| LCA CASE NUMBER | I-200-21028-039360 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-28 |
| DECISION DATE | 2021-02-04 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Manager, Supply Chain Process |
| SOC CODE | 11-9199.00 |
| SOC TITLE | Managers, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-03-05 |
| END DATE | 2024-03-04 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Forma Brands, LLC |
| EMPLOYER ADDRESS1 | 22 4th Street |
| EMPLOYER ADDRESS2 | 4th Floor |
| EMPLOYER CITY | San Francisco |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94103 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14159575720 |
| NAICS CODE | 44612 |
| EMPLOYER POC LAST NAME | Comolli |
| EMPLOYER POC FIRST NAME | Anne |
| EMPLOYER POC MIDDLE NAME | Marie |
| EMPLOYER POC JOB TITLE | Director, Talent Acquisition |
| EMPLOYER POC ADDRESS 1 | 22 4th Street |
| EMPLOYER POC ADDRESS 2 | 4th Floor |
| EMPLOYER POC CITY | San Francisco |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94103 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14159572005 |
| EMPLOYER POC EMAIL | anne.comolli@formabrands.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Grady |
| AGENT ATTORNEY FIRST NAME | Jennifer |
| AGENT ATTORNEY MIDDLE NAME | Ann |
| AGENT ATTORNEY ADDRESS1 | 4695 MacArthur Court |
| AGENT ATTORNEY ADDRESS2 | Suite 1100 |
| AGENT ATTORNEY CITY | Newport Beach |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92660 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19497986298 |
| AGENT ATTORNEY EMAIL ADDRESS | jgrady@gradyfirm.com |
| LAWFIRM NAME BUSINESS NAME | The Grady Firm, P.C. |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court of California |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 22 4th Street |
| WORKSITE ADDRESS2 | 4th Floor |
| LCA CASE WORKLOC1 CITY | San Francisco |
| WORKSITE COUNTY | SAN FRANCISCO |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 94103 |
| LCA CASE WAGE RATE FROM | 133037 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 133037 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business and Employment |
