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Case Number
I-200-17011-021352
1. Indicate the type of visa classification supported by this application (Write classification symbol):
H-1B
1. Job Title
Application Engineer
2. SOC (ONET/OES) code
15-1132
3. SOC (ONET/OES) occupation title
Software Developers, Applications
4. Is this a full-time position?
Yes
Period of Intended Employment
5. Begin Date (mm/dd/yyyy)
6/14/2017 12:00:00 AM
6. End Date (mm/dd/yyyy)
6/13/2020 12:00:00 AM
7. Worker positions needed/basis for the visa classification supported by this application
Total Worker Positions Being Requested for Certification
1
1. Legal business name
Battelle Memorial Institute
2. Trade name/Doing Business As (DBA), if applicable
Pacific Northwest National Laboratory
3. Address 1
902 Battelle Blvd. K1-49
10. Telephone number
509-375-3959
12. Federal Employer Identification Number (FEIN from IRS)
![redacted field](/includes/images/common/lab_redacted.gif)
13. NAICS code (must be at least 4-digits)
5417
Important Note: The information contained in this Section must be that of an employee of the employer who is authorized to act on behalf of
the employer in labor certification matters. The information in this Section must be different from the agent or attorney information listed in
Section E, unless the attorney is an employee of the employer.
1. Contact's last (family) name
Nichols
2. First (given) name
Michelle
4. Contact's job title
Immigration Consultant
5. Address 1
902 Battelle Blvd. - K1-49
12. Telephone number
509-375-3959
14. E-Mail address
Michelle.nichols@pnnl.gov
1. Is the employer represented by an attorney or agent in the filing of this application? If "Yes", complete the remainder of Section E below.
2. Attorney or Agent's last (family) name
15. Law firm/Business name
16. Law firm/Business FEIN
![redacted field](/includes/images/common/lab_redacted.gif)
17. State Bar number (only if attorney)
18. State of highest court where attorney is in good standing (only if attorney)
19. Name of the highest court where attorney is in good standing (only if attorney)
1. Wage Rate (Required)
From: $
75,000.00
To: $
2. Per: (Choose only one)
Year
1. Address 1
902 Battelle Blvd
5. State/District/Territory
WA
7. Agency which issued prevailing wage
7a. Prevailing wage tracking number (if applicable)
8. Wage level
II
9. Prevailing wage
$ 72,779.00
10. Per: (Choose only one)
11. Prevailing wage source (Choose only one)
Other
11a. Year source published
2016
11b. If "OES", and SWA/NPC did not issue prevailing wage OR "Other" in question 11, specify source
1. Is the employer H-1B dependent?
No
2. Is the employer a willful violator?No
3. If "Yes" is marked in questions I.1 and/or I.2, you must answer "Yes" or "No" regarding whether the
employer will use this application ONLY to support H-1B petitions or extensions of status for exempt H-1B
nonimmigrants?
If you marked "Yes" to questions I.1 and/or I.2 and "No" to question I.3, you MUST read Section I - Subsection 2 of the Labor
Condition Application - General Instructions Form ETA 9035CP under the heading "Additional Employer Labor Condition
Statements" and indicate your agreement to all three (3) additional statements summarized below.
- Displacement: Non-displacement of the U.S. workers in the employer's workforce
- Secondary Displacement: Non-displacement of U.S. workers in another employer's workforce; and
- Recruitment and Hiring: Recruitment of U.S. workers and hiring of U.S. workers applicant(s) who are equally or better qualified than the H-1B nonimmigrant(s).
4. I have read and agree to Additional Employer Labor Condition Statements A, B, and C above and as fully explained in Section I - Subsections 1 and 2 of the Labor Condition Application - General Instructions Form ETA 9035CP.
Yes
No
1. Last (family) name of hiring or designated official
Nichols
2. First (given) name of hiring or designated official
Michelle
4. Hiring or designated official title
Immigration Consultant
By virtue of the signature below, the Department of Labor hereby acknowledges the following:
This certification is valid
From 6/14/2017 12:00:00 AM
To 6/13/2020 12:00:00 AM
Department of Labor, Office of Foreign Labor Certification
Determination Date (date signed)
1/11/2017 12:00:00 AM
Case Number
I-200-17011-021352
The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified LCA.
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