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Labor Condition Application for H-1B &H-1B1 Nonimmigrants U.S. Department of Labor Employment and Training Administration Form ETA 9035 OMB Approval: Expiration Date: A. Program Designation You must choose one of the following: H-1B H-1B1 Chile H-1B1 Singapore B. Employer's Information 1. Return Fax Number ( ) 2. Employer's Name - If you want the application returned by mail, leave the Return Fax Number blank. 3.

Employer's Address (Number and Street) 4. Employer's City State Zip/Postal Code 5. Employer's EIN Number - C. Rate of Pay 6. Employer's Phone Number ( ) - Extension 1.

Wage Rate (or Rate From) (Required): 3. Rate is Per: $ $ 2. Rate Up To (Optional): . . Week Hour Year Month 2 Weeks 4.

Is this position , part-time? Yes No Please Note: Part-time hours worked by nonimmigrant(s) will be in the range of hours stated on the INS Form(s) I-129. D. Period of Employment and Occupation Information Please Note: The Date Information MUST be in MM/DD/YYYY format 1. Begin Date 2.

End Date / / 6 6 6 7 7 7 8 8 8 9 9 9 0 0 0 4. Number of H-1B or H-1B1 Nonimmigrants 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5 6 6 6 7 7 7 8 8 8 9 9 9 0 0 0 / 3. Occupational Code 1 1 1 2 2 2 3 3 3 4 4 4 5. Job Title / 5 5 5 Page Link Page Link 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. Draft Form ETA 9035 - Page 1 of 3 Labor Condition Application for H-1B &H-1B1 Nonimmigrants U.S. Department of Labor Employment and Training Administration Form ETA 9035 OMB Approval: Expiration Date: E. Information Relating to Work Location for the H-1B or H-1B1 Nonimmigrants This section is REQUIRED Do NOT write "Same As Above". This section MUST be filled out. 1.

City State , 2. Prevailing Wage 3. Wage is Per: 4. Wage Source $ .

5. Year Source Published 6. Other Wage Source Week Hour Year Month 2 Weeks SESA Collective Bargaining Agreement Other If OTHER is chosen as the Wage Source, Numbers 5 and 6 in this section MUST be filled out. 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: 4.

Wage Source $ . 5. Year Source Published 6. Other Wage Source Week Hour Year Month 2 Weeks SESA Collective Bargaining Agreement Other , If OTHER is chosen as the Wage Source, Numbers 5 and 6 in this section MUST be filled out.

F. Employer Labor Condition Statements Please Note: In order for your application to be processed, you MUST read section F of the Labor Condition Application cover pages under the heading "Employer Labor Condition Statements" and agree to all 4 labor condition statements 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 H-1B or H-1B1 workers. I have read and agree to Employer Labor Condition Statements 1, 2, 3, and 4 as set forth in Section F of the Labor Condition Application Cover Pages. Yes No G. 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 * 10th St. and Constitution Ave, NW * Washington, DC * 20530. Page Link Page Link 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. Draft Form ETA 9035 - Page 2 of 3 Labor Condition Application for H-1B &H-1B1 Nonimmigrants U.S. Department of Labor Employment and Training Administration Form ETA 9035 OMB Approval: Expiration Date: H. Public Disclosure Information You must choose one of the two options listed in this Section.

1. Public disclosure information will be kept at: Employer's principal place of business Place of employment I. 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 and F 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 applicaton, supporting documentation, and other records available to officials of the Department of Labor upon request during any investigation under the Immigration and Nationality Act. 1.

First Name of Hiring or Other Designated Official MI 2. Last Name of Hiring or Other Designated Official 3. Hiring or Other Designated Official Title 5. Date Signed / / MI 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.

J. Contact Information 1.

Contact First Name 2. Contact Last Name 3. Contact Phone Number ( ) - K. U.S. Government Agency Use Only Extension 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. Page Link Page Link 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. Draft Form ETA 9035 - Page 3 of 3