Application for Temporary Employment Certification

CW-1 Application for Temporary Employment Certification

FORM_ETA_9142C_General_Instructions_3.22.19

Application for Temporary Employment Certification

OMB: 1205-0534

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OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

IMPORTANT: Employers and authorized preparers must read these instructions carefully before completing the Form ETA9142C, CW-1 Application for Temporary Employment Certification and Appendices A to C. These instructions contain full
explanations of the questions and attestations that make up the Form ETA-9142C and Appendices A to C. In accordance with
Federal Regulations, incomplete or obviously inaccurate applications will not be certified by the Department of Labor.
Those items marked with an asterisk (*) are required and must be completed. Items marked with a section symbol (§)
are conditional and must be completed if applicable.
SPECIAL FILING INSTRUCTIONS: Employers that are unable to file electronically, either due to lack of internet access or
physical disability precluding electronic filing, may file the application by mail in accordance with 20 CFR 655.420(c). The mailed
application must include a statement explaining why the employer qualifies to file by mail. There is no specific format for the
statement but it must accompany the application at the time of filing. The NPC will return, without review, any application
received by mail that does not include a statement indicating the need to file by mail. Employers may use the following
address: U.S. Department of Labor* Employment and Training Administration * Office of Foreign Labor Certification * Chicago
National Processing Center * 11 West Quincy Court*Chicago, IL 60604-2105 * Attn: CW-1 Application.
Anyone, who knowingly and willingly furnishes any materially false information in the preparation of Form ETA-9142C and any
supporting documentation, or aids, abets, or counsels another to do so is committing a federal offense punishable by fine,
imprisonment, or both (18 U.S.C. §§ 2, 1001). Other penalties apply as well to fraud or misuse of this immigration document and
to perjury with respect to this form (18 U.S.C. §§ 1546, 1621).
Public Burden Statement
Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number.
Public reporting burden for this collection of information is estimated to average 1 hour and 50 minutes to complete the form and
its appendices, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
needed data, and completing and reviewing the collection of information. The burden estimate is as follows: Form ETA-9142C 45 minutes; Appendix A - 15 minutes; Appendix B - 20 minutes; Appendix C - 20 minutes; and recordkeeping - 10 minutes. The
obligation to respond to this data collection is required to obtain/retain benefits (Northern Mariana Islands U.S. Workforce Act of
2018, amending 48 U.S.C. 1806 et seq.). Please send comments regarding this burden estimate or any other aspect of this
information collection to the U.S. Department of Labor * Employment and Training Administration * Office of Foreign Labor
Certification * 200 Constitution Ave., NW * Box PPII 12-200 * Washington, DC * 20210 or by email to
[email protected]. Please do not send the completed application to this address.
Section A
Nature of CW-1 Application
1.

As a CW-1 employer, enter whether this application is for “New employment” or for a “Renewal of approved employment.”

If this application is for “Renewal of approved employment,” enter the date(s) which the CW-1 visa classification status will
expire for the nonimmigrant worker(s) to be employed under this labor certification. Use a month/day/full year (MM/DD/YYYY)
format.

Enter whether the employer is seeking to employ a long-term worker previously granted a CW-1 visa or CW-1 status as defined
by 20 CFR 655.402 by indicating “Yes” or “No.”

Enter whether any CW-1 workers employed under this application will be exempt from the statutory numerical limit on the total
number of foreign nationals who may be issued a CW-1 visa by indicating “Yes” or “No.” For more information on exemptions to
the CW-1 visa “cap,” please go to www.uscis.gov.

Enter whether the employer is requesting to waive the requirement set forth in 20 CFR 655.422, to obtain a valid Prevailing
Wage Determination (PWD) prior to the filing of the CW-1 Application for Temporary Employment Certification, by indicating
“Yes” or “No.” Please note: if “Yes” is marked, sections A.6 and A.7 must be completed.

If the employer has indicated in A.5 that they are seeking an emergency exemption, please mark the box and attach a
statement justifying the employer’s emergency situation.

If the employer has indicated in A.5 that they are seeking an emergency exemption, please mark the box and attach a
completed Form ETA-9141, Application for Prevailing Wage Determination.

Section B
Employer Information
Form ETA-9142C, GENERAL INSTRUCTIONS

Page 1 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

Enter the full name of the individual employer, joint employer, job contractor, partnership, corporation, i.e. the
employer filing this application. The employer’s legal business name required by this question is the exact name of the
individual, corporation, LLC, partnership, or other organization that is reported to the Internal Revenue Service.

Enter the full trade name or “Doing Business As” (DBA) name, if applicable, of the business, person, association,
firm, corporation, or organization, i.e., the employer filing this application.

