ETA 9142 Appendix Application for Temporary Employment Certification, Appe

O MB Approval:

Expiration Date

Application for Temporary Employment Certification

ETA Form 9089T – APPENDIX A

U.S. Department of Labor

For Use in Filing Applications Under the H-2A Agricultural Program ONLY

A. Rate of Pay Information for Multiple Crop or Agricultural Activities

Important Note: The rate of pay for each crop or agricultural activity MUST begin in the spaces below. If necessary, add attachment to continue and complete the rate of pay for all crop activities covered by the application.

Agricultural Crop Activity	Hourly Wage	Piece Rate Wage	Piece Rate Unit(s)	Special Pay (bonus, etc.)
	$ ____ . ___	$ ____ . ___
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	$ ____ . ___	$ ____ . ___
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	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___
	$ ____ . ___	$ ____ . ___

ETA XXXX: Appendix A Validity period: __________________ to _____________________ Page A.8 of A.1

Tracking Number: ___________________ Status: ___________________