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Case Number
I-200-17033-615598
1. Indicate the type of visa classification supported by this application (Write classification symbol):
H-1B
1. Job Title
Software 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)
7/1/2017 12:00:00 AM
6. End Date (mm/dd/yyyy)
6/30/2020 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
Paccar Inc
2. Trade name/Doing Business As (DBA), if applicable
3. Address 1
777 106th Avenue Ne
10. Telephone number
425-468-7431
12. Federal Employer Identification Number (FEIN from IRS)
13. NAICS code (must be at least 4-digits)
333924
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
Tullman
2. First (given) name
Adam
4. Contact's job title
Counsel
5. Address 1
777 106th Avenue Ne
12. Telephone number
425-468-7431
14. E-Mail address
Adam.tullman@paccar.com
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
Gittleman
3. First (given) name
Felicia
5. Address 1
1000 2nd Avenue Suite 1620
12. Telephone number
2063401033
14. E-Mail address
Fgittleman@cmlseattle.com
15. Law firm/Business name
Cowan Miller & Lederman
16. Law firm/Business FEIN
17. State Bar number (only if attorney)
16436
18. State of highest court where attorney is in good standing (only if attorney)
Washington
19. Name of the highest court where attorney is in good standing (only if attorney)
Washington State Supreme Court
1. Wage Rate (Required)
From: $
80,059.00
To: $
120,800.00
2. Per: (Choose only one)
Year
1. Address 1
12479 Farm To Market Road
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
$ 80,059.00
10. Per: (Choose only one)
11. Prevailing wage source (Choose only one)
OES
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
Tullman
2. First (given) name of hiring or designated official
Adam
4. Hiring or designated official title
Counsel
By virtue of the signature below, the Department of Labor hereby acknowledges the following:
This certification is valid
From 7/1/2017 12:00:00 AM
To 6/30/2020 12:00:00 AM
Department of Labor, Office of Foreign Labor Certification
Determination Date (date signed)
2/2/2017 12:00:00 AM
Case Number
I-200-17033-615598
The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified LCA.
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