Title Purpose
International Check Collection Form

Submit an international draft for deposit. See Accepting International Drafts for more information.
Extended Stay Justification

Provide justification for an extended stay on a business trip.

If you have questions about this form, please contact your local financial transaction or business service center.
Foreign Flag Carrier Approval Exemption Certification Form

Certify the necessity of using a foreign flag carrier for foreign travel.
Concur

Submit your expense report for a business-related trip or business meal.
Participant Fee Advance

Request a cash advance for a Cornell research project involving human subjects.
Project Advance Authorization

Request a cash advance for a Cornell site project.
Travel Advance Form

Request a cash advance for a Cornell business trip.

Because direct payment or corporate card is available for most travel expenses, travel advances will be limited to those expenses for which a traveler is expected to endure a hardship for out-of-pocket expenses while on travel, and expenses that could not have been paid for by direct payment or a Cornell corporate card. 

Advances are limited to faculty, staff members, and students. Expenses related to visitors should be charged directly to operating accounts.
Foreign National Questionnaire Paper Form

For foreign nationals only: Complete to be able to receive payments from the university, excluding payments for travel reimbursement and honoraria.

If possible, it is preferred that you complete this form electronically using the Foreign National Information System (FNIS). See the Foreign National Questionnaire page for details.

Foreign National Questionnaire Paper Form (PDF, 367 KB)

Submission Instructions

Mail, hand-deliver, or fax the completed form to the following address/fax number:

University Tax Office
377 Pine Tree Rd.
Ithaca, NY 14850
Fax: (607) 255-3198

Include the following documents:

  1. Copies of both sides of the I-94 form "Arrival and Departure Record" (small, white card inside the passport)
  2. Copy of your Visa (from your passport)
  3. Form I-20 or DS-2019 (formerly IAP-66)

Form instructions are available on the Foreign National Questionnaire page.

Form Completion Instructions

Part I: Personal Information

  1. Last / Family Name: Enter your last name, your family name.
  2. First Name: Enter your first name, not your family name.
  3. Middle Name:  Enter your middle name.
  4. U.S. Federal ID # (i.e. social security number): Enter the U.S. Social Security Number (SSN) issued by the U.S. Social Security Administration (SSA), not your ID number. Do not list numbers not assigned by the U.S. SSA (i.e., Canadian Social Insurance Number, etc.). All employees must have an SSN to work in the U.S. If you do not have an U.S.-issued SSN, enter your Individual Taxpayer Identification Number (ITIN) issued to you by the U.S. Internal Revenue Service (IRS).

Back

Part II: U.S. Local Address

  1. Address Line 1: Enter the house number, street name, and apartment number in which you reside in the U.S.
  2. Address Line 2: Enter any information used to identify your apartment/house that is not listed in the above line (if applicable, if not - leave blank).
  3. Address Line 3: Enter any information used to identify your apartment/house that is not listed in the above lines (if applicable, if not - leave blank).
  4. City: Enter the city in which you reside in the U.S.
  5. State: Enter the state in which you reside in the U.S.
  6. Zip: Enter the zip code of the city in which you reside in the U.S.

Back

Part III: Foreign Residence Address

  1. Address Line 1: Enter your non-U.S. house number, street name, and apartment number in which you reside.
  2. Address Line 2: Enter any information used to identify your apartment/house that is not listed in the above line (if applicable, if not - leave blank).
  3. City: Enter your non-U.S. city of residence.
  4. Province: Enter your province of residence (non-U.S.)
  5. Country: Enter your country of residence (non-U.S.)
  6. Postal Code: Enter the postal code of the country in which you reside (non-U.S.)

Back

Part IV: Citizenship and Passport Information

  1. Country of Citizenship: Enter the country in which you hold citizenship.
  2. Country that Issued Passport: Enter the country that issued your passport (may differ from your country of citizenship).
  3. Passport #: Enter your passport number.
  4. Visa # (not the control number that begins with a year): Enter your visa number, ensuring it is not the control number.

Back

Part V: Current Immigration Status in U.S.

  1. Either circle one of the following selections:
    1. J-2 Spouse or Child of Exchange Visitor
    2. H-1 Temporary Employee
    3. F-1 Student
    4. J-1 Exchange Visitor
    5. U.S. Immigrant / Permanent Resident
  2. Or enter your applicable U.S. immigration status in the "Other:" field.

Back

Part VI: If Immigration Status is J-1, What is the Sub-Type?

  1. Either circle one of the following selections:
    1. 12 Research Scholar
    2. 05 Professor
    3. 02 Short-Term Scholar
    4. 01 Student
  2. Or enter the correct information in the "Other:" field.

Back

Part VII: What is the Actual Primary Activity of This Visit?

