Jurisprudencia Law Office 20. ox M5, HOUSTON TX 77268-3005 TELEPHONE: 113-498-4998. AX 844-710-0050 Ena sj @hatmal.com June 23,2023 USCIS California Service Center Attn: 1-129 H-1B Regular Cap P.O, Box 10130 Laguna Niguel, CA 92607-1012 Re: 1-129 Labminde Staffing & Recruiting, LLC, Petitioner Camille Rosenas. Beneficiary Gentlemen: Attached please find the following documents in support of the above application: Form G-28 Filings Fee of $460 for 1-129, $500 Anti-Fraud Fee and $ 750 ACWIA Fee Form I-129 Copy of Certified Labor Condition Application Itinerary Company letter Client Leter Copies of supporting documentation: a. ASCP Certificate b. Transcript of Records c. Evaluation of Academic Documentation; d. Diploma ¢. Passport f. Birth Certificate g.Visascreen 9. Montana MT License 10, USCIS Registration Selection PAAVAGNA We hope you find everything in order Very truly yours, Oy, var wy SURISPRUDENCIANotice of Entry of Appearance as Attorney or Accredited Representative Department af Hameland Secu pus Form G-28 ‘OMB No. 161540105 Expire 08/21/2001 _ SEPP DHSS ee SEE [Part 1. Information Ahout Aftorney ar [Accredited Representative Part 2. Eligi Accredited Representative Information for Attorney or 1. USCIS Online Account Number (ifany) ploa9s50909518 Name of Auorney or Accredited Representative La, Family Name [SgRESPRUDENGIA (Last Named space provided in Part 6, Additional Information, 2b. Given Name [ELVEN (First Name) Licensing Authority Select all applicable items, [a] Fam an attomey cfigible to practice law in, and a ‘member in good slanding of, the bar of the highest courta of the follorring sates, possessions, Kriss, commonvealths, or the District of Columbia. I you need extra space to complete this section, use the 2a. Middle Nene [SANPEBANEE nx Lh. Rar Number (itapplieable) Address of Attorney or Accredited Representative 24033658 J.a, Street Number [po Box 683005 Le, 1(seleet only one box) [XJ am not [J am and Name subject to any order suspending, enjoining, staining, ab LJAp. [Se EJF disbartg, or otherwise restricting me in te pratice of law _tFyem are enbject fo any order, use the space ie City or Town [HOUSTON provided in Part 6. Additional Information to provide sn explanation, 14 site [3K] 20, 210 Code 7776 Same oF Lan mor Gagnon (i ppeabey ce (SURTSPRODENCTA TAW OFFICE “a 2a, [[] 1am an accredtied representative of the following Sut. Pastal Code Hf §. enter my appearance as an atomey or aeeredited representative atthe request of the (select only’ one box): Apnlicant J Pettoner —[_] Requestor By Denofciary Derivasive [1] Respondent (CE, CBP) Information About Client (Applicant, Petitioner, Requestor, Beneficiary or Derivative, Respondent, or Authorized Signavry for an Entity) 6a, Family Name [ongoe (Last Name) 6. Given Name [VANNTELON (First Name) Gar Midle Nese [REROREA Ta Name of Entity (itapplicable) TABMENDS| 7. Title uf Auorized Signatory for Entity (IFapplicable) EABMINDS GFAFFING AND RECRUITING LLC 8. Clien’s USCIS Online Account Number (iFany) > 9. Client's Alion Registration Number (A-Number) (iPany) PA Form G-28 09 17118 13.4. Stac[ % | 13. 21P Cute [93309 134, Province 13. Postal Code 13.h, Country [usa [Part 4. Client's Consent to Representation and [Signature Consent to Representation and Release of Information Thave requested the representation of and consented to being represented by the attomey or accredited representative named in Part 1. of this form. According to the Privacy Act of 1974 and U.S. Depariment of Homeland Security (DHS) policy. also consent to the disclosure to the named attorney ot accredited representative of any records pertaining to me that appear n any system of records of USCIS, ICE, or CBP. Page? of 4Fart 4. Cilent’s Consent to Representation and Signature (continued) [Part 5. Signature of Attorney or Accredited [Representative Options Regarding Receipt of USCIS Nutives uni Documents USCIS will send notices to both a renresented party (the client) and his, her, or its attorney or accredited representative either through mail or electronic delivery. USCIS will send all secure identity documents and Travel Documents tothe client's US. I you want to have notices and/or secure identity documents sen {0 your atfomey or accredited representative of recard rather than to you, please select all applicable items below. You may change these elections through written notice to USCIS, ta (2 Teequest that USCIS cond eriginal noises on an application or petition tothe business address