790A B Tracked

OMB Approval: 1205-0466 Expiration Date: 08/31/2022

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 §

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

H-2A Case Number:

FOR DEPARTMENT OF LABOR USE ONLY

Page B.1 of B.2

Validity Period: to

Case Status:

Determination Date: