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Case Number
I-200-17235-569030
1. Indicate the type of visa classification supported by this application (Write classification symbol):
H-1B
1. Job Title
Scrum Master Senior
2. SOC (ONET/OES) code
15-1199
3. SOC (ONET/OES) occupation title
Computer Occupations, All Other
4. Is this a full-time position?
Yes
Period of Intended Employment
5. Begin Date (mm/dd/yyyy)
9/13/2017 12:00:00 AM
6. End Date (mm/dd/yyyy)
9/12/2020 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
Anthem, Inc.
2. Trade name/Doing Business As (DBA), if applicable
3. Address 1
120 South Via Merida
10. Telephone number
805-557-6105
12. Federal Employer Identification Number (FEIN from IRS)
13. NAICS code (must be at least 4-digits)
524114
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
Hill
2. First (given) name
Vicky
4. Contact's job title
Legal Specialist Sr.
5. Address 1
2015 Staples Mill Road
12. Telephone number
804-354-7929
14. E-Mail address
Vicky.hill@anthem.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
King
3. First (given) name
James
4. Middle name(s)
William
5. Address 1
1075 Peachtree Street, Ne Suite 2500
9. Postal code
30309-3958
12. Telephone number
4048856720
14. E-Mail address
Nmihovich@seyfarth.com
15. Law firm/Business name
Seyfarth Shaw Llp
16. Law firm/Business FEIN
17. State Bar number (only if attorney)
420930
18. State of highest court where attorney is in good standing (only if attorney)
Georgia
19. Name of the highest court where attorney is in good standing (only if attorney)
Supreme Court
1. Wage Rate (Required)
From: $
92,810.00
To: $
115,000.00
2. Per: (Choose only one)
Year
1. Address 1
4241 Irwin Simpson Road
5. State/District/Territory
OH
7. Agency which issued prevailing wage
7a. Prevailing wage tracking number (if applicable)
8. Wage level
IV
9. Prevailing wage
$ 92,810.00
10. Per: (Choose only one)
11. Prevailing wage source (Choose only one)
OES
11a. Year source published
2017
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
Hill
2. First (given) name of hiring or designated official
Vicky
4. Hiring or designated official title
Legal Specialist Sr.
1. Last (family) name
Mihovich
2. First (given) name
Natalie
4. Firm/Business name
Seyfarth Shaw Llp
5. E-Mail address
Nmihovich@seyfarth.com
By virtue of the signature below, the Department of Labor hereby acknowledges the following:
This certification is valid
From 9/13/2017 12:00:00 AM
To 9/12/2020 12:00:00 AM
Department of Labor, Office of Foreign Labor Certification
Determination Date (date signed)
8/23/2017 12:00:00 AM
Case Number
I-200-17235-569030
The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified LCA.
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