O-1 Check-In And Compliance Form

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The University of Pittsburgh
Office of International Services
O-1 Check-In and Compliance Form
PLEASE PRINT NEATLY AND BE SURE TO COMPLETE ALL FIELDS.
Biographical Information
Name:
F
amily Name
Given Name
Middle Name
Gender:
Male
Female
Marital Status:
Married
Single
Date of Birth _____ / _____ / _____
mm
dd
yyyy
U.S. Home Address:
Street Address ________________________________________________________________________________________________
City, State/Province ______________________________________________________________________________________
Postal Code
Telephone______________________________ Fax_________________________________ E-Mail
Emergency Contact Information
Contact Name:
F
amily Name
Given Name
Middle Name
Relationship to you (e.g., mother, father, brother, etc.):
City, State/Province
Country and Postal Code
Telephone______________________________ Fax_________________________________ E-Mail
Maintaining your O-1 Status
PLEASE READ THE FOLLOWING CAREFULLY AND SIGN ON THE REVERSE
The O-1 visa category is for the temporary employment of “aliens of extraordinary ability” by a specific employer. Individuals
in O-1 status are permitted to remain in the U.S. as long as they maintain their O-1 status by working only for the employer
who has sponsored their status and by adhering to the original terms and conditions of employment. Any changes in
employment must be reported to the Office of International Services (OIS) in advance. Some examples of changes include, but
are not limited to, the following: a leave of absence, promotion, change in salary, or change of department.
It is critical that internationals in O-1 visa classification maintain their legal status in the United States. You must be aware of,
and comply fully with, the following:
Maintain a valid passport at all times, unless exempt from passport requirements.
Work only for the employer(s) that have obtained an approved O-1 petition on your behalf.
Report any proposed changes in employment conditions to the Office of International Services.
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