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Case Number
I-200-19105-408221
1. Indicate the type of visa classification supported by this application (Write classification symbol):
H-1B
1. Job Title
Resident Physician
2. SOC (ONET/OES) code
29-1062
3. SOC (ONET/OES) occupation title
Family and General Practitioners
4. Is this a full-time position?
Yes
Period of Intended Employment
5. Begin Date (mm/dd/yyyy)
6/1/2019 12:00:00 AM
6. End Date (mm/dd/yyyy)
5/31/2022 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
Vanderbilt University Medical Center
2. Trade name/Doing Business As (DBA), if applicable
3. Address 1
2525 West End Avenue
10. Telephone number
615-875-9124
12. Federal Employer Identification Number (FEIN from IRS)
13. NAICS code (must be at least 4-digits)
622110
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
Hartman
2. First (given) name
Deanna
4. Contact's job title
Senior Immigration Consultant
5. Address 1
2525 West End Avenue
12. Telephone number
615-875-9124
14. E-Mail address
Immigration@vumc.org
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
Graham
3. First (given) name
Paul
5. Address 1
50 West Big Beaver Road Suite 200
12. Telephone number
2486495404
14. E-Mail address
Ngraham@fragomen.com
15. Law firm/Business name
Fragomen, Del Rey, Bernsen And Loewy
16. Law firm/Business FEIN
17. State Bar number (only if attorney)
P64008
18. State of highest court where attorney is in good standing (only if attorney)
Michigan
19. Name of the highest court where attorney is in good standing (only if attorney)
Supreme Court
1. Wage Rate (Required)
From: $
57,303.00
To: $
0.00
2. Per: (Choose only one)
Year
1. Address 1
Nashville Va, 1310 24th Ave South
5. State/District/Territory
TN
7. Agency which issued prevailing wage
7a. Prevailing wage tracking number (if applicable)
8. Wage level
9. Prevailing wage
$ 56,126.00
10. Per: (Choose only one)
11. Prevailing wage source (Choose only one)
11a. Year source published
2018
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
Hartman
2. First (given) name of hiring or designated official
Deanna
4. Hiring or designated official title
Senior Immigration Consultant
By virtue of the signature below, the Department of Labor hereby acknowledges the following:
This certification is valid
From 6/1/2019 12:00:00 AM
To 5/31/2022 12:00:00 AM
Department of Labor, Office of Foreign Labor Certification
Determination Date (date signed)
4/15/2019 12:00:00 AM
Case Number
I-200-19105-408221
The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified LCA.
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