| LCA CASE NUMBER | I-200-23038-757235 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2023-02-07 |
| DECISION DATE | 2023-02-14 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Senior Frontend Engineer |
| SOC CODE | 15-1252.00 |
| SOC TITLE | Software Developers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2023-03-01 |
| END DATE | 2024-10-26 |
| 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 | Form Bio, Inc. |
| EMPLOYER ADDRESS1 | 106 E 6th St. |
| EMPLOYER ADDRESS2 | Ste. 900-135 |
| EMPLOYER CITY | Austin |
| EMPLOYER STATE | TX |
| EMPLOYER POSTAL CODE | 78701 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15083336799 |
| NAICS CODE | 541714 |
| EMPLOYER POC LAST NAME | Daniels |
| EMPLOYER POC FIRST NAME | Douglas |
| EMPLOYER POC JOB TITLE | Head of Engineering |
| EMPLOYER POC ADDRESS1 | 1401 Lavaca St |
| EMPLOYER POC ADDRESS2 | Ste. 155 |
| EMPLOYER POC CITY | Austin |
| EMPLOYER POC STATE | TX |
| EMPLOYER POC POSTAL CODE | 78701 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15083336799 |
| EMPLOYER POC EMAIL | doug@formbio.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Finkelman |
| AGENT ATTORNEY FIRST NAME | Jason |
| AGENT ATTORNEY MIDDLE NAME | S. |
| AGENT ATTORNEY ADDRESS1 | 5620 Republic of Texas Blvd. |
| AGENT ATTORNEY CITY | Austin |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 78735 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15123488855 |
| AGENT ATTORNEY EMAIL ADDRESS | jason@finkelmanlaw.com |
| LAWFIRM NAME BUSINESS NAME | Jason S. Finkelman, Attorney at Law, PLLC |
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Supreme Court of Texas |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 106 E 6th St. |
| WORKSITE ADDRESS2 | Ste. 900-135 |
| LCA CASE WORKLOC1 CITY | Austin |
| WORKSITE COUNTY | TRAVIS |
| LCA CASE WORKLOC1 STATE | TX |
| WORKSITE POSTAL CODE | 78701 |
| LCA CASE WAGE RATE FROM | 135000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 112362 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2022 - 6/30/2023 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
