ETA-9089 Appendix B: Additional Worksite Information

Application for Permanent Employment Certification

Form ETA-9089 - Appendix B 042221

Application for Permanent Employment Certification

OMB: 1205-0451

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O MB Approval: 1205-0451

Expiration Date: 05/31/2021

Application for Permanent Employment Certification

Form ETA-9089 – Appendix B: Additional Worksite Information

U.S. Department of Labor




ADDITIONAL WORKSITE INFORMATION


  1. Additional Worksite 1 §


1. County

2. State/District/Territory


3. MSA/OES Area Code


3a. MSA Name/OES Area Title




  1. Additional Worksite 2 §


1. County


2. State/District/Territory


3. MSA/OES Area Code


3a. MSA Name/OES Area Title




  1. Additional Worksite 3 §


1. County


2. State/District/Territory


3. MSA/OES Area Code


3a. MSA Name/OES Area Title




  1. Additional Worksite 4 §


1. County


2. State/District/Territory


3. MSA/OES Area Code


3a. MSA Name/OES Area Title




  1. Additional Worksite 5 §


1. County


2. State/District/Territory


3. MSA/OES Area Code


3a. MSA Name/OES Area Title


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



Form ETA-9089 – Appendix B FOR DEPARTMENT OF LABOR USE ONLY Page B.1 of B.1


PERM Case Number: ___________________ Case Status: __________________ Determination Date: ______________ Expiration Date: ______________

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AuthorMelanie Shay
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File Created2024-07-28

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