Form ETA-750A "Application for Alien Employment Certification"

What Is Form ETA-750A?

This is a legal form that was released by the U.S. Department of Labor - Employment & Training Administration on November 1, 2007 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2007;
  • The latest available edition released by the U.S. Department of Labor - Employment & Training Administration;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form ETA-750A by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Employment & Training Administration.

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Download Form ETA-750A "Application for Alien Employment Certification"

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OMB Approval No. 1205-0015
Expires: 08/31/2020
U.S. DEPARTMENT OF LABOR
IMPORTANT: READ CAREFULLY BEFORE COMPLETING THIS FORM
Employment and Training Administration
PRINT legibly in ink or use a typewriter. If you need more space to
answer questions in this form, use a separate sheet. Identify each answer
APPLICATION
with the number of the corresponding question. SIGN AND DATE each
sheet in original signature.
FOR
To knowingly furnish any false information in the preparation of this form
and any supplemental thereto or to aid, abet, or counsel another to do so is
ALIEN EMPLOYMENT CERTIFICATION
a felony punishable by $10,000 fine or 5 years in the penitentiary, or both
(18 U.S.C. 1001)
PART A. OFFER OF EMPLOYMENT
1. Name of Alien
(Family name in capital letter, First, Middle, Maiden)
2. Present Address of Alien
(Number, Street, City and Town, State ZIP code or Province, Country)
3. Type of Visa (if in U.S.)
The following information is submitted as an offer of employment
4. Name of Employer
(Full name of Organization)
| 5. Federal Taxpayer ID -- EIN
|
|
|
6. Address
(Number, Street, City and Town, State ZIP code)
7. Address Where Alien Will Work
(if different than Item 6)
8. Nature of Employer’s Business
9. Name of Job Title
10. Total Hours Per Week
11. Work
12. Rate of Pay
Activity
Schedule
a. Basic
b. Overtime
a. Basic
b. Overtime
(Hourly)
$
$
a.m.
p.m.
per ________
per ________
13. Describe Fully the job to be Performed
(Duties)
14. State in detail the MINIMUM education, training, and experience for a
15. Other Special Requirements
worker to perform satisfactorily the job duties described in item 13
above.
Grade
High
College
College Degree Required
(specify)
EDU-
School
School
CATION
(Enter
Major Field of Study
number of
years)
No. Yrs.
No. Mos.
Type of Training
TRAIN-
ING
Related
Related Occupation
(specify)
Job Offered
Occupation
Number
EXPERI-
Yrs.
Mos.
Yrs.
Mos.
ENCE
16. Occupational Title of
17. Number of
Person Who Will Be
Employees
Alien’s Immediate Supervisor
Alien Will Supervise
ENDORSEMENTS
(Make no entry in section – for Government use only)
Date Forms Received
L.O.
S.O.
R.O.
N.O.
Ind. Code
Occ. Code
Occ. Title
ETA 750 (Nov. 2007)
OMB Approval No. 1205-0015
Expires: 08/31/2020
U.S. DEPARTMENT OF LABOR
IMPORTANT: READ CAREFULLY BEFORE COMPLETING THIS FORM
Employment and Training Administration
PRINT legibly in ink or use a typewriter. If you need more space to
answer questions in this form, use a separate sheet. Identify each answer
APPLICATION
with the number of the corresponding question. SIGN AND DATE each
sheet in original signature.
FOR
To knowingly furnish any false information in the preparation of this form
and any supplemental thereto or to aid, abet, or counsel another to do so is
ALIEN EMPLOYMENT CERTIFICATION
a felony punishable by $10,000 fine or 5 years in the penitentiary, or both
(18 U.S.C. 1001)
PART A. OFFER OF EMPLOYMENT
1. Name of Alien
(Family name in capital letter, First, Middle, Maiden)
2. Present Address of Alien
(Number, Street, City and Town, State ZIP code or Province, Country)
3. Type of Visa (if in U.S.)
The following information is submitted as an offer of employment
4. Name of Employer
(Full name of Organization)
| 5. Federal Taxpayer ID -- EIN
|
|
|
6. Address
(Number, Street, City and Town, State ZIP code)
7. Address Where Alien Will Work
(if different than Item 6)
8. Nature of Employer’s Business
9. Name of Job Title
10. Total Hours Per Week
11. Work
12. Rate of Pay
Activity
Schedule
a. Basic
b. Overtime
a. Basic
b. Overtime
(Hourly)
$
$
a.m.
p.m.
per ________
per ________
13. Describe Fully the job to be Performed
(Duties)
14. State in detail the MINIMUM education, training, and experience for a
15. Other Special Requirements
worker to perform satisfactorily the job duties described in item 13
above.
Grade
High
College
College Degree Required
(specify)
EDU-
School
School
CATION
(Enter
Major Field of Study
number of
years)
No. Yrs.
No. Mos.
Type of Training
TRAIN-
ING
Related
Related Occupation
(specify)
Job Offered
Occupation
Number
EXPERI-
Yrs.
Mos.
Yrs.
Mos.
ENCE
16. Occupational Title of
17. Number of
Person Who Will Be
Employees
Alien’s Immediate Supervisor
Alien Will Supervise
ENDORSEMENTS
(Make no entry in section – for Government use only)
Date Forms Received
L.O.
S.O.
R.O.
N.O.
Ind. Code
Occ. Code
Occ. Title
ETA 750 (Nov. 2007)
OMB Control No. 1205-0015
Expires: 08/31/2020
18. COMPLETE ITEMS ONLY IF JOB IS TEMPORARY
19. IF JOB IS UNIONIZED (Complete)
a. No. of Open-
a. Number
b. Nam e of Local
b. Exact Dates You Expect
ings To Be
of
To Employ Alien
Filled by Aliens
Local
From
To
Under Job Offer
c. City and State
20. STATEMENT FOR LIVE-AT-WORK JOB OFFERS
(Complete for Private Household ONLY)
a. Description of Residence
b. No. Persons residing at Place of Employment
(“X” one)
c. Will free board and private
Number of
Adults
Children
Ages
room not shared with any-
(“X” one)
Rooms
one be provided?
House
BOYS
 YES
 NO
Apartment
GIRLS
21. DESCRIBE EFFORTS TO RECRUIT U.S. WORKERS AND THE RESULTS. (Specify Sources of Recruitment by Name)
. Applications require various types of documentation. Please read Part II of the instructions to assure that appropriate
22
supporting documentation is included with your application.
23. EMPLOYER CERTIFICATIONS
By virtue of my signature below, I HEREBY CERTIFY the following conditions of employment.
a.
I have enough funds available to pay the wage
e.
The job opportunity does not involve unlawful discri-
or salary offered the alien.
mination by race, creed, color, national origin, age,
sex, religion, handicap, or citizenship.
b.
The wage offered equal or exceeds the pre-
vailing wage and I guarantee that, if a labor certi-
f.
The job opportunity is not:
fication is granted, the wage paid to the alien when
the alien begins work will equal or exceed the pre-
(1)
Vacant because the former occupant is on
vailing wage which is applicable at the time the
strike or is being locked out in the course of
alien begins work.
a labor dispute involving a work stoppage.
(2)
At issue in a labor dispute involving a work
c.
The wage offered is not based on commissions,
stoppage.
bonuses, or other incentives, unless I guarantee
a wage paid on a weekly, bi-weekly, or monthly
The job opportunity’s terms, conditions and occupa-
basis.
g.
tional environment are not contrary to Federal,
State or local law.
d.
I will be able to place the alien on the payroll
on or before the date of the alien’s proposed
entrance into the United States.
h.
The job opportunity has been and is clearly open to
any qualified U.S. worker.
24. DECLARATIONS
DECLARATION
OF
Pursuant to 28 U.S.C. 1746, I declare under penalty of perjury the foregoing is true and correct.
EMPLOYER
SIGNATURE
DATE
NAME
(Type or Print)
TITLE
EMAIL ADDRESS
CONTACT TELEPHONE
FAX TELEPHONE
AUTHORIZATION OF
I HEREBY DESIGNATE the agent below to represent me for the purposes of labor certification and I TAKE FULL
AGENT OF EMPLOYER
RESPONSIBILITY for accuracy of any representations made by my agent.
SIGNATURE OF EMPLOYER
DATE
NAME OF AGENT
(Type or Print)
ADDRESS OF AGENT
(Number, Street, City, State, ZIP code)
EMAIL ADDRESS
CONTACT TELEPHONE
FAX TELEPHONE
OMB No.: 1205-0015 OMB Expiration Date: 08/31/2020 OMB Burden Hours averages 1.8 hours. OMB Burden Statement: 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. (Title 8 U.S.C. §§ 1882, 1884,
and 1188) Public reporting burden for this collection of information, which is to assist with planning and program management, includes 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 esti mate or any other aspect of this collection of information, including
suggestions for reducing this burden, to the U.S. Department of Labor, Room 12-200, 200 Constitution Ave. NW, Washington, DC 20210. (Paperwork Reduction Project OMB 1205-0015.)
PRIVACY ACT STATEMENT
In accordance with the Privacy Act of 1974, as amended (5 U.S.C. 552a), you are hereby notified that the inform ation provided
herein is protected under the Privacy Act. The Department of Labor (DOL) is maintaining a System of Records titled Employer
Application and Attestation File for Permanent and Temporary Alien Workers (DOL /ETA-7).
Case files developed in processing labor certification applications, labor condition applications, or labor attestations, may be
released to the employers which filed such applications, their representatives, and to named alien beneficiaries or their
representatives, if requested, to review Employment and Training Administration (ETA) actions in connection with appeals of
denials before the DOL Office of Administrative Law Judges and federal courts; to participating agencies such as the DOL
Office of Inspector General, Employment Sta ndards Administration. Department of Ho meland Security
s U.S, Citizenship and
'
Immigration Services and Bureau of Immigration and Customs Enforcement, and Department of State in connection with
administering and enforcing related immigration laws and regul ations; and to the DOL Office of Administrative Law Judges and
Federal Courts in connection with appeals of denials of labor certification requests, labor condition applications, and labor
attestations.
Further disclosures may be made under the following circumstances: in connection with federal litigation; for law enforcement
purposes; to authorized parent locator persons under Pub. L. 93 -647; to an information source in connection with personnel,
procurement, or benefit-related matters, to a contractor o r their employees, consultants, grantees or their employees, or
volunteers who have been engaged to assist the agency in the performance of a contract; for Federal debt collection purposes:
the Office of Management and Budget in connection with its legislative review, coordination, and clearance activities; if a
person about whom this record is maintained submits a written request to a Member of Congress or their staff and that request
is forwarded to the Department, we may release the information to the Me mber of Congress or Congressional staff in response
to the inquiry made on behalf of the subject of the record: and to the news media and the public when a matter under investiga tion
becomes public knowledge, the Solicitor of Labor determines the disclosur e is necessary to preserve confidence or integrity of
the Department, or the Solicitor of Labor determines that a legitimate public interest exists in the disclosure of information unless
the disclosure would constitute an unwarranted invasion of personal privacy.
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