| LCA CASE NUMBER | I-200-21084-174977 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-25 |
| DECISION DATE | 2021-04-01 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Clinical Trial Manager |
| SOC CODE | 15-2041.02 |
| SOC TITLE | Clinical Data Managers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-04-01 |
| END DATE | 2024-03-31 |
| 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 | Forma Therapeutics, Inc. |
| EMPLOYER ADDRESS1 | 500 Arsenal Street |
| EMPLOYER CITY | Watertown |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 2472 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16176791970 |
| NAICS CODE | 541714 |
| EMPLOYER POC LAST NAME | Allison |
| EMPLOYER POC FIRST NAME | Jayne |
| EMPLOYER POC JOB TITLE | Senior Manager, Benefits |
| EMPLOYER POC ADDRESS 1 | 500 Arsenal Street |
| EMPLOYER POC CITY | Watertown |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 02472 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16176791970 |
| EMPLOYER POC EMAIL | jallison@formatherapeutics.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Luna |
| AGENT ATTORNEY FIRST NAME | Jose |
| AGENT ATTORNEY MIDDLE NAME | M |
| AGENT ATTORNEY ADDRESS1 | 177 Milk Street |
| AGENT ATTORNEY ADDRESS2 | Suite 605 |
| AGENT ATTORNEY CITY | Boston |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 2109 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16173579300 |
| AGENT ATTORNEY EMAIL ADDRESS | info@gossimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Goss Associates, LLC |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | Massachusetts Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 500 Arsenal Street |
| LCA CASE WORKLOC1 CITY | Watertown |
| WORKSITE COUNTY | WATERTOWN CITY |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 2472 |
| LCA CASE WAGE RATE FROM | 147659 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 147659 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
