TO:



Services for International Students and Scholars

University of California, Davis

Gayle Oberlies, International Scholar Advisor

geoberlies@ucdavis.edu

PH: 530-752-7538

E-3 Temporary Worker

(Australian Citizens only)

Information and Petition Packet

For Sponsoring Academic Departments

Information and Procedures

Overview: E-3 Temporary Worker Classification ................................................................. 1

The UCD E-3 Process ............................................................................................................ 2

E-3 Checklist for Hiring Department ..................................................................................... 4

E-3 Checklist for Prospective Employee ............................................................................... 5

Sample Letter from Department Chair ................................................................................... 6

Forms

• UCD Department Request for E-3 Petition – Form A

• Actual Wage Information Memo for E-3 Nonimmigrant Employee – Form B

• Notice of Intent to File Labor Condition Application – Form C

• UC Davis Physician Supplement List – Form D

• Recharge Fees for SISS

Overview:

E-3 Temporary Worker Classification

Who Qualifies?

The E-3 visa classification allows Australian nationals to temporarily work in the U.S. in a “specialty occupation” under the Australia-United States Free Trade Agreement. A specialty occupation is one that requires a specialized body of knowledge and at least a bachelor’s degree (or the foreign equivalent). E-3 workers are granted status initially for two years at a time, with indefinite extensions.

A considerable benefit of the E-3 category is the opportunity for spouses (E-3Ds) to apply for work authorization within the United States. Please direct E-3 spouses to the United States Citizenship & Immigration Service (USCIS) web site for more information on applying for work authorization in the U.S.

E-3 Petitions Filed from Within the US:

Change of Status in the U.S.: If the prospective E-3 worker is inside the U.S. in another visa status, the petition will ask USCIS to change his/her status. If the scholar is currently working at UCD in another status that expires before the change to E-3 status is approved by USCIS, he/she must stop working in the interim period.

Extension of Status in the U.S.: Unlike the H-1B status, the E-3 visa holder must have a request for an extension approved prior to the expiration of the current E-3 status, in order for work to continue without interruption. There is no legal provision for an E-3 worker to continue working while an extension is pending. Therefore, it is very important to submit requests for an E-3 extension inside the US at least 6 months in advance.

How to Apply?

All UC Davis E-3 cases must be processed through SISS to ensure compliance with campus policy and federal regulations (by the Depts. of Homeland Security, Labor, and State). UC Davis departments wishing to hire an international scholar pursuant to E-3 status shall work with SISS to prepare the requisite forms and supporting documents. It is the responsibility of the employing department to prepare the E-3 petition and supporting documents for SISS.  These materials should not be completed by the individual worker on his or her own behalf, except the paperwork completed for dependent family members. 

Applying From within the U.S.:

To apply for an E-3 change or extension of status from within the US, SISS must file Form I-129, Petition for Nonimmigrant Worker and supporting documents with the USCIS Vermont Service Center. UC Davis departments should work with the scholar directly to prepare the required documents to forward to SISS for review and processing.

Applying From abroad:

Though an I-129 petition does not need to be filed with the USCIS, SISS will work with the Department to prepare a complete application package (which includes a Labor Condition Application filed with the Dept. of Labor) to send to the scholar abroad. The scholar is then responsible for scheduling an appointment at the appropriate U.S. embassy or consulate to apply for an E-3 visa stamp in his or her passport.

Processing Time for Cases filed in the US

SISS suggests that departments initiate E-3 change or extension of status requests 6 months in advance of the start date and allow SISS 60 days to prepare E-3 petitions for submission to the USCIS. The 60 day period commences when SISS has received complete E-3 documentation from the department and scholar (which is after the determination of the prevailing wage).

Please note that processing times may vary depending on the type of request (change or extension of status in the U.S.). There is no Premium Processing option to expedite E-3 petitions with USCIS. In the case of an E-3 status, the fastest way to obtain the status in general is by applying directly at the American Embassy or Consulate in Australia. Please consult with an international scholar advisor for further information on this option. E-3 requests that are not submitted 6 months in advance will risk the ability of the employee to continue with employment without interruption.

