Fillable Foreign National Data Form 2010 Revised

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Foreign National Data Form 2010 Revised

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The Foreign National Data Form 2010 Revised form is 2 pages long and contains:

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  • 101 other fields

Country of origin: US
File type: PDF

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HR:1/25/11
FOREIGN NATIONAL DATA FORM
Name:
(Family) Last First Middle
Social Security # or ITIN # : __________________________ TTU ID #: __________________________________________________
U.S. Local Address: Foreign Residence Address:
City: City:
State: Zip: Province:
Postal Code:
Date of Birth: ________/_________/_________ Country:
mm dd yyyy
Email Address: ___________________________________________________________________________________________________
Country of Citizenship: ______________________________
Country Issuing Passport: _____________________________________
Country of Tax Residency: ___________________________
Passport #: __________________________________________________
Visa #: ___________________________________________
Passport Expiration: __________________________________________
Visa Expiration: ___________________________________
I-94 Entry Date:_________________
Exit Date:__________________
Immigration Status:
____B-1 Business Visitor ____VWB Visa Waiver for Business
____J-1 Exchange Visitor ____H-1B Temporary Employee
___Canadian Walk Over
(w/I-94 Card)
____Other: ____________________________________________________________________________________________________
If in J-1 status, what subtype? (check one only) If in F-1 status, what is student type? (check one only)
____ Student ____Professor ____Research ____Undergrad ____Doctoral
____Scholar ____Masters
What is the actual primary activity of the visit? (Please check only one)
____Studying in a Degree Program ____Observing ____Training
____Teaching ____Consulting ____Temporary Employment
____Lecturing
____Conducting Research ____Here with Spouse
____Other:________________________________________________________________________________________________________
________/_________/_________ ________/_________/_________
mm dd yyyy mm dd yyyy
If married, is your Spouse in the United States?
Yes No
________/_________/_________
mm dd yyyy
The Foreign National Form must be completed before you can enter into a contract for services with or receive any form of payment from the
University. All applicable questions below must be answered. A copy of both sides of your I-94 card, copy of your ID page from your passport,
current U.S. visa, and I-20 or DS-2019 must be attached to this form. This form must be returned to the Immigration Specialist before any check can
be issued by Payroll or Accounts Payable and must also be completed by anyone receiving scholarship.
____U.S. Immigrant/Permant Resident-Alien Registration Receipt Card (green card) #:______________________________________________
PLEASE COMPLETE THE REVERSE SIDE OF THIS FORM WITH VISA HISTORY AND SIGNATURE
What is the ACTUAL DATE you first entered the US in your
present immigration status?
What is the START DATE on your current immigration form (i.e., I-20,
DS2019, etc)?
What is the PROJECTED END DATE of your current
immigration form (i.e., I-20, DS2019, etc)? ?
____Other: ____________________
____Other: ______________________________
____F-1 Student
Income Providing Activity: (Please circle one): Student Employment, Graduate Teaching Assistant, Graduate Research Assistant, Full-
Time Faculty, Full-time Administrator, Part-Time Administrator, Non-Student Temporary Employment, Athletic Scholarship
HR:1/25/11
Date of Entry Date of Exit
Visa
Immigration
Status
J-1
Subtype
Purpose
of Stay
yes no
yes no
yes no
yes no
yes no
yes no
yes no
yes no
yes no
yes no
Signature: ___________________________________________________________
Date:________________________________
Copies of Documents Attached to Form: Copies of Completed and Signed Forms:
__Passport __W-8-BEN
__Visa __W-9
__I-94 Card
__Form 8233
__Social Secutiry Card
__I-20
__DS-2019
Department Sponsoring:__________________________________
__H-1B
Department Contact:_____________________________________
__Invitation Letter (with dates & purpose) Phone Number:__________________________________________
Pay Method: ____________________________________________
Immigration Specialist Approval: ____________________________
Tax Obligations: _________________________________________
HR Approval: ___________________________________________
Human Resources Office Use Only
I hereby certify that all of the above information is true and correct. I understand that if my status changes from that which I
have indicated on this form I must submit a new Foreign National Information Form to the Human Resources Office.
PLEASE LIST ANY VISA IMMIGRATION ACTIVITY IN THE LAST THREE CALENDAR YEARS AND ALL F, J, M, Q, OR H VISAS SINCE 01/01/1985. (Note:
F & J students do not need to list short vacations home during semester breaks.)
Have you taken treaty benefits?
(Circle one)
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Foreign National Data Form 2010 Revised

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Completed 9 March 2020

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