OPT Information Update Form

OPT Update
OPT STEM Update

Name*
First Middle Last
Banner ID H#*
Start Date on EAD Card*
MM slash DD slash YYYY
End Date on EAD Card*
MM slash DD slash YYYY
Personal Information
Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Email address*
Please note: While on OPT, you are still REQUIRED to check your HCU email account – all OISS communication will be sent to your HCU email.
Employer Information
Full or Part time*
(Full time is more than 20 hrs/wk)
Company Name*
EIN*
Job Title*
Company Address
Street Address Address Line 2 City State ZIP Code
How responsibilities are related to major*
Supervisor Name*
First Last
Supervisor Phone Number*
Supervisor Email*
Employment Start Date*
MM slash DD slash YYYY
Employment End Date
MM slash DD slash YYYY
I am currently employed here*
Signature
Student Signature*
Date*
MM slash DD slash YYYY

Please complete this form once every 6 months during your 24-month STEM extension so that the HCU International Office can report your current information to DHS. If your personal information changes at any point, you have 10 days to report the change to the International Office. Once per year, you must complete the self-evaluation on page 5 of the I-983 and request your supervisor’s signature before returning the form to the HCU International Office so that we can report your progress to DHS.

Note: If you change employers while you are working during your 24-month STEM OPT extension, you must complete page 5 of the I-983 and have your previous supervisor sign. Turn in the old I-983 and then complete a NEW I-983 for the NEW employer to submit to the HCU International Office.

Student Full Legal Name*
First Middle Last
SEVIS ID #*
End Date on EAD Card*
MM slash DD slash YYYY
Personal Information
Current Mailing and Residential Address*
Street Address Address Line 2 City State ZIP Code
Email address*
Employer Information
Current Employer Name*
Current Employer Address*
Street Address Address Line 2 City State ZIP Code
Employment Start Date*
MM slash DD slash YYYY
Signature
Student Signature*
Date*
MM slash DD slash YYYY

OPT Information Update Form

Personal Information

Employer Information

Signature