Form ETA-9142C, GENERAL INSTRUCTIONS

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OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

Enter the street address of the employer’s principal place of business. The address must be a physical location and not a
separate P.O. Box. Since the addressing the CNMI does not always follow the same entry format, see the Address Note for
CNMI at the end of these general instructions.

If additional space is needed for the street address, use this line to complete the employer’s street address.

Enter the city of the employer’s principal place of business. If the city and country are the same, the name must still
be entered in both fields.

Enter the State, District or Territory of the employer’s principal place of business.

Enter the postal (zip) code of the employer’s principal place of business.

Enter the country of the employer’s principal place of business. If the city and country are the same, the name must
still be entered in both fields.

Enter the province of the employer’s principal place of business, if applicable. Enter “N/A” if not applicable.

10. Enter the area code and telephone number for the employer’s principal place of business. Include country
code, if applicable.
11. Enter the extension of the telephone number for the employer’s principal place of business, if applicable.
12. Enter the nine-digit Federal Employer identification Number (FEIN) as assigned by the IRS. Do not enter a social
security number.
Important Note: All employers, including private households, MUST obtain an FEIN from the IRS before completing
this application. Information on obtaining an FEIN can be found at www.IRS.gov.
13. Enter the four- to six-digit North American Industry Classification System (NAICS) code that best describes the
employer’s business, not the foreign national’s job classification. A listing of NAICS codes can be found at
http://www.census.gov/epcd/www/naics.html.
14. Mark the appropriate box to indicate the type of application being filed for temporary employment certification by
indicating whether the application is for an “Individual Employer” or a “Job Contractor-Joint Employer.” Only one
application type may be selected.
15. If B.14 is marked “Job Contractor – Joint Employer,” please complete Appendix A of the Form ETA-9142C.
16. If B.14 is marked “Job Contractor – Joint Employer,” provide the contract or other agreement establishing a bona fide
relationship to the workers sought under this application between the job contractor and the employer-client.
Section C
Employer Point of Contact Information
An employer point of contact is an employee of the employer whose position authorizes that employee to provide information and
supporting documentation concerning this Application for Temporary Employment Certification and to communicate with the
Department of Labor on behalf of the employer. The employer point of contact should be the individual most familiar with the
content of this application and the circumstances of the foreign worker’s employment.
Important Note: The employer point of contact information in this Section, specifically the name, telephone number, and email
address, must be different from the attorney/agent information listed in Section D, unless the attorney is an employee of the
employer.
1.

Enter the last (family) name of the employer’s point of contact.

Enter the first (given) name of the employer’s point of contact.

Enter the middle name of the employer’s point of contact.

Enter the job title of the employer's point of contact.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 3 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

17. Enter the business street address for the employer’s point of contact. The address must be a physical location and not a
separate P.O. Box. Since the addressing the CNMI does not always follow the same entry format, see the Address Note for
CNMI at the end of these general instructions.
5.

If additional space is needed for the street address, use this line to complete the street address.

Enter the city of the employer’s point of contact. If the city and country are the same, the name must still be entered
in both fields.

Enter the State, District or Territory of the employer’s point of contact.

Enter the postal (zip) code of the employer’s point of contact.

Enter the country of the employer’s point of contact. If the city and country are the same, the name must still be
entered in both fields.

10. Enter the province of the employer’s point of contact, if applicable.

Enter “N/A” if not applicable.

11. Enter the area code and business telephone number of the employer’s point of contact. Include country
code, if applicable.
12. Enter the extension of the telephone number of the employer’s point of contact, if applicable.
13. Enter the business email address, if applicable.
Section D
Attorney or Agent Information (If applicable)
Important Note: The attorney/agent information in this Section, specifically the name, telephone number, and email address,
must be different from the employer’s point of contact information in Section C, unless the attorney is an employee of the
employer.
1.

Identify whether the employer is represented by an attorney or agent in the filing of this application. Only mark one
box. If you mark “Attorney” or “Agent,” complete the remainder of Section D. If you mark “None,” in question 1, skip
questions 2 to 20 and continue to Section E.

Enter the last (family) name of the attorney/agent.

Enter the first (given) name of the attorney/agent.

Enter the middle name of the attorney/agent.

Enter the street address of the attorney/agent.

If additional space is needed for the street address, use this line to complete the attorney/agent’s street address.

Enter the city of the attorney/agent. If the city and country are the same, the name must still be entered in both fields.

Enter the state of the attorney/agent.

Enter the postal (zip) code of the attorney/agent.

