PREVAILING WAGE INFORMATION REQUEST For H-1B Specialty Occupations , PERM and H-2B NOTE: union contracts pay scales, are the prevailing wage. H-2B requests must include itinerary Due to federal funding reductions, it will take approximately 14 working days to process this request. 1. Name of Employer (Full name of organization) 2. Telephone (Area Code and Number) 3. Address (Number, Street, City or Town, County, State, ZIP Code) 4. Name of Alien 5. Address Where Alien Will Work (if different from item 3) 6. Nature of Employer's Business Activity 7. Job Title 8. Offered Rate of Pay per _____. Over Time Type of request (PERM, H-1B, H-2B) 9. Describe Fully the Job to be Performed (Duties) 13. Special Requirements (Example: driver license,, computer skills, production standard, drug test, reference check, foreign language, etc) 10. List the Minimum Requirements: College Education (Enter number of years) _______ College Degree Required (Specify) _______________________ ___________________________________________________ Specific Specialty ___________________________________________________ 11. State License Required 12. Experience Required (In Job Offered ) Yrs. Mos. Experience Required in Yrs. Mos. (A Related Occupation) Name occupation(s)) 14. Occupational Title of Person who will be Alien's Immediate Supervisor Mail to: Sharon Rood, Wage Analyst Alien Certification Program Oregon Employment Department-R&S 875 Union St. NE Salem, OR 97311 Phone: (503) 947-1659 Fax #: (503) 947-1634 Or e-mail: Prepared by: Sharon.K.Rood@state.or.us ______________ Phone: ________________Date:____________________ State of Oregon • Employment Department 15. Number of Employees Alien will Supervise _ __ If the information is to be sent to an address other than the employer's, (i.e attorney), please list name, address, and telephone number below: _________________________________________________________ __________________________________________ __________________________________________ ______________________________________ Fax #: _______________ Form #1974 (11/06) American LegalNet, Inc. www.FormsWorkflow.com