Form ETA-795 Agricultural and Food Processing Clearance Memorandum

Forms for Agricultural Recruitment System Affecting Migratory Farm Workers

ETA-Form 795

Forms for Agricultural Recruitment System Affecting Migratory Farm Workers

OMB: 1205-0134

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Agricultural and Food Processing

Clearance Memorandum

U.S. Department of Labor

Employment and Training Administration



OMB Approval No. 1205-0134

Expires: 07/31/99

1. To: (Name and Address)


3. Job Order Number:


4. Date of Issue:



5. Employer:












2. From: (Name and Address of Local Office)

6. Distribution:











7. Please note the following concerning the above job order:


















8. Employer’s Certification:

This clearance memorandum accurately describes the changes in employment conditions offered by me on the above Job Order.

Typed Name of Employer:

Signature: (Title if other than employer named.)

Date Signed:







9. By: (Typed Name of ES Agency Representative)

Title:

Telephone Number:




Signature:


Date Signed:




10. Applicant Holding Office: (“X” one)



Accepted (If accepted, list local offices extended to.)

Rejected (If rejected, provide reasons.)


Comments:






11. By: (Typed Name of ES Agency Representative)

Telephone Number:

Date Signed:




Public Burden Statement


Public reporting burden for the ETA Form 795 is estimated to be approximately 15 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 795 (Revised July 2009)

File Typeapplication/msword
File TitleAgriculural and Food Processing
AuthorESC
Last Modified Byordynsky.eugenia
File Modified2009-08-18
File Created2009-08-18

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