  1. Circle one of the following selections:
    1. 01 Studying in a Degree Program
    2. 02 Studying in a Non-Degree Program
    3. 03 Teaching
    4. 04 Lecturing
    5. 05 Observing
    6. 06 Consulting
    7. 07 Conducting Research
    8. 08 Training
    9. 09 Demonstrating Special Skills
    10. 10 Clinical Activities
    11. 11 Temporary Employment
    12. 12 Here with Spouse

Back

Part VIII: Entry and Activity Dates

  1. Based on the information on your I-94 form, enter the actual date your entered the U.S. in the mm/dd/yyyy format (e.g., 01/21/2007)
  2. Based on the information listed on your I-20 or DS-2019 (formerly IAP-66), enter the start date of your immigration status or this primary activity in the mm/dd/yyyy format (e.g., 01/21/2007)
  3. Based on the information listed on your I-20 or DS-2019 (formerly IAP-66), enter the projected end (finish) date of your immigration status or this primary activity in the mm/dd/yyyy format (e.g., 01/21/2007)

Back

Part IX: Income Providing Activity

  1. Enter the title of the income earning position you hold at Cornell, if applicable.

Back

Part X: Student Type

  1. Either circle one of the following selections:
    1. Undergraduate
    2. Masters
    3. Doctoral
  2. Or enter the information in the "Other:" field.

Back

Part XI: Spouse Information

  1. "Is your spouse (husband/wife) in the U.S.?" Circle the correct answer:
    1. Yes
    2. No
  2. "Number of children in the U.S.?" Enter the number of children in the U.S. with you if applicable.

Back

Part XII: Country of Tax Residence if Different from Citizenship

  1. Does your country of tax residence (country where you last paid taxes) differ from the country in which you hold citizenship? If so, did your tax residency end? Circle the correct selection:
    1. ​Yes
    2. No
  2. If "Yes" was selected, enter the date when the tax residency ended.

Back

Part XIII: List Any Visits to the U.S. in the Last Three Calendar Years

Note: You must also list all F, J, M, or Q visas since 1/1/1985. If necessary, attach an additional form or paper to include the required entries.

  1. Be sure to enter information in all of the listed columns:
    1. Date of Entry
    2. Date of Exit
    3. Visa Status (B-1, F-1, etc.)
    4. Primary Activity (tourist, student, etc.)
    5. Have you taken any treaty benefits? Yes or No

Back

Part XIV: Certification

  1. By signing the form, you are certifying the information is true and correct. You are also agreeing to submit a new form to the University Tax Office as soon as there are changes to your current (at the time of signing) visa status. Changes include, but are not limited to the following: 
    1. ​You change from a J-1 visa to a B-1B visa
    2. You receive a "green card"
  2. Changes to your visa status may also change your tax liability, for which you are held personally responsible.
  3. By signing this document, you agree to the conditions listed in the certification statement located above the signature field.
    1. ​Signature: Sign your full name
    2. Date: Enter the current date
    3. Local Phone: Enter a local phone number where you can be contacted
    4. E-mail: Enter the email address Cornell assigned you

Back
Foreign Visitors Honoraria/Expense Reimbursement Attestation Form

To verify your Visa status with the university in order to receive an honorarium or expense reimbursement.
Summer Salary Processing Form

Request summer salary in addition to your nine-month academic year appointment.
Credit Card Update Form

Request to change information associated with a Procurement Card or a Travel and Meal Card.
Business Meal Detail Form

Supply details of a business meal when the payment to the restaurant is made by procurement card.
FICA Tax Refund Authorization

Complete this form to authorize Cornell University to refund the employee's share of FICA taxes (i.e., Medicare and Social Security taxes withheld). An employee who is exempt from FICA taxes and eligible for a FICA refund will be repaid or reimbursed to the extent that the taxes are refunded by the IRS. Exemption requirements must be met.

IMPORTANT: Employees who have been contacted by the university regarding a FICA refund, must submit this completed form within 45 days of the certified mailing date, or the employee will be considered to have refused to provide authorization.
W-2 Reissue Request Form

For INACTIVE employees only. Request reissue of a W-2 form that is older than the current tax year.
Payroll Deduction Authorization Form

Authorize University Payroll to automatically deduct amounts from your paycheck, or change or terminate a deduction.
Vehicle Certification Form

Report personal use of a university-provided vehicle.
Paycheck/Advice Reversal/Return

Return paychecks to Payroll or request that a check be reversed by contacting Payroll.
Elective Tuition Refund Plan Enrollment

Enroll to insure 90% of tuition charges in the event the student withdraws due to a covered illness or accident.

Learn more about the Elective Tuition Refund Plan on the Bursar website.
Item Type Request

Request a new Student Financials item type for posting transactions within PeopleSoft: Item Type Request
Student Loan Exit Interview

Information about student loan exit interviews is available on the Loan Exit Interviews page of the Bursar website.