscription of currnt hardships Submit lgibly handwrittn or computr gnratd dscriptions only! Non-lgibl dscription will b dclind automatically! 6

7 Bank dtails IBAN: BIC: Account holdr: Copis of rcipts for all xpnss claimd (xcpt food stuffs) must b providd. Incomplt or untruthful dclarations and documts - in particular thos rgarding your financial situation - will b rjctd HTU Graz dos not assum liability for transmission rrors or othr rrors which might occur during submission Applicants hav no lgal claim to th srvics of th dpartmnt of social policy. Ys, I hav rad and undrstood all of th information givn hr. I hrby accpt that prsonal idntification and application data will b archivd and may b transmittd to funding institutions. My signatur confims that th information providd is tru. Dat: Signatur: 7

Remember you can apply online. It s quick and easy. Go to www.gov.uk/advancedlearningloans. Title. Forename(s) Surname. Sex. Male Date of birth D

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