Severe Economic Hardship Request Form (Page 2 of 5) in pdf

HOW TO COMPLETE YOU HARDSHIP APPLICATION

Complete and submit all of the documents attached to these instructions to the International Student

Services Office.

1. Severe Economic Hardship Request Form: Fully explain the unforeseen circumstances that are

causing you financial difficulties.

2. Sponsor’s Affidavit of Severe Economic Hardship: If your request is based on an unexpected

change in the financial ability of your sponsor to continue to provide you with the same level of

funding as previously, have your sponsor complete this affidavit.

3. Form I765: Complete items 1‐15.

Item #3 ‐ Your current mailing address in the U.S.

Item # 9 ‐ If you do not have a social security number, leave this blank. ISSO will give you

instructions for obtaining a social security number after you have received an EAD card.

Item # 10 ‐ “A‐number” or “I‐94 Number”. Enter the same admission number from your I‐94 card

unless INS previously assigned you an “A‐number”.

Item # 11 ‐ Indicate if you ever applied for Hardship employment or Practical training before

(excluding Curricular). If “yes”, enter where and when you applied, and whether it was granted or

denied. You will need to attach a photocopy of the Form I‐20 or EAD card that contains that

employment authorization to the application.

Your certification ‐ Sign, indicate your telephone number and date.

4. Two photographs: Ask for “green card type” photo where passport photos are available. Lightly

print your name and I‐94 # or A # on the back of each photo in pencil.

5. $380.00 Fee: In the form of a check or money order payable to the “USCIS or United States

Citizenship and Naturalization Service”.

6. I20 ID from the Borough of Manhattan Community College (the original document).

7. Photocopies of your current I‐94 card (both sides) passport and visa.

8. Letter of employment: Only required if you are requesting “expeditious” handling due to an offer

of employment.

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DOCS - REPORTS 04-25-02ISSO SEVERE ECONOMIC HARDSHIP EMPLOYMENT FORM 03-12-12.doc

Severe Economic Hardship Request Form Page 2