10. Enter the country of the attorney/agent. If the city and country are the same, the name must still be entered in both fields.
11. Enter the province of the attorney/agent, if applicable.
12. Enter the area code and telephone number of the attorney/agent. Include country code, if applicable.
13. Enter the extension of the telephone number of the attorney/agent, if applicable.
14. Enter the email address of the attorney/agent in the format [email protected] domain.
Form ETA-9142C, GENERAL INSTRUCTIONS

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OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

15. Enter the attorney/agent’s law firm or business name.
16. Enter the attorney/agent's law firm or business nine-digit FEIN assigned by the IRS.
17. Enter the attorney's state bar identification number. If the attorney is licensed in more than one state, enter only one
state bar identification number. If submitting this form electronically and the attorney is licensed in a state where the
bar association does not issue identification numbers, leave the field blank and once confirmed it will be automatically
pre-populated with “N/A.”
Important Note: The answers to questions 18 and 19 below should correspond to the same state for which a bar
number was provided in question 17, if any.
18. Enter the state of the highest state court where the attorney is in good standing.
19. Enter the name of the highest state court where the attorney is in good standing.
20. If “Agent” is marked in question D.1, an agreement or other document must be attached to the Form ETA-9142C demonstrating
the agent’s authority to represent the employer.
Section E
Job Opportunity
a.

Occupational Classification and PWD

Enter the six or eight-digit Standard Occupational Classification (SOC) / Occupational Information Network
(O*NET) code for the occupation, which most clearly describes the work to be performed. For example, the sixdigit SOC code for a fruit or vegetable harvester or orchard worker is 45-2092.02 (Farmworkers and Laborers,
Crop). The suggested SOC may be used as a tool in the wage determination process. However, the SOC issued
by the Department with the wage determination may differ.

Enter the occupational title associated with the SOC/O*NET (Occupational Employment Statistics) code. For
example, the occupational title associated with SOC/O*NET code 45-2092.02 is “Farmworkers and Laborers, Crop.”
The suggested SOC may be used as a tool in the wage determination process. However, the SOC issued by the
Department with the wage determination may differ.

If “No” is marked to question A.5, enter the PWD case number obtained from the U.S. Department of Labor for this
job opportunity.

Job Offer and Minimum Requirements.

Enter the title of the job opportunity for which temporary employment certification is being sought by the employer.

Enter the number of workers requested in the application for temporary employment certification.

Enter the beginning date for the worker’s period of employment. Use a month/day/full year (MM/DD/YYYY) format.

Enter the end date for the worker’s period of employment. Use a month/day/full year (MM/DD/YYYY) format.

Describe the job duties, in detail, to be performed by any worker filling the job opportunity. Specify any equipment to be
used and pertinent working conditions.

Use Items 6a through 6h to identify the anticipated days and hours of work per day and per week. Use a numerical (99.99)
format for each item below. An entry is required for each box listed in this field.
a.

Enter the total hours of work that will normally be offered to workers per week. The entry in this field must be at least 35.00
hours per week and cannot be less than the sum of the entries in Items 5b through 5h.

Enter the total hours of work that will normally be offered to workers on Sunday.

Enter the total hours of work that will normally be offered to workers on Monday.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 5 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor
d.

Enter the total hours of work that will normally be offered to workers on Tuesday.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 6 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

Enter the total hours of work that will normally be offered to workers on Wednesday.

Enter the total hours of work that will normally be offered to workers on Thursday.

Enter the total hours of work that will normally be offered to workers on Friday.

Enter the total hours of work that will normally be offered to workers on Saturday.

Use Items 7a and 7b to identify the normal daily work schedule for the job opportunity using the standard time in the area where
the work is expected to be performed (e.g., 9 a.m. to 5 p.m., 7 a.m. to 11 a.m., or 4 p.m. to 8 p. m.).
a.

Enter the start time of the day that work will normally begin and select a checkbox to indicate whether the expected start
time of work is “AM” or “PM”.

Enter the end time of the day that work will normally end and select a checkbox to indicate whether the expected end time
of work is “AM” or “PM”.

Identify whether the minimum U.S. diploma or degree required by the employer for the job opportunity is none, high
school/GED, Associates, Bachelor’s, Master’s, Doctorate, or Other. Only mark one box.

Enter the number of months of training required by the employer for the job opportunity. When answering this question, do not
duplicate time requirements – the training time required should not be counted as (added to) education or experience time
required.

10. Enter the number of months of experience required by the employer. If the answer to question b.9 is “None”, enter “0” (zero).
11. Use Items 11 and 11a to identify whether the worker(s) employed under the job opportunity will be required to perform
supervision of other employees.
11 Mark “Yes” or “No” as to whether the job opportunity supervises the work of other employees.
11a If “Yes” is marked in question 11, enter the total number of employees the job opportunity will supervise.
12 Enter the job related special requirements. Examples are shorthand and typing speeds, specific foreign language
proficiency, and test results. Document business necessity for a foreign language requirement. If there are no job related
special requirements or skills, enter “None.”
c.

