| LCA CASE NUMBER | I-200-23116-967337 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2023-04-26 |
| DECISION DATE | 2023-05-03 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Junior Product Designer |
| SOC CODE | 27-1021.00 |
| SOC TITLE | Commercial and Industrial Designers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2023-10-01 |
| END DATE | 2026-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Forms & Surfaces, Inc. |
| EMPLOYER ADDRESS1 | 30 Pine St. |
| EMPLOYER CITY | Pittsburgh |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 15223 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14806763265 |
| NAICS CODE | 332323 |
| EMPLOYER POC LAST NAME | Delgado |
| EMPLOYER POC FIRST NAME | Marisol |
| EMPLOYER POC JOB TITLE | Director of Human Resources |
| EMPLOYER POC ADDRESS1 | 30 Pine St. |
| EMPLOYER POC CITY | Pittsburgh |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 15223 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14806763265 |
| EMPLOYER POC EMAIL | Marisol.Delgado@forms-surfaces.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Rayer |
| AGENT ATTORNEY FIRST NAME | Frances |
| AGENT ATTORNEY MIDDLE NAME | Patricia |
| AGENT ATTORNEY ADDRESS1 | 1650 Market St., One Liberty Place |
| AGENT ATTORNEY ADDRESS2 | Suite 2800 |
| AGENT ATTORNEY CITY | Philadelphia |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 19103 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12156653704 |
| AGENT ATTORNEY EMAIL ADDRESS | frayer@cozen.com |
| LAWFIRM NAME BUSINESS NAME | Cozen O'Connor |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Pennsylvania |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 30 Pine St. |
| LCA CASE WORKLOC1 CITY | Pittsburgh |
| WORKSITE COUNTY | ALLEGHENY |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 15223 |
| LCA CASE WAGE RATE FROM | 60000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 59155 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2022 - 6/30/2023 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
