ETA-790B, Addendum Non-Criteria Agricultural Clearance Order

O MB Approval: 1205-0134

Expiration Date: XX/XX/XXXX

Non-Criteria Agricultural Clearance Order

Form ETA-790B Addendum A

U.S. Department of Labor

Additional Crop or Agricultural Activities and Wage Offer Information

Crop or Agricultural Activity	Wage Offer/Per	Work State	Piece Rate Offer	Piece Rate Units / Estimated Hourly Rate / Special Pay Information
	$ ______ . _____  HOUR  MONTH		$ ______ . _____
	$ ______ . _____  HOUR  MONTH		$ ______ . _____
	$ ______ . _____  HOUR  MONTH		$ ______ . _____
	$ ______ . _____  HOUR  MONTH		$ ______ . _____
	$ ______ . _____  HOUR  MONTH		$ ______ . _____

Additional Crop or Agricultural Activities and Wage Offer Information Continued

Crop or Agricultural Activity	Wage Offer/Per	Work State	Piece Rate Offer	Piece Rate Units / Estimated Hourly Rate / Special Pay Information

For Public Burden Statement, see the Instructions for Form ETA-790B.

Form ETA-790B Addendum A FOR STATEWORKFORCE AGENCY USE ONLY Page A.1 of A.1

Clearance Order Number: _______________________