of my atomey or accredited representative a listed inthis form. 1b. (7) [request that USCIS send any secure identity ‘document (Permanent Resident Card, Employment ‘Authorization Nscument, or Travel Document) that I receive tothe U.S, business address of my attomey or sceretited representative (or (oa designated mittary ‘or diplomatic address ina foreign country if permitted) NOTE: I your notice contains Form I-94, Arrival-Departure Record, USCIS will send the notice tothe U.S. business address af your attorney 1 evtvedited vepreseniaive, Ifyou would rather hhave your Form 1-94 sent directly to you, select Item Number Ls. Je. (1) I request that USCIS send my notice containing Form 1494 to me at my US. mailing address Signature of Client or Authorized Signatory for an Entity Signatory for an Entity 1h daca signi oidiiow [ Oe fas loets| ‘ iirva cl devas the regulations and eonulitons contained in 8 CFR 103.2 and 292 governing appearances and representation before DHS. | declare under penalty of perjury uniler the lew ofthe Listed States that tha information T have provided on this form is true and correct 4. Sinaur of tomey or Accredited Reese fis i Lb, DateofSignauremmatyw | U¢-[20]>003! 2a. Signature of Law Student or Lew Graduate th ‘ere baitiens Form G28 Oni7i8 Page tofPart 6. Additional Information Ifyou need extra space fo provide any additional information Within this form, use the space below. If you uced inne space than what is provided, you may make copies ofthis paste to complete and file with this form or attach a separate sheet of ‘paper. ‘Type or print your name at the top of cach sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet La Family Name (Last Namey | BONES Lb. Given Name | (First Namie) eee aa. Pave Number 4.b, Part Number 4.¢. lem Number 4a. es Middle Nawe [ASTORGR 2a, Page Number 2b. Part Number 2.¢. Item Number 24. Sa Page Number 5.b, Part Number S.¢. Item Number 5d, Ah. Part Number Le tom Nambar Bale 6a Page Numher 6b. Part Number 6.c. Item Number Ga, Form G-28 09 1718 Pages ofPetition for a Noi migrant Worker USCIS. Form 1-129 Department of Homeland Security \oaEDNo, HES U.S. Citizenship and Immigration Services Expires 1130/2025 Receipt Paria Approval (explain) ‘etion Block For fuscis Use Only tas | ictassitication approved No.of Workers: —___| F)consulate/POE/PFI Notified ok Cod: eee ere lity Dates aoe Dt xtemiion Granted i A cosvextension Granted > START ERE - Type or print in black ink, Part 1. Petitioner Information Ifyou ate an individual fling this petition, complete Item Number 1. Ifyou are a company or an organization filing this petition, ‘complete Item Number 2, 1, Legal Name of Individual Petitioner Family Name (Last Name) Given Name (First Name) Middle Name 2. Company or Organi Name TABMINDS STAVPING AND RECRUITING 3. Mailing Address of Individual, Company or Organization In Care Of Name [VANNTELON BONJOC Suet Nanberand Name ApS Fr Numer Fant Gueed B OBC pee GiyorTown iP Coie Ser asi Prova Postal Code Counny aaa 4 Goatacttfionatog Daytime Telephone Number abil Telephone Number_EnsilAdds ny) 5096072508 [ranelebaindetafTing om Cee Federal ployer denon Nunbar (FEIN) advil IRS Tax Number _US. Sil Sec Numer ian) plerszazers iF |» Form 129 Baition 11702222 BU IRESSe PRTERRCRTRESONSESNREROERS I Page lof 36Part 2. Information About This Petition (See instructions for fec information) 1. Requested Nonimmigrant Classification (Write classification symbol): [E-2B 2 Basis for Classification (select only one box): a. New employiment (1 b. Continuation of previously approved employment without change with the same employer. 1] & Change in previously approved employment. (1) & New concurrent employment. [1 e. Change of employer. [Cf Amended petition. \. Provide the most recent pettion/application receipt number forthe [Ww 9 NE beneficiary. If none exists, indicate "None." Requested Action (select only one box): [x] % Notify the office in Part , so each beneficiary can obtain a visa or be admutied. (NOTE: A petition is not required for E+, B-2, E-3. 