Foreign National Information Form

The Foreign National Information Form must be completed before payment can be received.

All applicable questions must be answered. In addition, copies of the following documents must be attached to the completed Foreign National Information Form:

Passport
I-94"Departure Record" (small white card inside your passport). If you did not receive an I-94 (or if it has already been removed), please attach a copy of the passport entry stamp related to this visit
U.S. Visa from your passport (if applicable)
Form I-20, if you have an F-1 Visa
Form DS-2019, if you have a J-1 Visa
Form I-797, if you have an H-1B Visa

This form must be printed, signed & dated, and returned to the sponsoring CSU department, along with all applicable documents listed above, before payment can be issued by Accounts Payable or Travel.
Please note: This is a 2 page form - use to the 'Print Preview' button at the bottom of the form to print the form - or Browser's 'Print Preview'.

(1) Last or Family Name
First Name
Middle Name

Birth date (mm/dd/yy)
(2) SSN or ITIN
(3) E-Mail

U.S. Local Street Address

(4) Address Line 1
(4) Address Line 2
(4) Address Line 3
(4) City
(4) State		Zip Code
(4) Phone

Foreign Residence Address

(5) Address Line 1
(5) Address Line 2
(5) Address Line 3
(5) Postal Code
(5) City
(5) Province/Region
(5) Postal Code
(5) Country

(6) Country of Citizenship
(7) Country That Issued Passport
(8) Passport #
(8) Passport Date of Expiry
(9) Visa # (Control Number)

(10) Immigration Status

U.S. Immigrant/Permanent Resident	F-1 Student
J-1 Exchange Visitor	J-2 Spouse/Child of Exchange Visitor
H-1B Temporary Employee	TN Temporary Employee
WB/B1 Business Visitor	WT/B2 Tourist Visitor

(11) If immigration status is J-1, what is the subtype?

01 Student	05 Professor
02 Short-term Scholar	12 Research Scholar
Other

(12) What is the actual primary activity of the visit?

	01 Studying in a Degree Program		07 Conducting Research
	02 Studying in a Non-Degree Program		08 Training
	03 Teaching		09 Demonstrating Special Skills
	04 Lecturing		10 Clinical Activities
	05 Observing		11 Clinical Activities
	06 Consulting		12 Here With Spouse

(13) What is the actual date you entered the United States for the 1st visit?
(mm/dd/yy)

(14) CSU Department Information

Department
Activity Performed

(15) For Consultants/Self-Employed Individuals (Honorariums)

Do you/will you have an office (fixed base) in the USA?	YesNo
Will the activity to receive the Honorarium last more than 9 days?	YesNo
Have you received Honorariums from 5 or more organizations in the prior 6 months?	YesNo

(16) Country of Last Residence (If Different From Foreign Address Residence)

(17) Have you visited the U.S. previously? Yes No

Please provide additional details of each prior visit in the fields provided - approximate if you are not sure.

Date of Entry	Date of Exit	Visa Immigration Status	J-1 Subtype	Primary Activity	Have you taken any treaty benefits?
					Yes No
					Yes No
					Yes No
					Yes No
					Yes No
					Yes No
					Yes No
					Yes No
					Yes No
					Yes No

I hereby certify that all of the above information is true and correct. I understand that if my status changes from that which I have indicated on this form, I must submit a new Foreign National Information Form to the Payroll Department.

SIGNATURE: ___________________________________________ DATE: _____________________

HOW TO COMPLETE THIS FOREIGN NATIONAL INFORMATION FORM:

1. Name. List full name and birthdate.
2. Enter SSN or ITIN.
3. Enter your current e-mail address.
4. Local Street Address. List your local US address.
5. Residence. List your non-US address.
6. Country of Citizenship(s).
7. Country that issued Passport. List country in which you were issued your passport - not the country where it was issued.
8. Passport #. Enter your passport number.
9. Visa #. Enter your Visa number (the Control Number).
10. Immigration Status. Check the type of immigration status that you currently hold. If you check US Immigrant/Permanent Resident,
holder of a "green" card, you may proceed to the bottom of the form. Sign and Date.
11. Immigration Status for J-1. Check the appropriate J-1 subtype.
12. Actual Primary Activity. Check one activity.
13. Actual Entry Date into the United States (your very first visit). Must include month, day and year -approximate if you don't know.
14. Department. Describe in general the service you will perform.
15. Consultants/Self-employed Individuals (Honorariums). Check the appropriate boxes - this includes any office at any location specifically identified with you.
16. The country of residence where you last resided - can be different from your legal residence - do not include the USA.
17. Have you visited the U.S. previously? If you answer yes, please provide data for each prior visit in the fields provided - approximate if you are not sure.