STATE OF MONTANA FOREIGN LABOR CERTIFICATION PREVAILING WAGE REQUEST by cdm14027

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									                                                       STATE OF MONTANA
                                                  FOREIGN LABOR CERTIFICATION
                                                    PREVAILING WAGE REQUEST

1. Employer Business Name:                                                     2. Job Site Address:


3. Nature of Business Activity:                                   4. County:                                                     5. Application:
                                                                                                                                        Permanent
6. Worker’s Name:                                    7. Job Title of Position Offered:                 8. Hours/Week                    H-2B
                                                                                                                                        H-1B
                                                                                                                                         Other
9. Pay Rate Offered:                                 10. Employer FEIN:                                11.     Non-Profit Research
   $                   per                                                                                     Institution of Higher Learning
                                                                                                               Other
12. Job Duties. Begin With Most Important Duty:




12a. Work performed will be supervised:           Closely         Moderately          Lightly

12b. Employee          will       will not supervise other employees

12c. Is job position covered by a union bargaining agreement?          Yes       No
13. Degree Required?          Yes        No (If yes, specify type and major field of study)            14. Experience Required?        Yes         No


                                                                                                       __________ years         __________ months

15. Training Required?        Yes       No (If yes, state type/duration)       16. License Required?     Yes           No (If yes, state type)

Type: ______________________ Duration:____________________

17. Other Special Job Requirements:                                            18. Date Request Submitted:


19. Name of Requestor:                                                         20. Address:


21. City, State, ZIP                                 22. Telephone Number:                             23. FAX Number:




 Please return form to: Montana Department of Labor and Industry
                        Research and Analysis Bureau (Foreign Labor Certification Unit)
                        P.O. Box 1728
                        Helena, MT 59624-1728
                        FAX: (406) 444-2638

 This document is maintained by the Montana Department of Labor and Industry as a public record and is available for inspection by the public and
 governmental agencies. FORM AC –3 (03/2005)

								
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