17-Month STEM OPT Extension Request Form

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1 International Services for Students & Scholars Phone: Fax: Month STEM OPT Extension Request Form Name: RIN (Rensselaer ID Number): SEVIS ID# N Local Address: Phone: Degree and Year Graduated: Your Current Name of Employer: Address of Employer: City, State and Zip Code: Employer, E-Verify ID#: Name of Supervisor: Phone number of supervisor: Your job title: Have you read and do you agree to the terms of being on the OPT extension as outlined in this packet? (Please check one) Yes No I certify that the above information is true and correct, & I have read & understand the information on following pages and agree to abide by it. Signature Date:

2 F-1 17-month STEM OPT Extension Who can apply for F-1 17-month STEP OPT Extension? You can apply for OPT extensions if you meet ALL of the following criteria: 1) You are an F-1 student on OPT; 2) You graduated with a degree in certain STEM fields: Actuarial Science, Computer Science Application, Engineering, Engineering Technologies, Biological and Biomedical Sciences, Mathematics and Statistics, Military Technologies, Physical Sciences, Science Technologies, Medical Scientist (MS, PHD); 3) Your employer is enrolled in the E-Verify program, a USCIS employment verification system (for more information visit When do I apply? USCIS recommends that you apply for extension between 90 and 120 days before your current OPT expires. You can, however, apply for 17-month extension any time during your first twelve months of OPT. Immigration service must receive your complete application for OPT Extension no later than the end date on the current EAD card. How do I apply? Step 1 Fax ( ) or the following information to the ISSS Office: Step 2 1. A completed 17-Month STEM OPT Extension Request Form (see below). 2. Letter from employer indicating how your employment relates to the STEM field listed on your I-20. Included in the letter is a statement that the employer will report your termination or departure from the company to the ISSS Office at RPI. 3. Completed Form I-765. a. Check first box renewal b. Fill out lines 1 through 17 c. #10. Put either your I-94 number or the A# listed on your current OPT card. d. #11. Since this is an extension answer, yes and fill in the rest of the information. e. #16. Eligibility Categories write (c) (3) (C). f. #17. Put in your degree field and your employer s E-Verify number. g. Sign and date it 4. Photocopy of EAD front and back. When the ISSS Office receives and reviews all the required information, they will print and send you a new I-20 for you with the International Office s recommendation for the OPT extension.

3 Step 3 After you receive your new I-20 from the ISSS Office, mail the following documents to the USCIS Service Center with jurisdiction over your residency area (for mailing address see list on last page): 1. Photocopy of page 1 and 3 of your new I-20 issued by the ISSS Office advisors with the recommendation for OPT STEM extension on page 3. Remember to sign it! 2. Copy of transcript, or diploma showing you have graduated. 3. Original Form I-765 filled out with your employers E-Verification number. 4. Statement from Employer on their letterhead regarding how the employment relates to the STEM field. 5. Copy of your current EAD card front and back 6. Photocopy of Form I-94 (both sides of cardstock I-94 or copy of electronic Form I-94 printout) 7. Photocopy of identifying page in your passport 8. Photocopy of ALL previous I-20s that have been issued to you including those from schools you transferred from. 9. Photocopy of your F-1 visa stamp in your passport even if it has expired. 10. Two passport photographs taken within the past 30 days. For picture requirements go to: Print your name and I-94 number on the back of each picture. 11. Check or money order for $380 made out to the Department of Homeland Security. What am I required to do after I receive F-1 OPT Extension? Report to the ISSS Office every six months from the start date of the extension with the information asked below. Notify the ISSS Office within ten days when there is a change in: o Legal name of student o Address of student (US and foreign) o of student o Employer/Company name o Address of Employer o When employment changes or terminates (dates)

4 Frequently Asked Questions on 17-month OPT Extension 1. Can I continue working after the end date of the first OPT period if I applied for OPT extension, but have not received a new Employment Authorization Document? Yes, if USCIS Service Center received your application for the 17-month OPT STEM extension before the end date of the first OPT period you can continue employment while the STEM extension application is pending, which is until a final decision on the I-765 is made or for 180 days, whichever is first. 2. Can I apply for OPT extension more than once? No, this is a onetime extension only, no matter how many degrees you receive. 3. Can I apply for 29-month OPT up front instead of getting an extension later? No, you can only apply for 12-month OPT first and then apply for 17-month OPT extension. 4. Can I travel if I applied for OPT extension, but have not received the new Employment Authorization Document? No, the immigration service advises that you travel after you receive the new EAD card. 5. What documents do I need to re-enter the U.S. while on OPT extension? a) I-20 recommending OPT extension and signed for travel by the ISSS Office within the last six months; b) New Employment Authorization Document (EAD card); c) Valid passport with a current F-1 visa stamp; d) Job offer letter or proof of employment.

5 ***************************************************************************** Your STEM extension application should be sent to the Service Center according to the state you currently live in. If you live in the following state, for U.S. Postal Services mail your application to: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Mississippi, New Hampshire, New Mexico, New York, North Carolina, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Oklahoma, Tennessee, Texas, Vermont, Virginia, U.S. Virgin Islands, West Virginia USCIS Dallas Lockbox P.O. Box Dallas, TX For express mail and courier services deliveries mail your application to: USCIS Dallas Lockbox Attn: AOS 2501 S. State Hwy. 121, Business Suite 400 Lewisville, TX ***************************************************************************** If you live in the following state, for U.S. Postal Services mail your application to: Alaska, Arizona, California, Colorado, Guam, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, North Dakota, Ohio, Oregon, South Dakota, Utah, Washington, Wisconsin, Wyoming, or Commonwealth of the Northern Mariana islands USCIS Phoenix Lockbox P.O. Box Phoenix, AZ For express mail and courier services deliveries mail your application to: USCIS Phoenix Lockbox Attn: AOS 1820 E. Skyharbor circle S Suite 100 Phoenix, AZ 85034

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