ETA-9089 Final Determination: Permanent Employment Certification

Application for Permanent Employment Certification

Form ETA-9089 Final Detirmination 042221

Application for Permanent Employment Certification

OMB: 1205-0451

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E mployment OMB Approval: 1205-0451

Expiration Date: 05/31/21

Application for Permanent Employment Certification

Form ETA-9089 – Final Determination: Permanent Employment Certification Approval

U.S. Department of Labor



PERMANENT EMPLOYMENT CERTIFICATION APPROVAL


A. U.S. Government Agency Use Only


Pursuant to the provisions of Sections 212(a)(5)(A) of the Immigration and Nationality Act, as amended, the Department hereby certifies that there are not sufficient workers who are able, willing, and qualified, and who will be available at the time of application for a visa and admission into the United States and place needed to fill the job opportunities for which certification is sought, and the permanent employment of the foreign worker will not adversely affect the wages and working conditions of workers in the United States similarly employed.


Therefore, by virtue of the signature below, the Department hereby acknowledges granting certification for the following Application for Permanent Employment Certification (Form ETA-9089):


1. DOL Case Number


2. Case Status

3. Employer Legal Business Name

4. Employer FEIN

5. Foreign Worker’s Last (family) Name

6. Foreign Worker’s First (given) Name

7. Foreign Worker’s Middle Name(s)

8. Job Title


9. SOC Code


10. SOC Occupational Title

Labor Certification Validity Information

11. Filing Date

12. Determination Date

13. Expiration Date

14. Department of Labor

Office of Foreign Labor Certification

(electronic signature)



Pursuant to 20 CFR 656, the aforementioned permanent labor certification is valid only for the job opportunity, the foreign worker, and the area of intended employment specified on the approved Form ETA-9089, including all appendices and any modifications approved by the Department. The aforementioned filing date on this approved Application for Permanent Employment Certification, established under 20 CFR 656.17(c), may be used as a priority date by the Department of Homeland Security and the Department of State, as appropriate. This approved Application for Permanent Employment Certification will expire if not filed in support of Immigrant Petition for Alien Workers (Form I-140) with the Department of Homeland Security by the aforementioned expiration date.


The foreign worker covered by this approved Application for Permanent Employment Certification has declared under Section B below, under penalty of perjury, that the foreign worker has read and reviewed every page of Appendix A for this approved Form ETA-9089, takes full responsibility for the accuracy of all information contained therein, and intends to accept permanent employment in the job opportunity specified on the approved Form ETA-9089, including all appendices, offered by the employer if granted a visa or an adjustment of status based on this permanent labor certification.


The employer covered by this approved Application for Permanent Employment Certification has declared under Section D below under penalty of perjury that it has read and reviewed every page of this approved Form ETA-9089, including all appendices, and takes full responsibility for the accuracy of all information contained therein and all documentation supporting this approved Application for Permanent Employment Certification, including any representations made by the employer’s authorized preparer, agent or attorney, as applicable.



B. Foreign Worker Declaration


I declare under penalty of perjury that I have read and reviewed all information contained in Appendix A of this approved Form ETA-9089, and that to the best of my knowledge the information contained therein is true and accurate. I understand that to knowingly and/or willfully furnish materially false information in the preparation of this form and any supplement thereto or to aid, abet, or counsel another to do so is a federal offense punishable by fines, imprisonment, or both (18 U.S.C. 2, 1001, 1546, 1621).


I further declare that I am the person identified under Section A, Fields 5, 6, and 7 above. I did not participate in any activities involving the interviewing or consideration of U.S. workers and intend to accept permanent employment in the job opportunity specified on this approved Form ETA-9089, including all appendices, offered by the employer if granted a visa or an adjustment of status based on this permanent labor certification.


1. Signature *

2. Date Signed *



C. Attorney or Agent Declaration


I declare under penalty of perjury that I am an attorney for the employer, or that I am an employee of, or hired by, the employer listed in Section C of the Form ETA-9089, and that I have been designated by that employer in accordance with 20 CFR 656.10(b) to act on its behalf in connection with this application.


I hereby certify that I have provided to the employer the entire Form ETA-9089, appendices, and all supporting documentation for review and to the best of my knowledge the information contained herein is true and accurate, including the employer’s declaration regarding activities that I have undertaken on the employer’s behalf in connection with this application. I understand that to knowingly and/or willfully furnish materially false information in the preparation of this form and any supplement hereto or to aid, abet, or counsel another to do so is a federal offense punishable by fines, imprisonment, or both (18 U.S.C. 2, 1001, 1546, 1621).



1. Attorney or Agent’s Last (family) Name *

2. First (given) Name *

3. Middle Initial §

4. Firm/Business Name §

5. Signature *


6. Date Signed *



D. Employer Declaration


I hereby designate the agent or attorney identified in Section C (if any) of the Form ETA-9089 to represent me for the purpose of labor certification and, by virtue of my signature in Field 5 below, I take full responsibility for the accuracy of any representations made by my agent or attorney, and my designated preparer identified in Section C above, on every page of the Form ETA-9089, including all appendices, and documentation supporting this application.


I declare under penalty of perjury that I have read and reviewed this application, including every page of the Form ETA-9089, appendices, and supporting documentation, and that to the best of my knowledge the information contained therein is true and accurate. I understand that to knowingly and/or willfully furnish materially false information in the preparation of this form and any supplement thereto or to aid, abet, or counsel another to do so is a federal offense punishable by fines, imprisonment, or both (18 U.S.C. 2, 1001, 1546, 1621).


1. Last (family) Name *

2. First (given) Name *

3. Middle Initial §


4. Title *


5. Signature *


6. Date Signed *



For Public Burden Statement, see the Instructions for Form ETA-9089.


Form ETA-9089 – Final Determination FOR DEPARTMENT OF LABOR USE ONLY Page 1 of 4


PERM Case Number: __________________ Case Status: _________________ Determination Date: _____________ Expiration Date: _____________

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMelanie Shay
File Modified0000-00-00
File Created2021-04-30

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