ETA-790A Addendum H-2A Agricultural Clearance Order Form ETA-790A Addendum

H-2A Temporary Agricultural Labor Certification Program

Form ETA-790A_Addendum_B_worksites-housing

H-2A Temporary Agricultural Labor Certification Program Existing Forms

OMB: 1205-0466

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H-2A Agricultural Clearance Order

Form ETA-790A Addendum B

U.S. Department of Labor


C. Additional Place of Employment Information


1. Name of Agricultural Business §

2. Place of Employment *

3. Additional Place of Employment Information §

4. Begin

Date §

5. End

Date §

6. Total

Workers §

































































D. Additional Housing Information


1. Type of Housing *

2. Physical Location *

3. Additional Housing Information §

4. Total

Units *

5. Total

Occupancy *

6. Applicable

Housing

Standards *






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal






Local

State

Federal



Form ETA-790A Addendum B FOR DEPARTMENT OF LABOR USE ONLY Page B.1 of B.2


H-2A Case Number: ____________________ Case Status: __________________ Determination Date: _____________ Validity Period: _____________ to _____________

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