Request to Extend Form DS-2019

Please complete and submit this form to request extended Form(s) DS-2019 for yourself and any accompanying J-2 dependents.

BEFORE YOU BEGIN:

Be sure to have available electronic copies of the following documents, which will need to be uploaded to the form:

  • Funding (for Guest Students and Guest Workers only): Evidence of continued exchange program funding through your extended program end date.
  • Health insurance: Evidence of continued qualifying health insurance coverage (click here for details) for both J-1 and J-2 dependents:
    • Postdoctoral fellows: Please print and attach a copy of your Current Benefits screen in Employee Self-Service (EMS).
    • VAIGS students: Please attach a copy of your Priority Health insurance/ID card. If you do not have your card, one can be printed from your MyHealth Insurance page.
    • Visiting students and researchers: Please provide proof of coverage through your requested program end date. The proof of coverage must contain the following information:
      • Names of all covered persons
      • Coverage start and end dates
      • Deductible limit (no more than $500 per accident/illness)
      • Coverage for accident/illness (no less than $100,000 per accident/illness)
      • Coverage for repatriation of remains (no less than $25,000)
      • Coverage for medical evacuation (no less than $50,000)
      • Coinsurance not to exceed 25%