| LCA CASE NUMBER | I-200-21236-541693 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-08-24 |
| DECISION DATE | 2021-08-31 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | NPI Technical Program Manager (Hardware) |
| SOC CODE | 17-2199.04 |
| SOC TITLE | Manufacturing Engineers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-30 |
| END DATE | 2024-08-29 |
| 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 | FormFactor, Inc. |
| EMPLOYER ADDRESS1 | 7005 Southfront Road |
| EMPLOYER CITY | Livermore |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94551 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19252904000 |
| NAICS CODE | 33441 |
| EMPLOYER POC LAST NAME | Shields |
| EMPLOYER POC FIRST NAME | Sarah |
| EMPLOYER POC JOB TITLE | Director, Human Resources |
| EMPLOYER POC ADDRESS1 | 7005 Southfront Road |
| EMPLOYER POC CITY | Livermore |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94551 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19252904970 |
| EMPLOYER POC EMAIL | Sarah.Shields@formfactor.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Zedginidze |
| AGENT ATTORNEY FIRST NAME | Tina |
| AGENT ATTORNEY ADDRESS1 | 909 Montgomery St |
| AGENT ATTORNEY ADDRESS2 | 200 |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94133 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14159864559 |
| AGENT ATTORNEY EMAIL ADDRESS | tzedginidze@jackson-hertogs.com |
| LAWFIRM NAME BUSINESS NAME | Jackson & Hertogs LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | CA Supreme Court |
|
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 617 River Oaks Parkway |
| LCA CASE WORKLOC1 CITY | San Jose |
| WORKSITE COUNTY | SANTA CLARA |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 95134 |
| LCA CASE WAGE RATE FROM | 134493 |
| LCA CASE WAGE RATE TO | 174000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 134493 |
| 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 | Atwal 88315 |
| PREPARER FIRST NAME | Sharon |
| PREPARER BUSINESS NAME | Jackson & Hertogs LLP |
| PREPARER EMAIL | satwal@jackson-hertogs.com |