Place of Employment and Wage Information

It is important for the employer to define the area of intended employment with as much geographic specificity as possible. This
information is used for purposes of reviewing and verifying regulatory compliance with advertising, positive recruitment
requirements, and prevailing wage determinations. The employer must provide enough geographic detail to cover all the known
worksite locations of intended employment. If the number of known worksite locations exceeds our system limits, you will be
required to submit more than one application. Please note that wages cannot be provided for unspecified/unanticipated locations.
CW-1 applications are limited to worksites in the CNMI.
Important Note: For job contractors filing under the CW-1 visa programs where multiple worksites are involved or where
special procedures apply, submit a separate attachment identifying, by business name and address, all physical
locations where the services or labor is expected to be performed. Enter the address of the first worksite location on the
form using questions c.1 through c.5. If “Yes,” is marked in E.c.6, a completed Appendix B must be completed.
1.

Enter the street address of the worksite location where work will be performed. The worksite address must be a physical
location and cannot be a P.O. Box.

If additional space is needed for the street address, use this line. If no additional space is needed, enter “N/A.”

Enter the city of the worksite location.

Enter the State, District or Territory of the worksite location.

Enter the postal (zip) code of the worksite location.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 7 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

Enter the rate of pay to be paid to worker(s). If the wage offer is expressed as a range, enter the bottom of the wage range
to be paid on the “From:” line and enter the top of the wage range on the “To:” line.

6a. Enter the rate of overtime pay, if applicable, to be paid to worker(s). If the wage offer is expressed as a range, enter the
bottom of the wage range to be paid on the “From:” line and enter the top of the wage range on the “To:” line. If no overtime
is offered, leave this section blank.
7.

Indicate whether the rate of pay is per hour, week, bi-weekly, or “Other” (e.g., month, year) by selecting the corresponding
box. Make only one selection.

7a. Briefly describe any conditions about the wage rate to be paid. For example, if the answer to question 7 is “Piece Rate,”
enter the units that govern how the piece rate is paid (e.g., 5/8 bushel, 90 pound bag or box, 10 box bin). Please also
describe here any bonuses, fringe benefits, subsidized housing or meals, or any other benefits associated with this job
opportunity. Enter “N/A” or “None” if there are no additional conditions about the wage rate to be paid.
8.

Enter whether wages are paid daily, weekly, every two weeks, or over a different period. Mark only one box

If work will not be performed in location(s) other than the address listed in questions c.1-c.5, mark “No.

10. If “Yes,” is marked in E.c.9, a completed Appendix B must be completed. Identify the geographic place(s) of employment
with as much specificity as possible, such as the city, state, and postal code where work will be performed. The employer
must provide enough geographic detail to cover all the worksite locations of intended employment.
d.

Other Material Terms and Conditions of the Job

Mark “Yes” or “No” to indicate whether the employer has read and agrees to provide each of the following terms and
conditions of employment as fully explained in these General Instructions and at 20 CFR 655, Subpart E.
Three Fourths Guarantee (20 CFR 655.423(f)):
(1) Offer to Worker. The employer must guarantee to offer the worker employment for a total number of work hours equal to
at least three-fourths of the workdays of the total period of employment specified in the work contract, beginning with the
first workday after the arrival of the worker at the place of employment or the advertised contractual first date of need,
whichever is later, and ending on the expiration date specified in the work contract or in its extensions, if any. See the
exception in 20 CFR 655.423(v).
(i)

A workday means the number of hours in a workday as stated in the work contract and excludes the worker’s
Sabbath and Federal holidays. The employer must offer a total number of hours to ensure the provision of sufficient
work to reach the three-fourths guarantee. The work hours must be offered during the work period specified in the
work contract, or during any modified work contract period to which the worker and employer have mutually agreed
and that has been approved by the CO.

