OPT NOTIFICATION FORM FOR
F-1 STUDENTS
F-1 students are required by Federal immigration regulations to report any changes in their address,
employment (including periods of unemployment or changes in employer information), visa status, and/or
personal information to the Office of International Programs within 10 days of the change. To report any
changes, complete this form and submit it to OIP. This information will be reported in SEVIS.
Note to Students on STEM OPT: Students on STEM OPT are also required to report to OIP by submitting
this form every six months, regardless of if there have been any changes.
FIRST NAME: Click here to enter text.
LAST NAME: Click here to enter text.
DATE OF BIRTH: Click here to enter text.
PHONE: Click here to enter text.
UTEP ID # Click here to enter text.
SEVIS ID # Click here to enter text.
EMAIL: Click here to enter text.
ALTERNATE PHONE: Click here to enter text.
I am submitting this form to report the following changes: (mark all that apply and provide the
required information)
☐Address
New Residential Address: Click here to enter text.
Click here to enter text.
City:Click here to enter text.
State: Click here to enter text.
Phone number: Click here to enter text.
Zip: Click here to enter text.
☐I started a new job (all fields required)
Employer Name: Click here to enter text.
Employer Address: Click here to enter text.
Job Title: Click here to enter text.
New Job Start Date (mm/dd/yyyy): Click here to enter a date.
Supervisor’s First and Last Name: Click here to enter text.
Supervisor’s Phone Number: Click here to enter text.
Supervisor’s Email: Click here to enter text.
I am working*: Choose:
Briefly explain how this job is related to your course of study: Click here to enter text.
Date your previous job ended/last date you were unemployed, if applicable: Click here to enter a date.
Do you wish to have your I-20 reprinted with the updated employment information? (Optional) Choose:
*Students must work at least 20 hours per week to maintain their F-1 visa status while on OPT.
If you are working in multiple jobs simultaneously, please provide all of the above information for all of your jobs by
submitting an additional copy(ies) of this form.
☐I am unemployed and/or I ended employment and am not currently working:
Last day you were employed, if applicable (mm/dd/yyyy): Click here to enter a date.
You are only allowed a maximum of 90 days of unemployment while on OPT. Students on the 17-month STEM
OPT may have up to 120 days of unemployment and students on the new 24-month STEM OPT may have up to
150 days of unemployment.
Office of International Programs
Division of Student Affairs
www.sa.utep.edu/oip
500 W University Ave.
Union East Bldg. Room 203
Phone: (915) 747-5664
[email protected]
Edited 4/18/2016
OPT NOTIFICATION FORM FOR
F-1 STUDENTS
☐My employer information has changed
Employer Name: Click here to enter text.
Employer Address: Click here to enter text.
Job Title: Click here to enter text.
New Job Start Date (mm/dd/yyyy): Click here to enter a date.
Supervisor First and Last Name: Click here to enter text.
Supervisor Phone Number: Click here to enter text.
Supervisor’s Email: Click here to enter text.
I am working (select one)*: Choose:
Briefly explain how this job is related to your course of study: Click here to enter text.
Date your previous job ended/last date you were unemployed, if applicable: Click here to enter a date.
Do you wish to have your I-20 reprinted with the updated employment information? (Optional) Choose:
*Students must work more than 20 hours per week to maintain their F-1 visa status while on OPT.
☐I have changed my visa status
My new visa status is: Click here to enter text.
My new status is effective on: Click here to enter a date.
Please submit a copy of your approval notice or visa, whichever is applicable. Once this is received, OIP will
close your SEVIS record.
☐My personal information has changed (name, legal sex, citizenship, etc.)
Please list the change: Click here to enter text.
Attach a copy of your new passport that reflects this change. Your I-20 can only be updated to reflect the
information as listed on your passport.
☐I am ending my OPT before it expires for the following reason(s): Click here to enter text.
Date you plan to depart the US (mm/dd/yyyy)*:Click here to enter a date.
*This means OIP will complete your SEVIS record / close your I-20.
☐Other
Please describe: Click here to enter text.
☐I am on STEM OPT and am due to report to OIP. I have had no changes in my address,
employment, visa status, or personal information since I last reported.
Additional comments or information for the DSO, if any: Click here to enter text.
(Continued on Next Page)
Office of International Programs
Division of Student Affairs
www.sa.utep.edu/oip
500 W University Ave.
Union East Bldg. Room 203
Phone: (915) 747-5664
[email protected]
Edited 4/18/2016
OPT NOTIFICATION FORM FOR
F-1 STUDENTS
Student Certification:
By typing my name below, I certify that the information I have provided on this form is true and accurate to
the best of my knowledge and that I will notify OIP of any future changes within 10 days.
Typed Name: Click here to enter text. Date: Click here to enter a date.
OFFICE USE ONLY
Email your completed form to [email protected].
Student is on:
□ OPT
ISSM Updated □
DSO Name:
Office of International Programs
Division of Student Affairs
www.sa.utep.edu/oip
□ STEM OPT
SEVIS Updated □
Total unemployment days accumulated to date:
Student emailed □
Date:
500 W University Ave.
Union East Bldg. Room 203
Phone: (915) 747-5664
[email protected]
Edited 4/18/2016