Research Corporation of the University of Hawaiʻi

Research Corporation
of the University of Hawai‘i
Human Resources Department
Type of O-1 request:
O-1 REQUEST FORM
Initial Entry (new employee is outside the U.S. and will enter in O-1 status)
Change of Status (person is in U.S. and will change to O-1 from a different visa status) Change of Employer (person is O-1 and will change from another U.S. employer to RCUH) Extension
Concurrent Employment
Amended Petition (change to RCUH employment)
Are you requesting USCIS Premium Processing Service? Yes No Part I: Biographical & Immigration Information
1. Name on Passport:
Last (surname): ______________________________ First (given): _________________________________ Middle (if any): _______________________________
2. Other Names (e.g., maiden name, other spellings, etc.):
3. Date of Birth (mm/dd/yyyy):
4. Social Security Number (if any):
5. A# (if any):
6. Nationality:
a. Country of Birth:________________________________ b. Province of Birth:_______________________________ c. Country of Citizenship:___________________________
7. Telephone Number: 8. Email Address:
9. Foreign Address:
Street Number and Name: Apt./Ste./Flr.:
City or Town:
State:
Province:
Postal Code:
Country:
10. If already in the United States:
Last Date of Arrival: __________________________ I-94# (attach copy): ___________________________________________ Current Nonimmigrant Status: __________________________ Expiration Date:____________________________________ Residential address in the US: _____________________________________________________________________________ If there are future travel plans for travel outside of the U.S., please list the destination and dates of departure & return*:
*Note: Individuals filing for a change of status to O-1 should not leave the U.S. once the RCUH files the petition with the service center if the approval is not received.
11. If this person is not in the United States (i.e., will obtain the visa before entering the U.S.), please indicate the consular post where the individual will obtain the visa:
RCUH Form I-103
Created 10/05 (Revised 11/10, 11/13, 05/15, 04/16, 11/16, 03/17)
O-1 Request Form Page 2 of 3
12. If this person is already in the United States, does this person have immediate family members which require change in their current nonimmigrant status? Yes No
If yes, complete the RCUH Dependent Information Form.
13. Is this person currently in removal (deportation) proceedings? Yes No
14. Has this person ever held an O-1 status? Yes No
15. Has this person ever been denied O-1 status? Yes No
16. Has this person ever been a J-1 exchange visitor or J-2 dependent in the U.S.? Yes No
If yes, list dates of J-1/J-2 status and provide copies of Forms DS-2019, IAP-66, or J entry visa stamps in passport.
Part II: Position Information
17. Position Title:
18. Intended O-1 period:
____________________ to ____________________
19. Address of Primary work location:
20. Address(es) of any additional work locations:
21. Name & job title of Supervisor(s):
22. FTE & Salary/Wages:
Full-time: $____________ per year
Part-time: $_______ per hour & #______ hours per week
23. Work Schedule (e.g., Monday-Friday 8-5):
24. Does an appropriate labor organization exist for the petition? Yes No If no, please provide brief explanation.
25. Is the required consultation or written advisory opinion being submitted with this petition? Yes No
Part III: Instructions
The O-1 Request Form and supporting documentation must be submitted to RCUH Human Resources five to six (5-6) months prior to the requested effective date of the O-1 status for standard processing and two (2) months prior to the requested effective date of the O-1 status for premium processing/expedited processing. A certified English translation must be provided for any document not in English.
The following are required supporting documents:
26. Copy of valid passport and Form I-94. Include most recent Form I-94 arrival/departure record in passport if already in the U.S.
If international travel and return is scheduled prior to submission of this petition, a copy of the I-94 record must be submitted to
RCUH immediately upon return.
27. RCUH I-129 Export Controls Compliance Certification Form. Principal Investigator/Supervisor must complete the UH Office of
Export Control’s I-129 Certification Decision Tree at http://www.hawaii.edu/offices/export/I-129/. The Principal
Investigator/Supervisor and the Dean/Director must sign the form.
28. Resume.
RCUH Form I-103
Created 10/05 (Revised 11/10, 11/13, 05/15, 04/16, 11/16, 03/17)

O-1 Request Form Page 3 of 3
29. Copies of academic degree(s). If the diploma does not clearly state the major field of study, transcripts must be submitted. Diploma(s) in a foreign language must be submitted with a certified translation. If degree was granted from an academic institution outside of the U.S., a foreign educational credential evaluation must be submitted.
30. Complete list of publications.
31. Written advisory opinion from a peer group or a person designated by the group with expertise in the person’s area of ability.
Submit letters of recommendation or affidavits with the CV or resume of the author(s).
32. Copies of membership in Professional Affiliations or Organizations which require outstanding achievements, as judged by
recognized national or international experts in the field.
33. Documentation of nationally or internationally recognized Awards or Honors for excellence in field of endeavor.
34. Copies of publications.
35. Documentation of original scientific, scholarly, or business-related contributions of major significance in the field.
36. Documentation of participation of a panel, or individually, as a judge of the work of others in the same or in an allied field of
specialization to that for which classification is sought.
37. Evidence of the person’s prior employment in a critical or essential capacity for organizations and establishments that have a
distinguished reputation.
38. Signed letter of support from the Principal Investigator which includes:
a. Intended employment period;
b. Description of Project;
c. Description of job offered; and
d. Description of person’s background and reason why he/she is most suitable for this position.
39. USCIS Filing Fees. Filing fees are subject to change. Check the USCIS website at http://www.uscis.gov/forms for current fees. All checks must be made payable to the “Department of Homeland Security” or “U.S. Department of Homeland Security.” Forward the check(s) to RCUH Human Resources. Filing fees must be paid by the project and cannot be passed on to the employee.
a. Form I-129. RCUH Human Resources will complete the form for petition.
b. Form I-907, Request for Premium Processing Service (Optional). RCUH Human Resources will complete the form for
petition.
31. RCUH Dependent Information Form & USCIS Filing Fee. (if applicable)
a. Form I-539: This fee may be paid by any source, including the employee. RCUH Human Resources will complete the form for petition.
40. Copies of previous Forms I-797, DS-2019, I-20. (if applicable)
41. Waiver of J-1 visa two-year foreign residence requirement (INA 212(e)) or an advisory opinion. Required for J-1 holders who
are subject to the two-year home country physical presence requirement.
Part IV: Certification
I certify that I have sufficient funding to support this action and related costs.
_______________________________________________________________ _________________________ Principal Investigator (Signature) Date
_______________________________________________________________ Principal Investigator (Print Name)
Project person responsible for the coordination of this action:
_______________________________________ __________________________________________ Name Phone Number & Email Address
Part V: RCUH Human Resources Visa Request Approval
_________________________________________________________ ______________________ Director of RCUH HR or Designee Date
RCUH Form I-103
Created 10/05 (Revised 11/10, 11/13, 05/15, 04/16, 11/16, 03/17)