(ii) In the event the worker begins working later than the specified beginning date, the guarantee period begins with the
first workday after the arrival of the worker at the place of employment, and continues until the last day during which
the work contract and all extensions thereof are in effect.
(iii) Therefore, if, for example, a work contract is for a 10-week period, during which a normal workweek is specified as 6
days a week, 8 hours per day, the worker would have to be guaranteed employment for at least 360 hours (10 weeks
× 48 hours/week = 480 hours × 75 percent = 360). If a Federal holiday occurred during the 10-week period, the 8
hours would be deducted from the total hours for the work contract, before the guarantee is calculated. Continuing
with the above example, the worker would have to be guaranteed employment for 354 hours (10 weeks × 48
hours/week = 480 hours − 8 hours (Federal holiday) = 472 hours × 75 percent = 354 hours).
(iv) A worker may be offered more than the specified hours of work on a single workday. For purposes of meeting the
guarantee, however, the worker will not be required to work for more than the number of hours specified in the work
contract for a workday, or on the worker’s Sabbath or Federal holidays. However, all hours of work actually
performed may be counted by the employer in calculating whether the period of guaranteed employment has been
met. If during the total work contract period the employer affords the U.S. or CW-1 worker less employment than that
required under this paragraph, the employer must pay such worker the amount the worker would have earned had
the worker, in fact, worked for the guaranteed number of days. An employer will not be considered to have met the

Form ETA-9142C, GENERAL INSTRUCTIONS

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OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor
work guarantee if the employer has merely offered work on three-fourths of the workdays of the work contract period
if each workday did not consist of a full number of hours of work time as specified in the work contract.
(2) Guarantee for piece rate paid worker. If the worker is paid on a piece rate basis, the employer must use the worker’s
average hourly piece rate earnings or the offered wage, whichever is higher, to calculate the amount due under the
guarantee in accordance with paragraph (1) above.
(3) Failure to work. Any hours the worker fails to work, up to a maximum of the number of hours specified in the work
contract for a workday, when the worker has been offered an opportunity to work in accordance with paragraph (1) above,
and all hours of work actually performed (including voluntary work over 8 hours in a workday or on the worker’s Sabbath
or Federal holidays), may be counted by the employer in calculating whether the period of guaranteed employment has
been met. An employer seeking to calculate whether the guaranteed number of hours has been met must maintain the
payroll records in accordance with this subpart.
Transportation and Subsistence (20 CFR 655.423(j)(1)):
(i)

Transportation to the place of employment. The employer must provide or reimburse the worker for transportation and
subsistence from the place from which the worker has come to work for the employer, whether in the U.S., including
another part of the Commonwealth, or abroad, to the place of employment if the worker completes 50 percent of the
period of employment covered by the work contract (not counting any extensions). The employer may arrange and pay
for the transportation and subsistence directly, advance at a minimum the most economical and reasonable common
carrier cost of the transportation and subsistence to the worker before the worker’s departure, or pay the worker for the
reasonable costs incurred by the worker. When it is the prevailing practice of non-CW-1 employers in the occupation and
in the Commonwealth to do so or when the employer extends such benefits to similarly situated CW-1 workers, the
employer must advance the required transportation and subsistence costs (or otherwise provide them) to workers in
corresponding employment who are traveling to the employer’s place of employment. The amount of the transportation
payment must be no less (and is not required to be more) than the most economical and reasonable common carrier
transportation charges for the distances involved. The amount of the daily subsistence must be at least the amount
permitted in § 655.173. Where the employer will reimburse the reasonable costs incurred by the worker, it must keep
accurate and adequate records of: The costs of transportation and subsistence incurred by the worker; the amount
reimbursed; and the date(s) of reimbursement. Note that the FLSA applies independently of the CW-1 requirements and
imposes obligations on employers regarding payment of wages.

(ii) Transportation from the place of employment. If the worker completes the period of employment covered by the work
contract (not counting any extensions), or if the worker is dismissed from employment for any reason by the employer
before the end of the period, and the worker has no immediate subsequent CW-1 employment, the employer must provide
or pay at the time of departure for the worker’s cost of return transportation and daily subsistence from the place of
employment to the place from which the worker, disregarding intervening employment, departed to work for the employer.
If the worker has contracted with a subsequent employer that has not agreed in the work contract to provide or pay for the
worker’s transportation from the former employer’s place of employment to such subsequent employer’s place of
employment, the former employer must provide or pay for that transportation and subsistence. If the worker has
contracted with a subsequent employer that has agreed in the work contract to provide or pay for the worker’s
transportation from the former employer’s place of employment to such subsequent employer’s place of employment, the
subsequent employer must provide or pay for such expenses.
2.

Daily Transportation: Enter “Yes” if the employer agrees to provide workers with daily transportation to and from the worksite
in accordance with applicable Federal and Commonwealth laws and regulations. Otherwise, enter “N/A.”

Overtime Available: Enter “Yes” if overtime will be made available to workers. Otherwise, enter “N/A.” The employer will keep
a record of workers’ earnings and provide the workers with the required earnings statements on or before each payday, which
must be at least every 2 weeks or according to the prevailing practice in the area of intended employment, whichever is more
frequent.

On-the-Job Training: Enter “Yes” if this position involves on-the-job training. Otherwise, enter “N/A.”