DOS Processing Times for cases filed abroad:

For processing times and more information about the E-3 visa application process, the E-3 applicant should visit the website of the US Embassy in Australia at:

**Fees (for change or extension of status only):

• Form I-129, petition for E-3 worker: $325 payable to DHS

• Form I-539, application to extend/change status for dependents: $290 payable to

• Recharge fee (see Recharge Fee for SISS on the last page)

** It is University policy that the department pay all processing fees, including the SISS recharge fee and I-129 petition fee. The employee is responsible for the fees to apply for a visa at a US embassy/consulate abroad.

The UCD E-3 Process

1. Carefully Read the Materials in the E-3 Request Packet

Contact SISS with any questions regarding E-3/E-3D eligibility.

2. Determination of prevailing wage

The department provides information about the proposed E-3 position by completing the Prevailing Wage Request form at and emailing it to SISS at pwrequest@ucdavis.edu for review. The international scholar advisor will research the prevailing wage and contact the department with any questions or concerns. The UCD offered salary must be at least 100% of the prevailing wage or the actual wage, whichever is higher. This step is not necessary IF the position is represented by a union and will be paid according to the collective bargaining agreement.

3. Department posts LCA notice and prepares E-3 materials

After SISS notifies the department that the prevailing wage requirement is met, the department completes the “Notice of Intent to File a Labor Condition Application to Employ a Nonimmigrant E-3 Temporary Worker” (Form C) and posts the notice in two conspicuous locations for ten consecutive days (e.g., on a departmental bulletin board where job announcements are generally posted, and in the lab or work area). During the posting period, the department prepares the applicable USCIS forms and supporting documentation for submission to SISS as explained on the E-3 Procedures Checklist. After posting, the department includes a copy of the notice stating where and when posted.

For positions represented by a union or bargaining unit:

Complete but do not post the Notice of Intent to File (Form C in this packet) and submit it to SISS with the remaining E-3 materials from the Procedures Checklist. SISS will notify the bargaining unit through the UCD Labor Relations Department, as required.

4. SISS files the Labor Condition Application

After receiving the E-3 materials from the department, SISS will file the LCA electronically with the Department of Labor and further prepare the E-3 petition and supporting materials.

5. For scholars in the U.S.: SISS files the E-3 petition with USCIS and monitors progress and approval

Once the E-3 petition package is finalized, SISS will submit it to the USCIS, Vermont Service Center. Within the next few weeks, the USCIS will return an official receipt notice. Eventually, the USCIS will adjudicate the petition based on current processing times.

6. For scholars abroad.: SISS prepares the package for the Department to forward to the scholar to apply for an E-3 visa through the U.S. embassy/consulate abroad

If the prospective E-3 worker is outside the U.S. or willing to travel abroad, SISS will not need to file a petition with the USCIS. Instead, the prospective scholar will apply for an E-3 visa with the package prepared by the department and SISS. This type of case is called Consular Processing. To enter the U.S. in E-3 status, the scholar will first apply for an E-3 visa stamp, using an approved LCA processed by SISS and other supporting documents. Then upon arrival to the US, the scholar will present his/her E-3 visa stamp (in his/her passport) and supporting documents as requested by the Immigration Inspector at the Port of Entry. The scholar will be given an I-94 card showing admission in the E-3 classification. The Department and/or scholar should provide SISS a copy of the I-94 card promptly after arrival.

E-3 Checklist For Hiring Department

The following material should be completed and submitted to SISS approximately 6 months before the scholar expects to begin work at UCD. Upon receipt of the complete E-3 materials, SISS requires at least 60 days to process the E-3 request unless special circumstances warrant expedited processing.

1. Prevailing Wage Request Form (at ). FIRST complete and email this form to SISS at pwrequest@ucdavis.edu and wait for SISS to confirm that the offered salary meets the prevailing wage before proceeding with the rest of this checklist. If the position will be a postdoctoral position, please use the “Postdoc Wage Information Sheet” at the bottom of the above webpage instead. Postdocs are now under union contract and it is not necessary to wait for a wage confirmation before submitting the E-3 packet.

2. UCD Department Request for E-3 Petition Form (Form A), including:

-Department attestations regarding E-3 employment per DOL regulations

3. Actual Wage Information Memo (Form B)

4. Copy of Notice of Intent to File a Labor Condition Application to Employ a Nonimmigrant

E-3 Temporary Worker (Form C)

5. If E-3 beneficiary will act as a physician:

-- Please see Physician Supplement (Form D), attached for additional required materials.

