Name* First Middle Last Banner ID H#*Degree Major/Minor*Requested OPT Start Date* MM slash DD slash YYYY Email address* Application Checklist: Form I-765; for question 27: (c)(3)(a) for Pre-Completion, (c)(3)(b) for Post-Completion. www.uscis.gov Final Semester Form, if applying for Post-Completion OPT Two passport-style photos. Write in pencil: name & admission number from I-94 on the back. 2 photocopies of your passport, I-94 card, visa, all previous I-20s, and previous EAD card(s), if any A check payable to "U.S. Department of Homeland Security.” Obtain a new I-20 from OISS with OPT recommendation and new completion date. G-1145 https://www.uscis.gov/g-1145 F-1 students are responsible for reporting their address, their employer’s name and address, any change in their legal name, and any period of unemployment while on OPT. Please AGREE to each statement below. The regulations governing these reporting requirements are: Regulation 1*8 CFR 214.2 (f) (5) defines the duration of status for F-1 students as the “time during which an F-1 student is pursuing a full course of study at an educational institution approved by the Service for attendance by foreign students, or engaging in authorized practical training following completion of studies…” I understand*Regulation 2*8 CFR 214.2 (f) (17) requires that “A student must inform the DSO and the Service of any legal changes to his or her name or of any change of address, within 10 days of the change, in a manner prescribed by the school. A student enrolled at a SEVIS school can satisfy the requirement in 8 CFR 265.1 of notifying the Service by providing a notice of a change of address within 10 days to the DSO, who in turn shall enter the information in SEVIS within 21 days of notification by the student.” I understand*Regulation 3*8 CFR 214.2 (f) (12) requires “An F-1 student authorized by the Service to engage in practical training is required to report any change of name or address, or interruption of such employment to the DSO for the duration of the authorized training. A DSO who recommends a student for optional practical training is responsible for updating the student’s record to reflect these reported changes for the duration of time that training is authorized.” I understand*Regulation 4*8 CFR 214.3 (g) (3) requires reporting within 21 days of change in “Any other notification request made by SEVIS with respect to the current status of the student” I understand*Disclaimer: The Office of International Student Services is able to provide you with general guidance. However, any advice provided to you by our office, as well as the information in this packet, does not constitute legal advice. Additionally, due to the fluid nature of governmental interpretation, USCIS may change its interpretation of the above mentioned immigration policies, procedures, regulations, and eligibility requirements for benefits at any time. This office will do its best to provide you with the most current guidance, but please be mindful that each case is fact-specific, and it is advised that you contact an experienced immigration attorney if you have questions regarding your situation. All information and documents included with the I-765 application is the sole responsibility of the student. Final Agreement* I have read, understood, and will abide by the above 8 CFR’sStudent Signature*Date* MM slash DD slash YYYY