Employer-Provided Tools and Equipment: Enter “Yes” if the employer agrees to provide to workers, without charge or
deposit, all tools, supplies, and equipment required to perform the duties assigned. Otherwise, enter “N/A.”

Board, Lodging, or Other Facilities: Enter “Yes” if the employer agrees to either provide workers with board, lodging, or other
facilities and/or to assist workers in securing board, lodging, or other facilities. Otherwise, enter “N/A.”

Form ETA-9142C, GENERAL INSTRUCTIONS

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OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

State all deduction(s) from pay not required by law and, if known, the amount(s). If no deductions other than those required by
law will be made from the workers’ pay, enter “N/A” or “None” in the space provide

Referral and Hiring Instructions

Enter verifiable methods by which prospective U.S. workers can contact the employer and apply for the job opportunity.
These methods must be identified and entries ARE REQUIRED for submission of this application. Include the days
and hours which applicants may apply for the job opportunity listed in this application.
Important Note: Enter at least two (2) verifiable methods by which prospective U.S. workers can contact the employer and
apply for the job opportunity must be identified and entries ARE REQUIRED for submission of this application. “N/A” may be
manually entered for E.d.3 or E.d.4.

Enter the area code and telephone number by which prospective U.S. workers can contact the employer and apply for the
job opportunity. If a phone number is not available, leave this field BLANK and the system will insert "N/A" at submission of
the application.

Enter the email address by which prospective U.S. workers can contact the employer and apply for the job opportunity. The
format must be [email protected] domain. If an email address is not available, please enter "N/A".

Enter the website address by which prospective U.S. workers can contact the employer and apply for the job opportunity.
The format must be domain name.domain suffix. Examples of valid suffixes include: .gov - Government agencies .edu Educational institutions .org - Organizations (nonprofit) .mil - Military .com - commercial business .net - Network
organizations. If a website address is not available, please enter "N/A".

Section F
Declaration of Employer and Attorney/Agent
1.

Check the appropriate box to indicate if the employer and its attorney or agent (as applicable) have read and agree to all the
terms, assurances, and obligations contained in the Appendix C (Declarations by the Employer and Attorney or Agent) and
have attached a signed and dated copy of Appendix C to this application.

If this application is submitted by a job contractor, check the appropriate box to indicate whether or not the employer-client
identified in Appendix A has read and agrees to all the terms, assurances, and obligations contained in Appendix C
(Declarations by the Employer and Attorney or Agent) and has attached a signed and dated copy of Appendix C to this
application. Select “N/A” if this application is not submitted by a job contractor.

Section G
Preparer
This section must be completed if the preparer of this application is a person other than the one identified in either Section C
(employer point of contact) or Section D (attorney or agent) of this application.
1.

Enter the last (family) name of the person preparing this application by or on behalf of the employer.

Enter the first (given) name of the person preparing this application by or on behalf of the employer.

If applicable, enter the middle initial of the person preparing this application by or on behalf of the employer. If the preparer
does not have a middle name, enter “N/A.”

Enter the FEIN, assigned by the IRS, for the firm or business submitting this application by or on behalf of the employer.

Enter the name of the firm or business that prepared this application by or on behalf of the employer.

Enter the business email address of the person that prepared this application by or on behalf of the employer. Format must
be in the format [email protected] domain. The email entered in this field must be the one regularly used by
the preparer to send and receive electronic communications from the Department with respect to the processing of this
application. If the preparer does not possess a business email address, please enter “N/A.”

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 10 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

Public Burden Statement Control Number 1205-053X
Please read this disclosure. No entries are required.
APPENDIX A – Job Contractor: Employer-Client Information Instructions
A job contractor means a person, association, firm, or a corporation that meets the definition of an employer and that contracts
services or labor on a temporary basis to one or more employers that are not an affiliate, branch, or subsidiary of the job
contractor and where the job contractor will not exercise substantial, direct day-to-day supervision and control in the performance
of the services or labor to be performed other than hiring, paying, and firing the workers. 20 CFR 655.402, 655.421. Pursuant to
20 CFR 655.421(a), a job contractor may only submit a CW-1 Application for Temporary Employment Certification, Form ETA
9142C, if it is filing as a joint employer with its employer-client. An employer-client means an employer that has entered into an
agreement with a job contractor, as defined in 20 CFR 655.402. Pursuant to 20 CFR 655.421(d)(1), a job contractor that is filing
as a joint employer with its employer-client must submit a completed CW-1 Application for Temporary Employment Certification,
Form ETA 9142C, that clearly identifies the joint employers (the job contractor and its employer-client) and the employment
relationship (including the actual place(s) of employment disclosed on the Form ETA-9142C). Please complete Sections A and
B below and attach this form to the Form ETA 9142C that will be submitted to the Department for processing.
Important Note: Employers are required to complete Appendix A when supplying information about the employer-client and its
point of contact. Submission of this information in any other form or format will not be accepted and will result in the application
being rejected for processing by the Department.
Section A: Employer-Client Information
1.

