| LCA CASE NUMBER | I-200-21245-561501 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-09-02 |
| DECISION DATE | 2021-09-10 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Business Systems Engineer |
| SOC CODE | 15-1133.00 |
| SOC TITLE | Software Developers, Systems Software |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-09-06 |
| END DATE | 2024-09-05 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Formagrid, Inc. |
| EMPLOYER ADDRESS1 | 799 Market Street |
| EMPLOYER ADDRESS2 | Flr 8 |
| EMPLOYER CITY | San Francisco |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94103 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14014396357 |
| NAICS CODE | 541511 |
| EMPLOYER POC LAST NAME | Haque |
| EMPLOYER POC FIRST NAME | Sara |
| EMPLOYER POC JOB TITLE | People Lead |
| EMPLOYER POC ADDRESS1 | 799 Market Street |
| EMPLOYER POC ADDRESS2 | Flr 8 |
| EMPLOYER POC CITY | San Francisco |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94103 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16504741288 |
| EMPLOYER POC EMAIL | sara.haque@airtable.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | John |
| AGENT ATTORNEY FIRST NAME | Kimberly |
| AGENT ATTORNEY ADDRESS1 | 2101 Wilson Blvd. |
| AGENT ATTORNEY ADDRESS2 | Suite 1100 |
| AGENT ATTORNEY CITY | Arlington |
| AGENT ATTORNEY STATE | VA |
| AGENT ATTORNEY POSTAL CODE | 22201 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17036784000 |
| AGENT ATTORNEY PHONE EXT | 0 |
| AGENT ATTORNEY EMAIL ADDRESS | kimberlyj@eiglaw.com |
| LAWFIRM NAME BUSINESS NAME | Erickson Immigration Group |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Pennsylvania |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 10200 Independence Parkway |
| WORKSITE ADDRESS2 | Apt. 1415 |
| LCA CASE WORKLOC1 CITY | Plano |
| WORKSITE COUNTY | COLLIN |
| LCA CASE WORKLOC1 STATE | TX |
| WORKSITE POSTAL CODE | 75025 |
| LCA CASE WAGE RATE FROM | 180000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 111176 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Talovich |
| PREPARER FIRST NAME | Alexandra |
| PREPARER BUSINESS NAME | Erickson Immigration Group |
| PREPARER EMAIL | alexandrat@eiglaw.com |
