| LCA CASE NUMBER | I-200-21103-218689 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-13 |
| DECISION DATE | 2021-04-20 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Senior Data Analyst |
| SOC CODE | 15-2099.00 |
| SOC TITLE | Mathematical Science Occupations, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-05-01 |
| END DATE | 2024-04-30 |
| 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 | Impact Health LLC |
| EMPLOYER ADDRESS1 | 8287 O'Brian Ave NE |
| EMPLOYER CITY | Otsego |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 55330 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16122818968 |
| NAICS CODE | 62199 |
| EMPLOYER POC LAST NAME | Kussman |
| EMPLOYER POC FIRST NAME | Daniel |
| EMPLOYER POC MIDDLE NAME | Charles |
| EMPLOYER POC JOB TITLE | President and CEO |
| EMPLOYER POC ADDRESS 1 | 8287 O'Brian Ave NE |
| EMPLOYER POC CITY | Otsego |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 55330 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16122818968 |
| EMPLOYER POC EMAIL | dkussman@impacthealth.global |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Aaker |
| AGENT ATTORNEY FIRST NAME | Zachary |
| AGENT ATTORNEY MIDDLE NAME | Steven |
| AGENT ATTORNEY ADDRESS1 | 7900 Xerxes Ave S |
| AGENT ATTORNEY ADDRESS2 | Suite 220 |
| AGENT ATTORNEY CITY | Bloomington |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55431 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19527464111 |
| AGENT ATTORNEY EMAIL ADDRESS | zachary@martin-law.com |
| LAWFIRM NAME BUSINESS NAME | Martin Law LLC |
|
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Supreme Court of Minnesota |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 8287 O'Brian Ave NE |
| LCA CASE WORKLOC1 CITY | Otsego |
| WORKSITE COUNTY | WRIGHT |
| LCA CASE WORKLOC1 STATE | MN |
| WORKSITE POSTAL CODE | 55330 |
| LCA CASE WAGE RATE FROM | 90000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 76794 |
| 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 Employment |
