Employer Application

Company Information

Company Name:

Mailing Address:

Street Address:

City, State & Zip:

Phone Number:

Fax Number:

E-Mail Address:

Web Site Address:

Contact Person:

Type of Entity:

Location Established:

Date Established:

County Where Your Principal Office is Located:

Do You Require Drug Testing?

Do You Provide Housing?

Rent Cost per Month:

Utility Cost per Month:

Total Housing Cost per Month:

Start Date of H-2B Employees:

End Date of H-2B Employees:

Closest Bus Station:

Closest Airport:

Taxpayer EIN:

 

Department of Homeland Security requires the following information. Your petition for workers cannot be submitted without it. You may use actual or estimates.

 

Gross Income:

Net Income:

 

Employment Information

# of Employees - Peak Season:

# of Employees - Non-Peak Season

Anticipated Number Of H-2B Employees Needed (be realistic, do not inflate)

 

Positions needed to be filled through the H-2B program: (housekeepers, cooks helpers, cooks, dishwashers; number & pay rate)

 

 

In order for us to facilitate your Labor Certification in a timely manner, the following material must be mailed and/or faxed to us: [contact page]

 

  • 941 reports and payroll reports from the past 2 years

  • Leaderhead (30)

  • Marketing information (brochures, etc)

  • List past recruiting efforts

  • Occupancy/Sales fluctuations for past two years (to show seasonal/peak needed)

  • Signed G-28 & ETA 750's

  • Check for appropriate fee

  • Monthly payroll report

Comments

**By hitting submit, I certify that the information provided is true and correct to the best of my knowledge**