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OPT Form

As an F-1 student on OPT, you are required by USCIS to report your employer's address and any changes while on OPT. Use this form to report those required changes as they happen.

  (eg. 1000123456)

  (eg. N1234567890)


Are you Self Employed

If Yes provide your Occupation

If yes, you will need to fill out this form on a regular basis with a list of the short term jobs.
If you work for an agency or contract based employer, put the name of the agency or contract company as the name of the employer and the address where you report to work.

Are you currently Employed:

Type of OPT
12 Month OPT
17 Month OPT     Please provide Supervisor's detail

If employed, please put the employment site address:

   e.g 1234567890 (no special character)

No P.O. Box address. Must be Street Address of Employer


  only the 5 digit zip code

If you have more than one employer,