Form ETA-790 Agricultural and Food Processing Clearance Order

Agricultural and Food Processing Clearance Order

Pedido de Empleados para Agricultura y Procesamiento de Alimentos

U.S. Department of Labor Employment and Training Administration

OMB. Approval No. 1205-0134, Expires 08131/2009

1. Employer's Name and Address (Number, Street, City, State, Zip Code, and telephone number)/ Nombre y Dirección del Empleador (Numero, calle, ciudad, código postal y teléfono)

Numbers 4, 5, 6, 7 and 8 for State use only.
4. Industry Code/Código de Industria	5. Job Order #/No. Orden de Empleo
6. Occupational Title and Code /Titulo Ocupacional y Código
7. Clearance Order Issue Date / Fecha de Tramite
8. Job Order Expiration Date / Fecha de vencimiento
9. Anticipated Period of Employment / Periodo Anticipado de Empleo From/ Desde: To/Hasta:
10. No. of Worker's Requested I No. de Trabajadores Pedidos
11. Anticipated Hours of Work per Week/Horas Anticipadas de Trabajo por Semana. Total: ________ Sunday I Domingo______ Monday / Lunes______ Tuesday / Martes_______ Wednesday I Miércoles____ Thursday / Jueves______ Friday / Viernes_____ Saturday / Sábado______
12. Collect Calls Accepted from/Se Aceptan Llamadas a Cobrar de: Employer / El Empleador Yes  No  Local Office / La Oficina Local Yes  No 

2. Location and Direction to Work Site/Dirección del lugar de trabajo

(If additional space is needed, use separate sheet of paper)

3. Location and Description of Housing / Dirección y Descripción de la Vivienda

(If additional space is needed, use separate sheet of paper).I Si necesita más espacio, utilice documento adicional.)

13. Board Arrangements / Arreglo de Alojamiento

14. Referral Instructions / Instrucciones para el Referimiento de Candidatos

15. Job Specifications / Descripción del Trabajo

(If more space is needed, summary of Material Job Specifications in ENGLISH can be included in separate document, and may also be included in SPANISH)

16. Wage Rates, Special Pay Information and Deductions / Tarifa de Pago, Información Sobre Pagos Especiales y Deducciones (Rebajas)

Crop Activities I Cultivos

Hourly Wage

Piece Rate / Unit(s)

Special Pay

(bonus, etc.)

Deductions I

YES /

SI

NO

Pay Period

Periodo de Pago

Salario por Hora

Pago por Pieza / Unidad(es)

Pagos Especiales

(Bono, etc.)

Deducciones

$

$

Social Security / Seguro Social

Weekly / Semanal

$

$

Federal Tax

Impuestos Federales

$

$

State Tax Impuestos

Estatales

Bi-weekly /

cada 2 semanas

$

$

Meals / Comidas

$

$

Other (specify)/ Otro

Other / Otro

More Details About the Pay / Mas Detalles Sobre el Pago

(If additional space is needed, use separate sheet of paper. I Si necesita más espacio, utilice documento adicional.)

17. Transportation Arrangements / Arreglos de Transportación

(If additional space is needed, use separate sheet of paper. I Si necesita más espacio, utilice documento adicional.)

18. Is it the prevailing practice to use Farm Labor Contractors (FLC) to recruit, supervise, transport, house, or pay workers for this (these) crop activity(ies)? Es la costumbre en el área de usar Contratistas Agrícolas para reclutar, supervisar, transportar, dar vivienda, o pagarle a los trabajadores en estos tipos de cosecha(s)? Yes / Si  No 

If you have checked yes, what is the FLC wage for each activity? / Si contesto "Si," cual es el salario quo le paga al Contratista Agrícola por cada actividad?

19. Unemployment Insurance provided? Seguro de Desempleo? Yes  No 

20. Workers' compensation insurance provided? Indemnización por accidence de trabajo: Yes  No 

21. Are tools provided at no charge to the workers? / Se le proveen las herramientas de trabajo a los trabajadores sin cargo alguno? Yes  No 

22. List any arrangements which have been made with establishment owners or agents for the payment of a commission or other benefits for sales made to workers. (If there are no such arrangements, enter "None") / Indique todo acuerdo o convenio con los propietarios del establecimiento o sus representantes con respecto al pago de una comisión u otros beneficios por ventas hechas a los trabajadores. (Si no hay ningún acuerdo o convenio, indique "Ninguno")

23. List any strike, work stoppage, slowdown, or interruption of operation by the employees at the place where the workers will be employed.

(If there are no such incidents, enter "None") /

Enumere toda huelga, paro o interrupción de las operaciones por parte de los empleados en el lugar de empleo. (Si no hay, indique "Ninguno")

24. Address of Order Holding Office (include Telephone number)/Dirección de la Oficina donde se Radico la Oferta (incluya numero de teléfono)

25. Name of Local Office Representative (include direct dial telephone number) / Nombre del Representante de la Oficina Local (Incluya numero de teléfono)

26. Employer's Certification: This job order describes the actual terms and conditions of the employment being offered by me and contains all the material terms and conditions of the job.

Certificación del Empleador: Esta orden de trabajo describe los términos y condiciones de trabajo, y contiene todos los materiales, términos, y condiciones ofrecidos.

Employer's Signature & Title/ Firma y Titulo del Empleador

READ CAREFULLY, In view of the statutorily established basic function of the Employment Service as a no-fee labor exchange, that is, as a forum for bringing together employers and job seekers, neither the ETA nor the State agencies are guarantors of the accuracy or truthfulness of information contained on job orders submitted by employers. Nor does any job order accepted or recruited upon by the One-Stop Career Center constitute a contractual job offer to which the One-Stop Career Center, ETA or a State agency is in any way a party.

Public Burden Statement

Public reporting burden for the ETA Form 790 is estimated to be approximately 60 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and reviewing the collection. Respondents’ obligation to reply to these requirements is mandatory by 20 CFR 653.500 and 44 U.S.C. 3501. Persons are not required to respond to this collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection, including suggestions for reducing this burden, to the U.S. Department of Labor, Migrant and Seasonal Farmworker Program, Room S4209, 200 Constitution Avenue, NW, Washington, DC 20210.

ETA 790 (Rev. July 2009)

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