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Case Number
I-200-17111-548455
1. Indicate the type of visa classification supported by this application (Write classification symbol):
H-1B
1. Job Title
Principal 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)
10/11/2017 12:00:00 AM
6. End Date (mm/dd/yyyy)
10/10/2020 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
Staples, Inc
2. Trade name/Doing Business As (DBA), if applicable
3. Address 1
500 Staples Drive
10. Telephone number
508-253-3226
12. Federal Employer Identification Number (FEIN from IRS)
13. NAICS code (must be at least 4-digits)
453210
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
Wise / Moore
2. First (given) name
Stephanie / Kristin
4. Contact's job title
Global Mobility Analyst/coord.-global Benefits
5. Address 1
500 Staples Drive
12. Telephone number
508-253-3226
14. E-Mail address
Immigration@staples.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
Wilson
3. First (given) name
Mariah
5. Address 1
100 High Street 3rd Floor
12. Telephone number
6175740400
14. E-Mail address
Shartwell-ishikawa@fragomen.com
15. Law firm/Business name
Fragomen, Del Rey, Bernsen & Loewy, Llp
16. Law firm/Business FEIN
17. State Bar number (only if attorney)
MA680693
18. State of highest court where attorney is in good standing (only if attorney)
Massachusetts
19. Name of the highest court where attorney is in good standing (only if attorney)
Supreme Judicial Court
1. Wage Rate (Required)
From: $
120,581.00
To: $
2. Per: (Choose only one)
Year
1. Address 1
Staples, Inc. 500 Staples Drive
5. State/District/Territory
MA
7. Agency which issued prevailing wage
7a. Prevailing wage tracking number (if applicable)
8. Wage level
III
9. Prevailing wage
$ 103,709.00
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
Wise / Moore
2. First (given) name of hiring or designated official
Stephanie / Kristin
4. Hiring or designated official title
Global Mobility Analyst / Coord.-global Benefits
1. Last (family) name
Hartwell-ishikawa
2. First (given) name
Simone
4. Firm/Business name
Fragomen, Del Rey, Bernsen & Loewy, Llp
5. E-Mail address
Shartwell-ishikawa@fragomen.com
By virtue of the signature below, the Department of Labor hereby acknowledges the following:
This certification is valid
From 10/11/2017 12:00:00 AM
To 10/10/2020 12:00:00 AM
Department of Labor, Office of Foreign Labor Certification
Determination Date (date signed)
4/21/2017 12:00:00 AM
Case Number
I-200-17111-548455
The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified LCA.
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