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Draft; 240; 1

ICR 202602-1205-002 · OMB 1205-0508 · Object 166199700.

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Record metadata
application/vnd.openxmlformats-officedocument.wordprocessingml.document
Draft; 240; 1
Office of Foreign Labor Certification
Writer
2026-05-27
2026-07-24
complete

Extracted Text



Important Note: Identify any additional worksite(s) for which the employer is requesting issuance of an additional prevailing wage.

Additional Worksite 1


For Official Government Use Only
SOC Code:	SOC Title:
Minimum Requirements Prevailing Wage Source:

Prevailing Wage per Minimum Requirements:
$	per  	
Alternative Requirements (PERM and H-1B only) Prevailing Wage Source:

Prevailing Wage per Alternative Requirements:
$	per  	

Additional Worksite 2


For Official Government Use Only
SOC Code:	SOC Title:
Minimum Requirements Prevailing Wage Source:

Prevailing Wage per Minimum Requirements:
$	per  	
Alternative Requirements (PERM and H-1B only) Prevailing Wage Source:

Prevailing Wage per Alternative Requirements:
$	per  	

Additional Worksite 3


For Official Government Use Only
SOC Code:	SOC Title:
Minimum Requirements Prevailing Wage Source:

Prevailing Wage per Minimum Requirements:
$	per  	
Alternative Requirements (PERM and H-1B only) Prevailing Wage Source:

Prevailing Wage per Alternative Requirements:
$	per