6. SISS Recharge Sheet

7. ORIGINAL Letter from employer - see SISS sample included in this packet

-- To USCIS (if scholar in the US) and to Dept. of State (if scholar abroad)

-- From the Department Chair

-- Must include the following information:

-- Brief description of duties and temporary nature of position

-- Dates of appointment (only for which funding is available; maximum two years)

-- Salary (annual salary or hourly, if part-time)

-- Requirements for position offered (e.g. specific BS, MS, PhD etc. degree)

-- Academic qualifications of scholar beneficiary

-- Special skills/relevant background of applicant

8. Form I-129 (for change or extension of status cases only) Petition for E-3 Nonimmigrant Temporary

Worker, found at:

9. Fee(s) for cases filed within the U.S. only - Please have checks sent directly to your department and then include checks with the E-3 packet that is sent to SISS.

-- Form I-129: $325 check payable to DHS (please note: premium processing is not available for E-3 petitions)

-- Request a check through DaFIS:

Vendor: #0000016361: Remit to: 0010; Group Code: 2, Object Code: 7215

Payment Purpose: “I-129 fee for (scholar’s name).”

E-3 Checklist for Employee

(Department may wish to provide this page to the prospective or continuing employee.)

It is the responsibility of the employer to file a petition for the E-3 Temporary Worker for a prospective employee. If nonimmigrant employee will be sponsored for E-3 status by UCD, the employing academic department will need the following information from the employee:

A copy of the highest degree/diploma. If the degree is not from a US institution, it is generally a good idea to include a degree evaluation from a reputable company. Petitions filed without a degree evaluation may be approved but there is also a slight risk of receiving a “Request for Evidence (RFE)” from the USCIS. Please consult with an international scholar advisor for further information.

A current copy of the curriculum vitae or resume with a list of publications, if applicable.

If applicable, copy of any required license to practice the occupation in California

A copy of the passport identification pages (showing validity of at least 6 months)

Address in the home country and the name of the city where you will apply at a U.S. Embassy or Consulate for the E visa(s). Provide this even if you will change status inside the United States.

If you and/or family members are currently in the United States, please provide the following materials:

Documents to prove legal status in the US for E-3 and any E-3D dependents:

single-sided copy of both sides of Form I-94 (small white card stapled into passport)

copy of most recent visa in passport

copy of ID pages in passport

copy of evidence of marital or birth relationship (with English translation) for any E-3 dependents

If scholar is in J status:

single-sided copy of front page of current and all previous DS-2019 forms

DS-2019 copies for J-2 dependents and J-2 Employment Authorization Document (EAD), if applicable

If scholar is in F-1 status:

single-sided copy of pages 1 and 3 of I-20 form

copy of employment authorization document (if applicable)

copy of I-20(s) for F-2 dependents (if applicable)

If scholar is in E-3/H-1B/O-1/TN status

single-sided copy of front of all prior I-797 approval notices for scholar and any dependents

If E-3 beneficiary or dependents have filed for permanent residency

copy of I-140 receipt/approval notice and/or copy of I-485 receipt/approval notice

copy of advance parole document

copy of employment authorization document (EAD)

Form and Fee for E-3 Dependents Changing to, or Extending, E-3D Status

I-539 Form, found on the SISS website at:

Check to DHS for $290 total for all dependents

E-3 STATUS

Sample Letter

(Use Department Letterhead)

Date

U.S. Embassy

Consulate (city, country where scholar will apply for a visa)

or

U.S. Department of Homeland Security

U.S. Citizenship and Immigration Services

To Whom It May Concern:

We would like to temporarily employ Mr./Ms./Dr. for the period of _____________ to ___________(the total period can be no more than 2 years). The salary will be $ _________ (per year or per hour, if part-time).

(Explain briefly in lay terms what the person will be doing which should match the job duties listed on the prevailing wage request form.) Also, if this person is a physician, include an appropriate statement regarding patient contact. See the “Physician Supplement to the E-3 Checklist” for more information). The minimum requirement for this position is a (BS/MS/PhD, etc.) degree in (field) or a related field. (To qualify for E-3 status, the position must minimally require a bachelor’s degree).

Mr./Ms./Dr. is well-qualified for this temporary (teaching/ research/professional) position in a specialty occupation. S/he earned a (BS, MS, etc.) degree in (academic field) in (year) at (institution) and (PhD, MD, etc.) degree in (academic field) in (year) at (institution). S/he has a strong background in (field of specialty).

