Fillable CSU Fresno Veteran PR Form 825/X-CCY

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CSU Fresno Veteran PR Form 825/X-CCY

On average this form takes 3 minutes to complete

The CSU Fresno Veteran PR Form 825/X-CCY form is 1 page long and contains:

  • 0 signatures
  • 11 check-boxes
  • 7 other fields

Country of origin: US
File type: PDF

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___________________________________________
Employee Name
___________________________________________
Fresno State ID
Please complete information on reverse side.
Highest Level of Education
Institution Name: _____________________________________________ State: ____________________
Major: _______________________________________ Month/Year Graduated: _____________________
Gender
Male Female
Alien Status
(825/X-CCY)
If U.S. Citizen check box to the right, if NOT then complete boxes below. U.S. Citizen
X - Visa Type: CC – See Chart for Country Codes
F Visa type (Non-citizen – student Visa)
Permanent resident (OOR) Non-resident (OON) _______(MO/YR) exp date
J Visa type (Non-citizen Exchange Visitor D/S – enter as 9999
Z Visa type All other types of non-citizen visas (e.g. H-1B, TN) __________________
Y – Tax Resident Code: R – Resident N – Non-resident
ZZZZ – Work Authorization end date = ____ / ______ (MM/YY)
Veteran Status
Please indicate your status by checking one of the following:
A. Veteran of the Vietnam-era B. Special Disabled Veteran
C. Other Eligible Veteran N. NONE of the above
____________________________________________________________________ _____________________________
Employee’s Signature Date
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CSU Fresno Veteran PR Form 825X-CCY

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Completed 1 March 2020

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