Enter the full name of the individual employer-client. The employer-client’s full legal business name is the exact name of the
individual, corporation, LLC, partnership, or other organization that is reported to the IRS.

Enter the full trade name or “Doing Business As” (DBA) name of the employer-client, if applicable. Enter “N/A” if not
applicable.

Enter the street address of the employer-client’s principal place of business. The address must be a physical location and
not a P.O. Box.

If additional space is needed for the street address, use this field to complete the employer-client’s street address. If no
additional space is needed, enter “N/A.”

Enter the city of the employer-client’s principal place of business.

Enter the State, District, or Territory of the employer-client’s principal place of business.

Enter the postal (zip) code of the employer-client’s principal place of business.

Enter the country of the employer-client’s principal place of business.

Enter the province of the employer-client’s principal place of business, if applicable. Enter “N/A” if not applicable.

10. Enter the area code and telephone number for the employer-client’s principal place of business. Include country code, if
outside of the United States.
11. Enter the extension of the telephone number for the employer-client’s principal place of business, if applicable. Enter “N/A”
if not applicable.
12. Enter the nine-digit FEIN as assigned by the IRS. Do not enter a social security number.
Note: All employers, including private households, MUST obtain an FEIN from the IRS before completing this application.
Information on obtaining an FEIN can be found at www.irs.gov.
13. Enter the four-digit NAICS code that best describes the employer’s business, not the CW-1 job opportunity. A listing of
NAICS codes can be found at www.census.gov/eos/www/naics/.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 11 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

B. Employer-Client Point of Contact Information
1.

Enter the last (family) name of the employer-client’s point of contact.

Enter the first (given) name of the employer-client’s point of contact.

Enter the middle name(s) of the employer-client’s point of contact, if applicable. Enter “N/A” if not applicable.

Enter the job title of the employer-client’s point of contact.

Enter the business street address for the employer-client’s point of contact. The address must be a physical location and not
a separate P.O. Box. Since the addressing the CNMI does not always follow the same entry format, see the Address Note
for CNMI at the end of these general instructions.

If additional space is needed for the street address, use this field to complete the street address. If no additional space is
needed, enter “N/A.”

Enter the city of the employer-client’s point of contact.

Enter the State, District, or Territory of the employer-client’s point of contact.

Enter the postal (zip) code of the employer-client’s point of contact.

10. Enter the country of the employer-client’s point of contact.
11. Enter the province of the employer-client’s point of contact, if applicable. Enter “N/A” if not applicable.
12. Enter the area code and business telephone number of the employer-client’s point of contact. Include country code, if the
point of contact is located outside of the United States.
13. Enter the extension of the telephone number of the employer-client’s point of contact, if applicable. Enter “N/A” if not
applicable.
14. Enter the business email address of the employer-client’s point of contact in the format [email protected]
domain. The email entered in this field must be the same as the one regularly used by the employer-client’s point of contact
for its business operations and capable of sending and receiving electronic communications from the Department with
respect to the processing of this application. If the employer-client’s point of contact does not possess a business email
address, please enter “N/A.”
APPENDIX B – Additional Place of Employment and Wage Information Instructions
Important Note: Employers are required to complete Appendix B when supplying information about additional worksites.
Submission of additional worksite information in any other form or format will not be accepted. Only worksites entered on the
Form ETA-9142C and Appendix B will be used in the processing of the employer’s request for temporary labor certification.
Complete Items 1 through 5 below for each worksite location where the services or labor is expected to be performed, as
applicable. If the employer intends for the workers sought to perform labor or services at more than ten (10) worksite locations,
the employer must complete as many additional worksite location entries on the Appendix B as are necessary to list all intended
worksite locations for this application.
1.

Enter the city covering the worksite location. If the work to be performed is located outside a city or in a rural or isolated
geographic area, enter the nearest city in the geographic area. If the work to be performed covers multiple cities and towns
within the geographic area, enter “Multiple Cities and Towns”. The employer must provide enough geographic detail to
cover all the known worksite locations of intended employment. If the number of known worksite locations exceeds our
system limits, you will be required to submit more than one application. Please note that wages cannot be provided for
unspecified/unanticipated locations. CW-1 applications are limited to worksites in the CNMI.

Enter the two-letter postal abbreviation for the State, District, or Territory of the worksite location.

Enter the postal code of the worksite location.

