| LCA CASE NUMBER | I-200-21306-683204 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-11-02 |
| DECISION DATE | 2021-11-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Process Engineer |
| SOC CODE | 17-2141.00 |
| SOC TITLE | Mechanical Engineers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-11-29 |
| END DATE | 2024-11-28 |
| 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 Street |
| AGENT ATTORNEY ADDRESS2 | Suite 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 | California Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 7005 Southfront Road |
| LCA CASE WORKLOC1 CITY | Livermore |
| WORKSITE COUNTY | ALAMEDA |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 94551 |
| LCA CASE WAGE RATE FROM | 104062 |
| LCA CASE WAGE RATE TO | 140000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 104062 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Cruz - 88919 |
| PREPARER FIRST NAME | Jose |
| PREPARER BUSINESS NAME | Jackson & Hertogs LLP |
| PREPARER EMAIL | jcruz@jackson-hertogs.com |
