Social Security Verification Form printable pdf download

Social Security Verification Form

International Student Services

459 Schmitz Hall, Box 355832

Seattle, WA 98195-5832

Phone: 206.221.7857 Fax: 206.543.9772

iss.washington.edu

To be completed by Student

Student Name: _______________________________

__________________________

(Last)

(First)

UW Student Number: __ __ __ __ __ __ __ Country of Citizenship: ___________________

SEVIS #: N __ __ __ __ __ __ __ __ __ __ Email: _________________@uw.edu

Visa type: □ F-1 □ J-1

New Students:

I confirm that I have:

□ Updated my local Seattle address in MyUW

□ Registered full-time

SOCIAL SECURITY VERIFICATION FORM

To be completed by Hiring Official

UW Employing Department/On-Campus Contractor: __________________________________________

UW Employer Identification Number (EIN): 91-6001537

Job Location:

____________________________________________

Street Address:

Zip code:_______________

Supervisor’s Name: ______________________________________

Phone:___________________

Beginning Date:_______________

Ending Date:______________

Hours/Week:______________

Job Description: _______________________________________________________________________

This is to serve as notification that the student listed above has been offered employment.

I understand that F-1 and J-1 students are not eligible to work more than 20 hours per week while school is in session.

Full-time employment is permitted during vacation periods, if the student intends to register the subsequent quarter.

For detailed information, visit:

Hiring Official Name: ____________________________________ Title: _______________________

Signature: ____________________________________________ Date: _______________________

To be completed by International Student Adviser

I have verified that this student is enrolled full-time, has been registered in SEVIS and is therefore eligible to

accept employment on the University of Washington, Seattle campus.

Signature: _____________________________________________ Date: _______________________

International Student Adviser, Designated School Official

Allow 7-10 business days for ISS processing.

Social Security Verification Form