OPT Extension OPT Extension Application Documents Upload Personal InformationName* Given name Family / surname SEVIS ID Number*This is on your I-20. VALID Email or SAU Email* Are you currently on your OPT Extension and updating your employer information?*YesNoCurrent OPT End date on your EAD card?* MM slash DD slash YYYY US Phone*What was your last day of employment with your previous employer?* MM slash DD slash YYYY Enter your physical (home) address:*This is not the mailing address for your I-20. This is the address where you currently reside and that our office has to put in SEVIS. Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer Information Complete this section with the information from Section 3 of your Form I-983.Company's Name (Employer)* 9 DIGIT EIN Number (XX-XXXXXXX) NOT E-Verify #*This is not the Everify number. Job Title Complete this section with the information from Section 5 of your Form I-983.Employer Site Address- From Section 5 of your I-983 Form*Please verify the address through https://tools.usps.com/zip-code-lookup.htm?byaddress. Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor Name* First Last Supervisor Phone*Supervisor Email* Document UploadPlease label and Upload the following documents: I-983 Form, OPT EAD card, Offer letterFiles: Please label and Upload the following documents: I-983 Form, OPT EAD card, Offer letter* Drop files here or Select files Accepted file types: pdf, jpeg, gif, png, pdfa, pdfx, doc, docx, rtf, Max. file size: 29 MB, Max. files: 5. OPT Extension ResponsibilitiesBy submitting this form you are verifiying that you have read the OPT Extension webpage, and you understand the responsibilities required for maintaining F-1 status during your period of STEM OPT. Δ