I-20 REQUEST FORM FOR F-1 STUDENTS

If you are an F-1 international student and you need a new I-20, please complete this form. If there has been a change to your program, personal, or financial information, you will need to complete this form so we can update your SEVIS record and issue you a new I-20 if necessary. These changes must be reported to our office within 10 days.Please return this form to the International Student Advisor, Office of International Education, Suite 103, Carole Weinstein International Center. Please allow 5 days to process your request. We will email you when your new I-20 is available for pick up in the Resource Center, 1st floor, Carole Weinstein International Center.

We will accept and process these forms throughout the semester, but the last possible date to submit this form is May 1st for the spring semester and December 1 for the fall semester. Forms submitted after these dates will not be processed, which may affect your ability to travel outside the U.S. Exceptions will be considered for unforeseen circumstances – please make an appointment with the International Student Advisor to discuss this.

A. Student Information Section

FAMILY NAMEGIVEN NAME UR ID

CAMPUS ADDRESSCAMPUS TELEPHONE

EMAIL ADDRESSACADEMIC MAJOR

SEVIS ID N00DATE OF BIRTH CITIZENSHIP

(mm/dd/yyyy)

B. Please check off one or more boxes below and complete all information with required documentation. Incomplete sections will cause a delay in processing your request.

I-20 is lost and I need a replacement.

I-20 is stolen and I need a replacement.

I-20 is damaged and I need a replacement.

All of the signature lines on the last page are full and I need a new signed page for travel.

There has been a change to my program information and I need an updated I-20 for the following reasons(please attach documentation of these changes, such as Bannerweb or Registrar's report indicating new major, new graduation date, etc).

Change in major - Current major(s)New Major(s)

Change in program start date - Current start dateNew start date

(mm/dd/yyyy) (mm/dd/yyyy)

Change in program end date - Current end dateNew end date

(mm/dd/yyyy) (mm/dd/yyyy)

Other (please explain):

NOTE: If your program start and/or end dates have changed, please also complete one of the checkboxes on Page 2 for early or delayed completion.

There has been a change to my personal information and I need an updated I-20 for the following reasons (please attach documentation of these changes, such as marriage certificate indicating new name, copy of passport indicating new citizenship, etc):

Change in name - Current Family Name New Family Name

Change in name - Current Given Name New Given Name

Change in Citizenship - Current Citizenship New Citizenship

Change in Foreign Address - Current Foreign Address

New Foreign Address

There has been a change in my U.S. Address (within 10 days of the change, please also complete

form AR-11, which is available online at:

Current U.S. Address

New U.S. Address

There has been a change to my financial information and I need an updated I-20 for the following reasons (Do NOT complete this section if there is no substantial change to your scholarship since tuition, room, board, and other fees change each year.Please attach documentation of these changes, such as Financial Aid letter indicating new UR scholarship amount, bank letter indicating personal funds, etc.):

Change in UR scholarship amount - Current Amount$ New Amount$

Change in non-UR scholarship amount - Current Amount$ New Amount$

Name/Source of non-UR scholarship

Change in student's personal funds - Current Amount$ New Amount$

Change in student's family funds - Current Amount$ New Amount$

Change in funds from other sources (sponsor, home government, etc.) -

Current Amount$ New Amount$

Type of source

I am withdrawing from UR (please complete the following information and attach documentation from Dean's office):

Last semester attended Date of withdrawal

(ex: Fall 2005) (mm/dd/yyyy)

Reason for withdrawal

I am returning to UR after a leave of absence (please complete the following information and attach documentation of re-admission from the Dean's office):

Last semester attended Re-admission date (semester start date)

(ex: Fall 2005) (mm/dd/yyyy)

I am completing my educational program earlier than anticipated (please attach documentation of this change, such as Bannerweb or Registrar's report indicating early completion date):

Current completion date New completion date

(mm/dd/yyyy) (mm/dd/yyyy)

Reason for early completion

I am completing my educational program later than anticipated (please attach documentation of this change, such as Bannerweb or Registrar's report indicating delayed completion date):

Current completion date New completion date

(mm/dd/yyyy) (mm/dd/yyyy)

Medical or academic reason for delayed completion

PLEASE RETURN THIS FORM BY EMAIL TO

Office of International Education

28 Westhampton Way, University of Richmond, VA 23173

FAX: 1 (804) 289-8904 TELEPHONE: 1 (804) 289-8836

DO NOT WRITE BELOW – FOR Office of International Education USE ONLY:

International Student Advisor Authorization

(signature)

Printed NameKrittika Onsanit Date

SEVIS reporting made by

(signature)

ACCESS database updates made by

(signature)

BANNER database updates made by

(signature)

Name Date

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