ETA 790A - Addendu Additional Place of Employment Information

Criteria and Non-Criteria Agricultural Clearance Order Forms and H-2A Application for Temporary Employment Certification in States and by Employers Covered by Injunction of the Farmworker Protection.

EF_09_Form ETA-790A_Addendum_B_508 Compliant

on-Criteria (not H-2A related) Clearance Orders

OMB: 1205-0562

Document [pdf]
Download: pdf | pdf
OMB Approval: 1205-0466
Expiration Date: XX/XX/XXXX

H-2A Agricultural Clearance Order
Form ETA-790A Addendum B
U.S. Department of Labor

C. Additional Place of Employment Information
1. Name of Agricultural Business §

2. Place of Employment *

3. Additional Place of Employment Information §

4. Begin
Date §

5. End
Date §

6. Total
Workers §

D. Additional Housing Information
Form ETA-790A Addendum B
H-2A Case Number: ____________________

FOR DEPARTMENT OF LABOR USE ONLY
Case Status: __________________

Determination Date: _____________

Page B.1 of B.2
Validity Period: _____________ to _____________

OMB Approval: 1205-0466
Expiration Date: XX/XX/XXXX

1. Type of Housing *

H-2A Agricultural Clearance Order
Form ETA-790A Addendum B
U.S. Department of Labor
3. Additional Housing Information §

2. Physical Location *

4. Total
Units *

5. Total
Occupancy *

6. Inspection Entity *

 Local authority
 SWA
 Other State authority
 Federal authority
 Other
_______________

 Employer-provided
 Rental or public
accommodations

 Local authority
 SWA
 Other State authority
 Federal authority
 Other
_______________

 Employer-provided
 Rental or public
accommodations

 Local authority
 SWA
 Other State authority
 Federal authority
 Other
_______________

 Employer-provided
 Rental or public
accommodations

 Local authority
 SWA
 Other State authority
 Federal authority
 Other
_______________

 Employer-provided
 Rental or public
accommodations

 Local authority
 SWA
 Other State authority
 Federal authority
 Other
_______________

 Employer-provided
 Rental or public
accommodations
For Public Burden Statement, see the Instructions for Form ETA-790/790A.

Form ETA-790A Addendum B
H-2A Case Number: ____________________

FOR DEPARTMENT OF LABOR USE ONLY
Case Status: __________________

Determination Date: _____________

Page B.2 of B.2
Validity Period: _____________ to _____________


File Typeapplication/pdf
File TitleETA-790A Addendum B
AuthorOffice of Foreign Labor Certification
File Modified2022-08-12
File Created2022-07-25

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