Foreign National Form

The Foreign National Form must be completed with copies of all supporting documentation.

Indicate if this is a New or Revised or Visa Change form

• New: Complete all sections
• Revised: Complete name, revised sections and sign Visa
• Change: Complete name, sections 2 and 3, and sign

Section 1

1. Enter your name: Last name, first and middle (This should be the same as shown on your social Security Card if applicable, otherwise use your name as shown on your visa.)
2. Enter your Employee Id number or student id number: It is eight digits long
3. If applicable enter the department you are working for
4. Enter your U.S. social security number issues by the U.S. or ITIN (Individual Taxpayer Identification Number) if you have one, otherwise leave blank (Make a copy to submit with form)
5. Enter your date of birth
6. Enter your Marital status – either Married or Single
7. Sex: Mark the M box for male or the F box for female
8. If your marital status is married
   a. Is your spouse present in the U.S.? Mark Y for yes or N for no.
   b. Is your spouse working in the U.S.? Mark Y for yes or N for no.
9. Number of other dependents present in the United States: Enter dependents other than spouse present in the U.S.
10. Local residence address information: Enter your local address and contact information
11. Foreign residence address: Enter your non US address
12. Country of citizenship: Enter your country of citizenship
13. Country of passport: Enter the country which issued the passport
14. Passport number: Enter your passport number (Make a copy of the information pages along with any pages that have been date stamped)
15. Expiration Date: Enter expiration date of passport
16. Country of tax residence: Enter your country of permanent residency (not United States)
17. Did tax residency end: Mark Y for yes or N for no. If Yes give date.

Section 2: Immigration Status

1. Current Visa number
2. Current I-94 number if applicable From the list select the Visa type that applies to you and follow the directions for that visa type.
3. F-1 or J-1 student: Check either Student or Student (on Practical Training)
   a. Make copies of I-20 or DS-2019 or I-766
   b. If on practical training make a copy of card
   c. Enter name of Institution where enrolled
   d. Check the degree program: Undergraduate or Masters or Doctoral or complete Other
4. J-1 Exchange visitor
   a. Make copy of DS-2019
   b. Select the subtype from the list that applies to you: Trainee, Teacher, Professor, Alien Physician or Research Scholar
5. J-1 Dependent of J-1 Exchange Visitor: Make copy of DS-2019 and front and back copy of EAD(Employment Authorization Card)
6. H-1B Temporary Employee: Make a copy of I-797
7. O-1 alien of Extraordinary Ability: Make a copy of I-797
8. B-1 Business/B-2 Tourist: Make a copy of passport stamp
9. Status Adjustment applicant: Make a copy of I-766
10. Lawful Temporary Resident: Make a copy of I-766
11. Conditional Permanent Resident: Copy I-551 card or copy of passport stamp
12. Other: some examples are WB Business Wavier, WT Tourist Wavier, Canadian without visa, Employment Authorization Card – Make copies of documents

Section 3: Primary Activity of Visit

1. Primary Activity of visit: Select the one that applies
2. Anticipated date of departure from United States

Section 4: Visa Immigration Status

Visa Immigration Status: Enter the information for all visits to the US and visas held, and all changes of immigration status

• From: Enter the date arrived in the US for visit
• To: Enter the date left the US
• Visa Type: Enter the visa type for the visit
• Student: Y for yes or N for no
• Treaty claimed: Y for yes or N for no

 Attach information pages and visa pages for each trip

Section 5: Tax Information

Sign and date form

Send completed form with supporting documentation to Payroll.

Ph: 940.369.5500
Fax: 940.369.5976

Email: sysfn@untsystem.edu