Form ETA 9035 Labor Condition U.S. Department of Labor OMB Approval: 1205-0310 Application for Employment and Training Administration Expiration Date: 01/31/2012 Nonimmigrant Workers H-1B H-1B1 Chile H-1B1 Singapore A. Program Designation You must choose one: E-3 Australian 1. Return Fax Number B. Employer's Information If you want the application returned by mail, leave the Return Fax Number blank. 2. Employer's Name ( ) - 3. Employer's Address (Number and Street) State 4. Employer's City 5. Employer's EIN Number Zip/Postal Code 6. Employer's Phone Number - ( Extension ) - C. Rate of Pay 1. Wage Rate (or Rate From) (Required): $ 3. Rate is Per: . Year $ . Week Month 2. Rate Up To (Optional): 4. Is this position part-time? Hour Please Note: Part-time hours worked by nonimmigrant(s) will be in the range of hours stated on the USCIS Form(s) I-129. Yes No 2 Weeks D. Period of Employment and Occupation Information Please Note: The Date Information MUST be in MM/DD/YYYY format , 3. Occupational Code 4. Number of Nonimmigrant Workers 1. Begin Date / / 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 2. End Date / / 5. Job Title E. Information Relating to Work Location for the Nonimmigrant Worker(s) Do NOT write "Same As Above". This section MUST be filled out. 1. City 3. Wage is Per: 2. Prevailing Wage $ . Week Month 5. Year Source Published Year Hour 2 Weeks This section is REQUIRED State 4. Wage Source OES If OTHER is chosen as the Collective Wage Source, Numbers 5 Bargaining and 6 in this section MUST Agreement be filled out. Other 6. Other Wage Source Page Link ï ê é ï î í If filing the form electronically, the Page Link field will be automatically created for you upon printing. If filing the form manually, please ensure that the Page Link field contains a 6 digit number that is repeated on all 3 pages. 3417 Form ETA 9035 - Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com Labor Condition Application for Nonimmigrant Workers U.S. Department of Labor Employment and Training Administration Form ETA 9035 OMB Approval: 1205-0310 Expiration Date: 11/30/2008 E. Subsection A Information for Additional or Subsequent Work Location This Section should be completed only if filing for more than 1 work location. 1. City State , 2. Prevailing Wage 3. Wage is Per: Year . $ Month 5. Year Source Published 4. Wage Source Week OES Hour Collective Bargaining Agreement 2 Weeks If OTHER is chosen as the Wage Source, Numbers 5 and 6 in this section MUST be filled out. Other 6. Other Wage Source F. Employer Labor Condition Statements Note: In order Labor Condition Application ! Pleasepages under thefor your application to be processed, you MUST read section E of thelabor condition statements cover heading "Employer Labor Condition Statements" and agree to all 4 summarized below: (1) Wages: Pay nonimmigrants at least the local prevailing wage or the employer's actual wage, whichever is higher, and pay for , non-productive time. Offer nonimmigrants benefits on the same basis as U.S. workers. (2) Working Conditions: Provide working conditions for nonimmigrants which will not adversely affect the working conditions of workers similarly employed. , (3) Strike, Lockout, or Work Stoppage: No strike or lockout in the occupational classification at the place of employment. (4) Notice: Notice to union or to workers at the place of employment. A copy of this form to the nonimmigrant worker(s). I have read and agree to Employer Labor Condition Statements 1, 2, 3, and 4 as set forth in Section E of the Labor Condition Application Cover Pages. Yes No F-1. Additional Employer Labor Condition Statements - H-1B Employers Only Please Note: In order for an application regarding H-1B nonimmigrants to be processed, you MUST read Section F-1 Subsections 1 and 2 of the Labor Condition Application cover pages under the heading "Additional Employer Labor Condition Statements" and choose one of the 3 alternatives (A, B, or C) listed below in Subsection 1. If you mark Alternative B, you MUST read Section F-1 - Subsection 2 of the cover pages under the heading "Additional Employer Labor Condition Statements" and indicate your agreement to all 3 additional statements summarized below in Subsection 2. 