Thank you for assisting with this petition.

Sincerely,

Professor and Chairperson

Department of _______________

UCD Department Request for E-3 Petition - Form A

A. ABOUT THE VISITING E-3 SCHOLAR:

1. Name of E-3 employee (from passport ID page):

|      |      |      |

|(Family/Last) |(Given/First) |(Middle) |

|2. City and country of birth: |      |Country of citizenship: |      |

|3. Current Address: |      |      |      |      |      |

| |(Street) |(Apt. #) |(City) |(State) |(Zip Code) |

|4. Phone (work): |      | E-mail: |      |

|5. If this person is currently in the U.S., please complete (a) – (f): |

| a. What is his/her current immigration status? |      |

| b. What date did this status begin? |      |

| c. What is the expiration date on the visitor's current I-94 (white card in passport)? |      |

| d. Who is his/her current visa sponsor? |      |

| e. If in E-3 status, state initial entry date: |      |

| f. When does his/her passport expire? |      |

|6. If this person is outside the U.S., list dates of prior periods of stay in the U.S. for the past 6 years and visa type(s): |

| |      |

|7. Address outside the U.S.: |      |

| |      |

| |      |

|8. U.S. embassy or consulate abroad where scholar will apply for a visa: |      |

B. ABOUT E-3 SCHOLAR’S DEPENDENTS (Spouse and children under 21)

1. Dependents’ names, relationship to H-1B scholar, dates of birth, and U.S. immigration status:

|Family/Last Name |Given/First Name |Middle Name |Relationship (Spouse, |Date of Birth |Immigration Status |

| | | |Child) |(mm/dd/yyyy) | |

|      |      |      |      |      |      |

|      |      |      |      |      |      |

|      |      |      |      |      |      |

|      |      |      |      |      |      |

|      |      |      |      |      |      |

|      |      |      |      |      |      |

|      |      |      |      |      |      |

|2. Initial entry date if in E-3D status: |      |(if available, provide evidence of initial entry) |

| |

|3. Dependents’ city and country of birth, and country of citizenship: | |

|Name of Dependent |City of Birth |Country of Birth |Country of Citizenship |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

C. ABOUT THE UNIVERSITY POSITION:

|1. Payroll Title: |      |

|2. Annual Salary: |$       |per year |

| and Hourly Salary: |$       |per hour |Salary Range (if applicable): |      |

|3. |      |% appointment |

|4. Anticipated dates of employment: (from) |      |(to) |      |

|5. Is funding guaranteed for the entire employment period? |Yes: | | No: | |

|6. Location of employment: |

| a. single job location – specify city/county/state: |      |

| b. job is peripatetic in nature; normal duties include frequent travel from location to location |

| c. job will include occasional travel of 10 consecutive days or less |

| d. job includes short-term placements in second work location of: |

| (i) less than 30 days during one year period; |

| (ii) up to 60 days during one year period; |

| (iii) more than 60 days in one year period, but employee will maintain an “office” at the primary location |

| e. job includes a secondary work location for more than 60 days per year during which the employee |

| will not maintain an “office” at the primary work location: |

| Specify secondary work location: |      |

| |      |

Note: a separate Prevailing Wage Request form must be completed for primary and secondary work locations, but not for short-term placements.

D. DEPARTMENT ATTESTATION:

1. The salary being paid to the above-named employee is at least the actual wage being paid to all other individuals with similar experience and qualifications for the specific employment in question or the prevailing wage level of the occupation in the area of employment, whichever is higher.

2. If the position is not represented by a bargaining unit:, a Notice of Intent to file a Labor Condition Application (attached) has been posted in two conspicuous locations at the place of employment and will remain posted for ten

consecutive days. Please return a copy of the completed "Notice of Intent" to SISS with the E-3 petition materials.

3. The vacation time, sick leave, and other benefits offered to this employee are equivalent to that offered to other

U.S. workers in the same classification.

4. Employment of this person will not adversely affect the working conditions (hours, shifts, vacation periods, fringe

benefits, etc.) of similarly employed workers.

5. There is no strike, lockout, or work stoppage due to a labor dispute in this occupation.

6. We fully understand that misrepresentation or willful failure to pay wages or meet working conditions as required

may incur penalties including payment of back wages, civil money penalties, or debarment of UCD from the employment of E-3 non-immigrants.

