F-1 Student: STEM OPT Change of Employment Reporting

This form is for SUNY Poly graduates with APPROVED STEM OPT Extension authorization from USCIS.

Students engaged in STEM OPT Extension employment must report ALL changes in their employment within 10 days of the change occurring. Such changes may include (but are not limited to):

Change in employer site address
Change in supervisor/supervisor’s contact information
Adding new employment
Ending employment with an employer

All changes require submission of an updated I-983 for the employer in the report.

Please allow up to 21 days, as allowed by federal reporting requirements, for processing of your request.

*There is no need to contact the ISS to inquire about the status of your request. Once your request is processed, you will be notified through your SUNY Poly email.*

Name(Required)

First Last

SUNY Poly University ID#(Required)

Preferred email(Required)

This is the email address the ISS will use to contact you.

SEVIS ID(Required)

Your SEVIS ID may be found at the top of your Form I-20.

Are you submitting:(Required)

End of employment report

Add a new employer report

Change in current employment information

Select all that apply. If you are ending employment but do not have a new employer at this time, you may submit a request to add an employer at a future date. If you are adding a new employer, but fail to indicate that you are ending your previous employment, then your SEVIS record will list (2) active employers. Please make sure you are submitting all required information and requests.

Complete all fields in this section if submitting an END OF EMPLOYMENT report

End of Employment: Old Employer Name(Required)

Provide the name of your former employer/company if submitting an end of employment report.

End of Employment: End date of employment(Required)

Enter the last date of employment with your former employer/company if submitting and end of employment report.

End of Employment: Upload your I-983 (Required)(Required)

Max. file size: 50 MB.

Complete all fields in this section if submitting a request to ADD A NEW EMPLOYER

Add a New Employer: New Employer Name(Required)

Provide the name of your new employer/company if you have changed employment.

Add a New Employer: Start Date(Required)

Provide the start date of your employment with your new employer if you have changed employment.

Add New Employer: Full Time or Part Time(Required)

Full time (more than 20 hours per week)

Part time (less than 20 hours per week)

Add a New Employer: EIN Tax ID(Required)

Provide the EIN for your new employer if you have changed employment. **Please note, this is NOT your employers E-Verify number.**

Add a New Employer: Employers Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Add A New Employer: Supervisor Name(Required)

First Last

Add a New Employer: Supervisor E-mail(Required)

Add a New Employer: Employer Phone Number(Required)

Add a New Employer: Upload your I-983 (Required)(Required)

Max. file size: 50 MB.

Add a New Employer: Please briefly explain how your employment is related to your program of study(Required)

Complete all fields in this section if submitting a request to CHANGE CURRENT EMPLOYMENT INFORMATION

Change in Current Employment: What information about your current employment has changed?(Required)

Site Address

Supervisor information

Full Time/Part time status

Other

Select all that apply.

Change in Current Employment: Please explain what other information has changed in your employment.(Required)

Change in Current Employment: Enter New Site Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Change in Current Employment: New Supervisor Name(Required)

First Last

Change in Current Employment: New Supervisor Email(Required)

Change in Current Employment: New Supervisor Phone Number(Required)

Change in Current Employment: Upload Updated I-983(Required)

Max. file size: 50 MB.

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