Fillable OPT and STEM OPT Reporting Form Complete this (Florida Polytechnic University)

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OPT and STEM OPT Reporting Form Complete this (Florida Polytechnic University)

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The OPT and STEM OPT Reporting Form Complete this (Florida Polytechnic University) form is 2 pages long and contains:

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  • 11 check-boxes
  • 41 other fields

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File type: PDF

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OPT and STEM OPT Reporting Form
____________________________________________________________________________________________________
Fl Poly● 4700 Research Way, Lakeland, FL 33805-8531● intlstudentaffairs@floridapoly.edu
Complete this form to report any changes while on OPT or STEM OPT. All changes must be reported within 10 days of the
change. (STEM OPT Students: Submit this form every six months to complete your 6‐month validity reporting
requirement even if there have been no changes.)
…………..………………………………………………………………………………………………………………………………………………………………………………
PERSONAL INFORMATION
FL Poly ID: ____________________________________ SEVIS Number: N0___________________________________
Last Name: _________________________________ First Name: ___________________________________________
Phone number: _____________________________ Email Address: _________________________________________
Current Home Address: ____________________________________________________________________________
City: _______________________________________________ State: _________________ Zip Code: ____________
I am currently on (check one): OPT STEM OPT
…………………………………………………………………………………………………………………………………………………………………………………………
I AM REPORTING:
Please check all that apply. All fields are required for each update you are reporting.
☐New Address (Address where you reside)
Street Address: ___________________________________________________________________________________
City: ____________________________________________ State: _________________ Zip Code: ________________
☐New Employer* If you have multiple employers, complete this form for each employer.
(*STEM OPT students must also submit a new Form I‐983 Training Plan)
Former Employer (if any): __________________________________________________________________________
Former Employment Start Date: ____________________ Former Employment End Date: _______________________
New Employer: _________________________________ Employer Identification Number (EIN): _________________
Employment Start Date: __________________________ Employment End Date: _____________________________
Employer’s Address: _______________________________________________________________________________
City: ____________________________________________ State: _________________ Zip Code: ________________
Your Title: _______________________________________________________________________________________
Read “Employment Requirements” on page 2 and then check one:
☐Full Time (20 or more hours/week) ☐Part‐Time (Less than 20 hours/week)
Briefly explain how this employment is related to your program of study. The explanation you provide will be entered in
SEVIS. ________________________________________________________________________________________
________________________________________________________________________________________________
Supervisor’s Last Name: __________________________ Supervisor’s First Name: ___________________________
Supervisor’s Phone Number: ______________________ Supervisor’s Email: _______________________________
☐ Ended Employment*
Former Employer’s Name: __________________________________________________________________________
Former Employment Start Date: ____________________ Former Employment End Date: _______________________
(*STEM OPT students must submit the “Final Evaluation on Student Progress” found on page 5 of the I‐983 Training Plan.)
OPT and STEM OPT Reporting Form
____________________________________________________________________________________________________
Fl Poly● 4700 Research Way, Lakeland, FL 33805-8531● intlstudentaffairs@floridapoly.edu
☐ Report Unemployment. Refer to the Employment Requirements box below.
Date you became unemployed: ______________________________________________________________________
☐ 6‐Month Validity Report (STEM OPT Students Only). I am on STEM OPT and am submitting this form for my 6‐month
validity report. I confirm that there have been no changes to my employment, legal name, home address, and/or I983
Training Plan since I last reported.
☐ I plan to depart the U.S. and discontinue my OPT or STEM OPT. Please complete the Exit Form.
(*STEM OPT Students must submit the “Final Evaluation on Student Progress” found on page 5 of the I‐983 Training
Plan.)
I understand that upon my departure, my F‐1 status will be completed.
My departure date is: _____________________________________________________________________________
☐ Other. Please explain and provide any supporting documentation. _________________________________________
________________________________________________________________________________________________
STEM OPT Student Certification (Please initial)
_____ I am aware I need to complete and submit an updated Form I‐983 Training Plan to a Fl Poly Global Immigration Advisor within 10 days when 1)
beginning a new job with a new employer or 2) any time there is a “material change” in the terms and conditions of the original I‐983 Training Plan.
Material changes can include but are not limited to: Any change in the employer’s Employer Identification Number (EIN); Any reduction in
compensation that is not tied to a reduction in hours worked; Any significant decrease in hours per week; Changes to the employer’s commitments
or student’s learning objectives as documented on the Form I‐983.
By signing this form, I acknowledge that I am aware of the employment requirements of my OPT or STEM OPT and that
the information I provided on this form is true and accurate.
Signature: _________________________________________________________ Date: __________________________
Employment Requirements
Pre‐ and Post‐Completion OPT
• All employment must relate to the degree program listed on your I‐20.
• To avoid accruing unemployment on Post‐Completion OPT, you must work 20 hours or more per week. If you have multiple employers, your total weekly
employment should total at least 20 hours.
• You can have up to 90 days of unemployment.
• The following activities are considered allowable employment:
o Paid Employment.
o Unpaid employment (volunteer or unpaid intern). Employment must not violate any labor laws and students on post‐completion OPT must keep
documentation from their employer that verifies that they worked at least 20 hours per week.
o Multiple employers. For students on part‐time Pre‐Completion OPT only, total hours per week cannot exceed 20.
O Multiple short‐term employers (gigs). Maintain a list of all gigs, the dates, and duration.
o Work for hire (1099 employment). Keep documentation showing the duration of the contract period and the name and address of contracting
company.
o Self‐employed business owner. You must have the proper business licenses and be actively engaged in a business that is related to your degree
program.
o Employment through an agency or consulting firm. Students on Post‐Completion OPT must keep documentation showing that they worked an
average of 20 hours or more per week while employed by the agency.
STEM OPT
• All employment must be paid.
• All employment must be related to your qualifying STEM degree.
• You must work at least 20 hours per week.
• Your employer must be enrolled in E‐Verify and have an IRS Employer Identification Number (EIN).
• The employer must sign the Form I‐983 Training plan, agreeing to the wage, working conditions, supervision, site visit, and reporting obligations.
• You must be a bona fide employee of your employer. Staffing companies (temp agencies) or employment through consulting firm arrangements
that provide labor for hire are not permitted.
• Self‐employment is not permitted.
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OPT and STEM OPT Reporting Form Complete this (Florida Polytechnic University)

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Completed 15 August 2020

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