7. We agree to consult with SISS prior to making any change in this appointment, including salary, title, percentage of the appointment, change of department, or termination. SISS will determine whether it will be necessary to amend the petition with USCIS prior to making a change, in order to fully comply with federal regulations governing E-3 employment.

8. We agree to pay expenses associated with this petition such as mandatory government filing fees, mailing costs, the SISS recharge fee, etc. Please complete the recharge approval form, to be submitted with this request.

|Department Chair: |      | |      |

| |Name |Signature |Date |

|Department: |      |College or Division: |      |

|Supervisor: |      | |      |

| |Name |Signature |Date |

|Department Contact:|      | |      |      |      |

| |Name |Signature |email |phone |Date |

---------------------------------------------------------------------------------------------------------------------------------------------------

UCD School of Medicine Appointments ONLY:

|Approved by: |      |for School of Medicine Dean's Office. |

| |Name | |

| | |      |

| |Signature |Date |

Actual Wage Information Memo for

E-3 Nonimmigrant Employee – Form B

Complete and keep this form and the required attachments in the E-3 employee’s departmental personnel file. Also include a copy of this completed form when submitting the E-3 petition to Services for International Students and Scholars (SISS).

Under the E-3 federal regulations, employers are required to pay E-3 nonimmigrants the higher of the prevailing wage in the geographical area of the intended employment, and the actual wage. The actual wage is defined as the wage rate paid by the employer to all individuals with similar experience and qualifications at the work location of the proposed E-3 employment, for the specific employment in question.

The E-3 federal regulations require that employers maintain documentation in the E-3 employee’s file to indicate how, based on objective standards, the employee’s actual wage rate was determined. Employers may take into consideration “objective standards relating to experience, qualifications, education, specific job responsibility and function, specialized knowledge, and other legitimate business factors” in establishing this actual wage rate. This documentation must be available to authorities of the U.S. Department of Labor in the case of a review of the employer’s E-3 procedures.

IMPORTANT: Under the E-3 federal regulations, in the event that UC Davis gives employees raises, or provides for other adjustments in wages, E-3 employees must be given the raise or adjustment, consistent with UCD’s legitimate established criteria. The employing unit must complete a new “Actual Wage Information Form” if, during the validity of the employee’s E-3 status, there are any adjustments to the E-3 employee’s wage rate or more generally to the wage rate of employees with the same payroll title (i.e. merit increase, cost of living increase, salary range adjustments, etc.). The original of the updated form must be kept in the E-3 employee’s personnel file. A copy of the updated form must also be sent to: SISS, Attention: Daniel Padron.

FORM MUST BE TYPED

|1. E-3 Employee’s Name: |      |      |      |

| |(Family/Last) |(Given/First) |(Middle) |

|2. Employing Department/Division at UCD: |      |

|3. E-3 Appointment Dates: |Start Date: |      |End |      |

| | | |Date: | |

|4. UC Payroll Title: |      |

|5. Wages per YEAR: |$       | Percentage Time: |      % |

|6. State objective standards (listed in paragraph 3 above) used to set the E-3 employee’s wage for this position. If the employee’s pay rate is above the entry |

|level rate for this pay title, include an explanation of the factors used to determine this employee’s higher pay rate. For “off-scale” and “decoupled” faculty |

|salaries, an explanation of how the exact salary was arrived at is required. |

|      |

|      |

|      |

|      |

|      |

|7. List all work locations at which the employee will work for 60 working days or more each calendar year. For each non-UC Davis work location, you must attach an |

|explanation of how the E-3 employee’s salary compares to salaries for workers with similar job duties and qualifications at that work location. Attach the relevant|

|salary scale for all work locations. |

|I)       |

|II)       |

|III)       |

|IV)       |

I certify that the information on this form is correct and complete:

|      | |      |

|Name of supervisor or department chair |Signature |Date |

Actual Wage Information Form

Notice of Intent to File a Labor Condition Application to Employ a Nonimmigrant E-3 Temporary Worker – Form C

|Number of E-3 nonimmigrants sought: |      |

|Position Title: |      |

|Wages Offered: |      |

|Period of Employment: from |      | to |      |

| |(date) | |(date) |

|Location(s) where E-3 nonimmigrant will be employed: | |

|1) |      |      |      |

| |(city) |(county) |(state) |

|2) |      |      |      |

| |(city) |(county) |(state) |

|Location(s) of postings: |      |

| |      |

|Posting period (10 days): from |      | to |      |

| |(date) | |(date) |

Occupational Classification: Occupations in College and University Education

The Labor Condition Application is available for public inspection at:

Services for International Students and Scholars

University of California, Davis

Davis, CA 95616-8698

Complaints alleging misrepresentation of the material facts in the Labor Condition Application and/or failure to

comply with the terms of the Labor Condition Application may be filed with any office of the Wage and Hour Division

of the United States Department of Labor.