2. Subsection 2 1. Subsection 1 If Alternative B in Subsection 1 is marked, the following Choose ONE of the following 3 alternatives: Additional Labor Condition Statements are applicable: A Employer is not H-1B dependent and is not a willful violator. B Employer is H-1B dependent and/or a willful violator. C Employer is H-1B dependent and/or a willful violator BUT will use this application ONLY to support H-1B petitions for exempt nonimmigrants. A. Displacement: Non-displacement of the U.S. workers in employer's work force; B. Secondary Displacement: Non-displacement of U.S. workers in another employer's work force; and C. Recruitment and Hiring: Recruitment of U.S. workers and hiring of U.S. worker applicant(s) who are equally or better qualified than the H-1B nonimmigrant(s). I have read and agree to Additional Labor Condition Statements 2 A, B, and C. Page Link Page Link ï ê é ï î í Yes No If filing the form electronically, the Page Link field will be automatically created for you upon printing. If filing the form manually, please ensure that the Page Link field contains a 6 digit number that is repeated on all 3 pages. 3417 Form ETA 9035 - Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com Labor Condition Application for Nonimmigrant Workers U.S. Department of Labor Employment and Training Administration Form ETA 9035 OMB Approval: 1205-0310 Expiration Date: 11/30/2008 G. Public Disclosure Information You must choose one of the two options listed in this Section. Employer's principal place of business 1. Public disclosure information will be kept at: Place of employment H. Declaration of Employer By signing this form, I, on behalf of the employer, attest that the information and labor condition statements provided are true and accurate; that I have read the sections E, F, and F-1 of the cover pages (Form ETA 9035CP), and that I agree to comply with the Labor Condition Statements as set forth in the cover pages and with the Department of Labor regulations (20 CFR part 655, Subparts H and I). I agree to make this application, supporting documentation, and other records available to officials of the Department of Labor upon request during any investigation under the Immigration and Nationality Act. MI 1. First Name of Hiring or Other Designated Official 2. Last Name of Hiring or Other Designated Official 3. Hiring or Other Designated Official Title 5. Date Signed / / 4. Signature - Do NOT let signature extend beyond the box Making fraudulent representations on this Form can lead to civil or criminal action under 18 U.S.C. 1001, 18 U.S.C. 1546, or other provisions of law. I. Contact Information MI 1. Contact First Name 2. Contact Last Name Extension 3. Contact Phone Number ( ) - J. U.S. Government Agency Use Only By virtue of my signature below, I hereby acknowledge this application certified for Date Starting _________________________________ and Date Ending _______________________________________ ______________________________________________________________ _________________ _________________ Signature and Title of Authorized DOL Official ETA Case Number Date The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified labor condition application. K. Complaints Complaints alleging misrepresentation of 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, U.S. Department of Labor. Complaints alleging failure to offer employment to an equally or better qualified U.S. worker, or an employer's misrepresentation regarding such offer(s) of employment, may be filed with: U.S Department of Justice * Office of the Special Counsel for Immigration-Related Unfair Employment Practices* 950 Pennsylvania Ave, NW * Washington, DC * 20530. If filing the form electronically, the Page Link field will be automatically created for you Page Link upon printing. If filing the form manually, please ensure that the Page Link field contains a Page Link é ï î í ï ê 6 digit number that is repeated on all 3 pages. 3417 Form ETA 9035 - Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com OMB Paperwork Reduction Act (1205-0310) These reporting instructions have been approved under the Paperwork Reduction Act of 1995. Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Obligations to reply are mandatory (Immigration and Nationality Act, Sections 212(n) and (t) and 214(c). Public reporting burden for this collection of information, which is to assist with program management and to meet Congressional and statutory requirements, is estimated to average 1 hour per response, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Room C-4312, 200 Constitution Ave. NW, Washington, DC 20210. (Paperwork Reduction Project OMB 1205-0310.) Do NOT send the completed application to this address. American LegalNet, Inc. www.FormsWorkflow.com