Enter any additional details or information about the place of employment where work will be performed, if applicable.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 12 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor

Based on the requirements of the employer’s work itinerary, use the following field to enter additional information about the
job opportunity.
•

Crew ID – Enter a single-digit number or letter to identify each crew of workers, as applicable.

•

Total Workers – Whether associated with a distinct work crew or not, enter the total number of workers expected to
perform work at the worksite location, as applicable.

•

Begin Date - Enter the expected start date for the period of employment at this worksite location, as applicable. Use a
month/day/year (mm/dd/yyyy) format.

•

End Date – Enter the expected end date for the period of employment at this worksite location, as applicable. Use a
month/day/year (mm/dd/yyyy) format.

•

Basic Wage Rate - Enter the basic rate of pay to be paid for the period of employment at this worksite location, if
applicable. If the wage offer is expressed as a range, enter the bottom of the wage range to be paid on the “From:” line
and enter the top of the wage range on the “To:” line.

•

Per – Enter the following two-letter designations for the unit of pay, as applicable: “HR” – hourly; “WK” – weekly; “BW” –
biweekly; “MH” – monthly; “YR” year; or “PR” piece rate.

APPENDIX C – Employer and Attorney/Agent Declarations for CW-1 Employers Instructions
A.

Attorney or Agent Declaration

Enter the last (family) name of the attorney/agent representing the employer in the filing of this application.

Enter the first (given) name of the attorney/agent representing the employer in the filing of this application.

Enter the middle initial of the attorney/agent representing the employer in the filing of this application, if applicable. Enter
“N/A” if not applicable.

Enter the firm or business name of the attorney/agent representing the employer in the filing of this application. The firm or
business name is the exact name that is reported to the IRS.

The attorney/agent must sign the application. Read the entire application and verify all contained information prior to signing.

The attorney/agent must date the application. Use a month/day/year (mm/dd/yyyy) format.

Employer Declaration

Enter the last (family) name of the person with authority to sign on behalf of the employer.

Enter the first (given) name of the person with authority to sign on behalf of the employer.

Enter the middle initial of the person with authority to sign on behalf of the employer, if applicable. Enter “N/A” if not
applicable.

Enter the job title of the person with authority to sign on behalf of the employer.

The person with authority to sign on behalf of the employer must sign the application and provide his or her initials next to
each condition of employment. Read the entire application, including each condition of employment, and verify all contained
information prior to signing.

The person with authority to sign on behalf of the employer must date the application. Use a month/day/year (mm/dd/yyyy)
format.

Important Note: The employer provides a copy of Appendix C with its application package to OFLC, retaining the
original.

Form ETA-9142C, GENERAL INSTRUCTIONS

Page 13 of 14

OMB Approval: 1205-053X
Expiration Date: XX/XX/XXXX

CW-1 Application for Temporary Employment Certification
Form ETA-9142C General Instructions
U.S. Department of Labor
ADDITIONAL GENERAL INSTRUCTIONS – ADDRESS ENTRIES FOR THE CNMI
The collection of address information on the Form ETA-9141C requires the disclosure of a physical location. Since employers
operating in the CNMI have different methods of expressing the physical location(s) of their establishments where work is
performed, the Form ETA-9141C should be filled out in accordance with the examples provided below. Please note that each
example has some address information, other than a P.O. Box, identifying the physical location where a person would need to
report for or otherwise perform work.
For the CNMI, the Address 1 field must be used to identify the street name and, if available, street number (e.g., 1338 Asension
Drive) where the employer’s establishment is located. The Address 2 field may be used to provide additional details on the
physical location, including an office suite or floor number. This field may be used to identify a combination of the P.O Box and
island (e.g., Saipan) on which the employer’s establishment is located. The City field must be used to identify the name of the
nearest city, town or village on the island in which the employer’s establishment is located, and the State field must be recorded
as “MP” where located within the CNMI. Each major island in the CNMI has its own United States Postal Code as follows: 96950
(Saipan), 96951 (Rota), and 96952 (Tinian).
Form ETA-9141C Field Name

Example Entry

Address 1

Palm Avenue, Beach Road

Address 2 (apartment/suite/floor and number)

Saipan

City

Garapan

State

Postal Code

96950

Form ETA-9141C Field Name

Example Entry

Address 1

Lots 00r50, 005r52, 005r47

Address 2 (apartment/suite/floor and number)

Rota

City

Songsong Village

State

Postal Code

96951

Form ETA-9141C Field Name

Example Entry

Address 1

8th

Address 2 (apartment/suite/floor and number)

PO Box 520790, Tinian

City

San Jose Village

State

Postal Code

96952

Form ETA-9142C, GENERAL INSTRUCTIONS

Avenue

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