Hiring Department:

For positions not covered by a union or bargaining unit, after SISS notifies your department that the position passes the prevailing wage test, the department must post the above “Notice of Intent to File a Labor Condition Application To Employ an Alien E-3 Temporary Worker” in two locations for ten consecutive days. This may be on a departmental bulletin board where job announcements are generally posted and in the lab or work area.

UC Davis Physician Supplement

List – Form D

If the prospective E-3 employee holds a Medical Degree, please submit the items below,

in addition to the items listed on the E-3 procedures checklist.

Graduates of Foreign Medical Schools

Teaching and research positions:

1. Letter from the department chair to USCIS must state:

a. “No patient contact is involved in this position.”

OR

b. “Any patient contact will be incidental to his/her teaching and/or research.”

2. Scholar’s Medical degree

OR

Full and unrestricted license to practice medicine in a foreign state

3. State license or other authorization to perform patient care (Required only if patient care is involved.)

Non-teaching and research positions:

1. Medical degree

OR

Full and unrestricted license to practice medicine in a foreign state

2. State license or other authorization to perform patient care

3. Documentation of having passed parts I, II, III of the United States Medical Licensing Examination (USMLE).

4. Documentation of having passed the ECFMG English language proficiency test. (Not required for graduates of Canadian medical schools.)

Graduates of U.S. Medical Schools

1. Medical degree

2. State license or other authorization to perform patient care

Recharge Fees for

Services for International Students and Scholars

SISS service fees will be recharged to the academic department or program which hosts and/or hires the international faculty member or researcher. This fee can only be paid on a department recharge basis and cannot be paid directly by the scholar. Reimbursement for this recharge may be available through your college dean's office. Contact that office if you have questions about applying for reimbursement.

Please note that this recharge does not include any filing fees payable to Department of Homeland Security (DHS) for processing of applications.

Please return this Scholar Recharge Approval Form with the completed department request form or application materials to Services for International Students and Scholars (SISS), UCD campus. Questions about recharges should be addressed to Simone Kueltz (skueltz@ucdavis.edu) or 530-752-7536.

University of California, Davis

Scholar Recharge Approval

|Scholar Name: |      |      |

| |Last/Family Name(s) |First/Given Name(s) |

|Administrative |      |      |      |

|Contact Info: | | | |

| |Name |Phone |E-mail |

|Department: |      |College or Division: |      |

|Recharge to DaFIS acct/sub acct number: |      |      |      |

| |COA |DaFIS account number |Sub account number |

| | |7 Digit |5 Digit (optional) |

|Please check |Visa Type |Requests received by |Requests received on or |

|one: | |12/31/2016 |after 1/1/2017 |

| |J-1 Exchange Visitor (DS-2019) – new or extension |$415.00 |$490.00 |

| |TN (Mexicans and Canadians Only) – new or extension |$765.00 |$490.00 |

| |E-3 (Australians only) – new or extension |$770.00 |$2,000.00 |

| |H-1B (Specialty Occupations) – new or extension |$1125.00 |$2,000.00 |

| |O-1 (Extraordinary Ability) - new |$3,350.00 |$4,490.00 |

| |O-1 (Extraordinary Ability) - extension |$550.00 |no charge |

| |Permanent Residence Petition without Outside Counsel |$4,490.00 |$4,4490.00 |

| |Permanent Residence Petition with Outside Counsel |$2,865.00 |$2,865.00 |

| |(This fee is for SISS; this does not include attorney fees.) | | |

Note: A change in job offer may require a new visa document/petition and an additional recharge.

SIGNATURE AUTHORIZATION: I authorize this departmental recharge for SISS to support the employment of the above-named international scholar.

|Dept. Chair: |      |Signature: | |Date: |      |

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