ࡱ> LNK#` >bjbj .BJ vvvvvvv,t DDDDDtL(DFFFFFF$h+ j]vDDjvvDD vDvDDDlvvD c>d0 ,!!!v(,:fF,,,jj:,,,  dvvvvvv  Certification of J-1 Scholar Employment for Social Security Number Application  Instructions: This form may be typed on-line but must be printed on department letterhead. The hiring department must complete Section A including an original signature. The scholars must then take this form, along with passport, DS-2019, and I-94 card, to the Slutzker Center for endorsement in Section B. Once endorsed, this form must accompany all other required materials when the scholar applies for a number at the Social Security Administration Office. Please note that the scholar may only work according to the terms of their appointment letter.  Syracuse University Hiring Department Information First name of the scholar (as it appears on DS-2019)  FORMTEXT      Last name of the scholar (as it appears on DS-2019)  FORMTEXT      Scholar s SU ID #:  FORMTEXT      Name of the campus employer/department (e.g. Physics, Biology, etc):  FORMTEXT      Employer Identification Number (EIN): 15-0532081Employer / Department address (include city, state, and zip code);  FORMTEXT      Nature of scholar s employment:  FORMTEXT      Employment start date: (MM/DD/YYYY) Name of scholar s immediate supervisor:  FORMTEXT      Title of scholar s immediate supervisor:  FORMTEXT      Supervisor s telephone number:  FORMTEXT       __________________________________________ _______________________ Signature of Scholar s Immediate Supervisor Date Signed  Certification of ARO/RO at the Slutzker Center for International Services  This section will be endorsed only after section A is completed and signed This is to certify that the above named J-1 scholar is attending Syracuse University. The scholar is working on-campus as described above. The scholar may apply for a Social Security Number on or after ________________________. QRSTa@ V   h j l ŻnŻ]Oh"vCJOJQJ^JaJ h"v6CJOJQJ]^JaJ h"v56CJOJQJ^JaJ h"v6>*CJOJQJ^JaJh"vCJOJQJ^JaJh"v5CJOJQJ^JaJh"vCJOJQJ^JaJh"vOJQJ^Jh"v5CJ OJQJ^JaJ &h"v5B*CJOJQJ^JaJph&h"v5B*CJ OJQJ^JaJ phh"vQRST j[[[$A &P#$/Ifkd$$Iflf++  t 6PA  f0+644 lap f$$A &P#$/Ifa$>   h j {e{$ & F$A &P#$/Ifa$h$A &P#$/If^hqkd$$Iflf++ t 6PA 0+644 laj l f ~mmmmmmx$A &P#$/IfkdY$$Iflf++  t 6PA  f0+644 lap f  f h | ~ h j ~ ݜwݎ`Vh"vOJQJ^J,jh"v5CJOJQJU^JaJ,j{h"v5CJOJQJU^JaJh"vCJOJQJ^JaJ h"v6CJOJQJ]^JaJ1jh"v5CJOJQJU^JaJmHnHu,jh"v5CJOJQJU^JaJh"v5CJOJQJ^JaJ&jh"v5CJOJQJU^JaJ h fUUUUx$A &P#$/Ifkdc$$IflF!f+8 t 6PA 0+6    44 la~   "$PjlռխխpռխխYռխKhvCJOJQJ^JaJ,jFh"v5CJOJQJU^JaJ,j?h"v5CJOJQJU^JaJh"vOJQJ^Jh"vCJOJQJ^JaJh"vCJOJQJ^JaJh"v5CJOJQJ^JaJ1jh"v5CJOJQJU^JaJmHnHu&jh"v5CJOJQJU^JaJ,j"h"v5CJOJQJU^JaJ yhhx$A &P#$/Ifkd$$Ifl0Kf+ t 6PA 0+644 la"{{x$A &P#$/Ifskd$$Iflf++ t 6PA 0+644 la"$lnprtvxz|{hhhhhhhhx$A &P#$/IfK$x$A &P#$/Ifskd$$Iflf++ t 6PA 0+644 la |~kdM$IfK$L$lִ t06    44 laytsl~NPdfhrtvxӵ឵ӵnӵW,j h"v5CJOJQJU^JaJ,j h"v5CJOJQJU^JaJ1jh"v5CJOJQJU^JaJmHnHu,jh"v5CJOJQJU^JaJ&jh"v5CJOJQJU^JaJh"vOJQJ^Jh"vCJOJQJ^JaJh"v5CJOJQJ^JaJhs5CJOJQJ^JaJ~Nvhkd$$Ifl0f+ t 6PA 0+644 lax$A &P#$/Ifvxyhhhx$A &P#$/Ifkdv $$Ifl0f+ t 6PA 0+644 laabyjjjjj$A &P#$/Ifkd $$Ifl0f+ t 6PA 0+644 labcd:b::t;<==>>峧}{}}wh"vUh"v5CJOJQJ^JaJh"vCJOJQJ^Jh"v6CJOJQJ^JaJh"vCJOJQJ^Jh"v5CJOJQJ^JaJ&h"v5B*CJOJQJ^JaJphh"v5CJ OJQJ^JaJ h"vOJQJ^J h"v56CJOJQJ^JaJbcd|fP$h$A &P#$/If^ha$$ & F$A &P#$/Ifa$$$A &P#$/Ifa$qkd> $$Iflf++ t 6PA 0+644 la::r;~ll]]]]]]]$A &P#$/If$$A &P#$/Ifa$kd $$Iflf++  t 6PA  f0+644 lap f Name of Responsible-Alternate Responsible Officer:____________________________________________ ____________________________________________ ________________________ Signature of International Scholar Advisor Date Signed Responsible-Alternate Responsible Officer Syracuse University - Slutzker Center for International Services - 310 Walnut Place, Syracuse, NY 13244-2380 - Phone: (315) 443-2457 Fax: (315) 443-3091 r;<===>>>>sqqskd $$Iflq f++ t 6PA 0+644 la $A /If$A &P#$/If,1h/ =!"#T$% $$If!vh5+#v+:V l  t 6PA  f0+65+/ p f$$If!vh5+#v+:V l t 6PA 0+65+/ $$If!vh5+#v+:V l  t 6PA  f0+65+p ftDText1tDText2tDText3$$If!vh5855 #v8#v#v :V l t 6PA 0+65855 tDText4$$If!vh55#v#v:V l t 6PA 0+655tDText5$$If!vh5+#v+:V l t 6PA 0+65+tDText6$$If!vh5+#v+:V l t 6PA 0+65+$IfK$L$q!vh55555555#v#v:Vl t655yts$$If!vh55#v#v:V l t 6PA 0+655tDText8tDText9$$If!vh55#v#v:V l t 6PA 0+655vDText10$$If!vh55#v#v:V l t 6PA 0+655$$If!vh5+#v+:V l t 6PA 0+65+/ $$If!vh5+#v+:V l  t 6PA  f0+65+p f$$If!vh5+#v+:V lq t 6PA 0+65+@@@ NormalCJ_HaJmH sH tH b@b Heading 1 $$% &P#$/@&a$5CJOJQJ\^JDAD Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List j@j v Table Grid7:V0J BQRST3GZnoH\]}';<[opqrsabcdBC? 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