Ucf Human Resources-Foreign National Information Form
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1
2FOREIGN NATIONAL INFORMATION FORM (PAGE 1)
The Foreign National Information Form must be completed before you can receive any form of payment. All applicable questions
below must be answered. A copy of the following documents should be attached to this form: passport, U.S. visa, both sides of the I-
94 card, and the I-20, I-797, DS-2019 or work authorization card that was issued to you. For new employees, this form must be
submitted before any check can be issued by UCF Human Resources - Payroll.
1. Title ___ First ________________ Middle ___ Last or Family Name ______________________________
2. Social Security # _______________ 3. Birthdate _________________ 4. EMPLID _________________
5. Check one of the following:
New Employee
Current Employee- Immigration Status Has Changed
6. US Local Address
7. Foreign Residence Address
Street Address ________________________________
________________________________________
Line 2
________________________________
________________________________________
City
________________________________
________________________________________
State
______________
Zip Code
____________
Province/Region
______ Country_________
8. Country of Citizenship _________________________
9. Visa # __________________________________
10. Passport # ___________________________________
11. Passport Expiration Date ________________
12. Have you ever had another immigration status in the U.S.?
Yes
No
(If yes, see page 2.)
13a. Have you taken steps to apply for permanent residence?
Yes
No
13b. If you marked yes and you are a student, are you receiving any state benefits such as in-state tuition or the Bright Futures
Award?
Yes
No
14. Current Immigration Status
U.S. Immigrant/Permanent Resident
F-1 Student
J-2 Spouse or Child of Exchange Visitor
J-1 Exchange Visitor
H-1 Temporary Employee
Applied for Permanent Residence
TN
Other: __________________________
15. If Immigration Status is J-1, what is the subtype? Only check one of the following:
01 Student
05 Professor
12 Research Scholar
02 Short Term Scholar
Other: ______________________
16. What is the actual Primary Purpose of the visit? Only check one of the following:
01 Studying in a Degree Program
05 Observing
09 Demonstrating Special Skills
02 Studying in a Non-Degree Program
06 Consulting
10 Clinical Activities
03 Teaching
07 Conducting Research
11 Temporary Employee
04 Lecturing
08 Training
12 Here with Spouse
17. What is the actual date you entered the U.S. for the Current Primary Activity? (month, day, year) ______
18. What is the start date of your Immigration Status? (month, day, year) _____________________________
19. What is the end date of your Immigration Status? (month, day, year) ______________________________
20. What is your Job Title (example: Professor)? ____________________________________
21. In which department of UCF do you work (example: Chemistry)? _________________________________
22. What is your estimated annual income for the year? _____________________________________________
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 Office of Human Resources, Records
Department.
Signature ______________________________ Date _________ Email Address ___________________________
13Nov2015
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