1-11 Chile/Singanore, or TN visa heneficiaries ) (1b. Change the starus and extend the stay of each beneficiary hecause the beneficiary(ies is are now in the United States in ‘another status (see instructions far limitations). ‘This is available only when you check "New Employinent" in Item ‘Number 2,, above, 1D & Extend ine stay of each benettcrary because the beneticiary(ses) now hold(s) this status, 1 @. Amend ne say of ech beneficiary because the bene 7 & Eatean tie situs of a noninamigram classtteatton based on a tree trace agreement. (See rade Agreement Supplement to Form [-129 for TN and H-IB1.) ary(ies) now hold(s) this status, P71 Change status o a nonimmigrant classification based on a five trade agreement. (See Trade Agreement Supplement fo Form I-129 for TN and H-1B1.) ‘Total number of workers included in this petition, (See instructions relating io [y ‘whan mors than ons worker can be included.) Part 3, Beneficiary Information (information about the hencficiary/beneficiaries you are filing for. Complote tho blocks below. Use the Attachment-I sheet to name each beneficiary included in this petition.) 1, Ian Entertainment Group, Provide the Group Name 2. Provide Name of Beneficiary Fatnily Name (Last Name) Given Name (First Name) Middle Name /ROSRNAS (CAMILLE JOY fsupvaN 3. Provide all other names the beneficiary has used. Include nicknames, aliases, maiden rane, and names from sll previous marriages. amily Name (Last Name) Given Name (First Name) Middle Name 4. Other Information Date of birth (mmiddiyyyy)___Gender US. Social Security Number GFany) 03/24/1996 (Male (Female > Fo 129 Edition 1170222 Toe ee Th Page of 36[Part 3. Beneficiary Information (Information about the beneficiary/beneficiaries you are filing for. Complete the blocks below. Use the Attachment-1 sheet to name each beneficiary included in this petition.) (continued) ‘Alien Registration Number (A-Number) Country of Birth >| PuTLrPPaES Provine of Binh f Counry of Chizeship or Nationality pavao Dau soR |feunuteeanes 5. Ifthe beneficiary is in the United States, complete the following: Date of Last Arrival (mm/dd/yyyy) 1-94 Amrival-Departure Record Number Passport or Travel Document Number >| [p1598576B Date Passport or Travel Document Date Passport or Travel Document Passport or Travel Document Country of Issued imnvad yyy) Expires (mmiddiyyyy) Issuance 09/24/2021 (09/13/2031, [PuTLEPPINES ‘Current Nonimmigrant Status Date Stats Expires or D/S (mam/dd'yyyy) Stuxleut ean! Exchauye Visitor Information System (SEVIS) Number (if Employment Authorization Document (EAD) any) Number (itany) 6 Current Residential U.S. Address if enplcable) (do not list a P.O. Box) Street Number and Name Apt. Ste. Fl. Number [Nor IN THE UNITED STATES ooo City or Town, State Zab Code Part 4. Processing Information a beneficiary or beneficiaries named in Part 3 is/are outside the United States, or a requested extension of slay or change of stalus cannot be granted, state the U.S. Consulate or inspeetion fzility you want notified if this petition is approved. a, Type of Unie (select only one Dox}: [XJ Consulate | Prelight inspection [J Port of Entry D. OMee Address (Clty) €. US. State or Foreign Country pa Pozurermiss |. Beneticiary’s Foreign Address ‘Stet Number and Name AptSte. Fl Number P5 STA RITA DONA ASTNCTON oog City vt Town State [pavao Province Postal Code Country [pavao DEL SUR [2000 PHILTPPTNRS 2. oes each person inthis petition havea valid passport?” Yes [J] No. Af no, gor Pare’, and ype or print your explanation, Fonm F129 Edition 11/0222 HINBRUieRReaeE SACI NESE Page 3 oF 36see aR EESTI ETERS Part 4, Processing Information (continued) ‘Ave you Ting any ote petons wi hs one? 1D Yes. Ityes, how many? No ‘Ave you filing any applications for replacement ila -¥4, artval-Deparute Kecords with ths petition’ Note thatthe beneficiary was issued an electronic Form 1-94 by CBP when helshe was admitted tothe United States a an air or sea pvt, he! she may be able to obtain the Form 1-94 from the CBP Website at www.chp,gov/i94 instead of filing an application for a sreplacemenvinitial 194. 1 Yes. tyes, how many? > $. Are you filing any applications for dependents with this petition? 1 Yes. ityes, now many? BH vo 6. Isany beneficiary inthis petition in removal proceedings? 1 Yes. 1yes, proceed to Part 9, and list the beneficiary s(ies) name(s). Have you evr filed an immigrant patition for any beneficiary inthis petition? 1 Yes. ityes, how many? ® 8 Did you mdicate you were tiling anew petition in Part 2.2 Yes. Ifye, answer the qucstions below 1 No. tno, proceed to teem Number 9, at ‘any Denetictary inthis petition ever been given the classilication you are now requesting within the last seven years? 1 Yoo. 1Pyes, proceed to Part 9, end type or print your explanation ‘b, Has uny beneficiary in this petition ever been denied the classification you are now requesting within the last seven years? 1 Vee, IFyee, proved to Part 9, and type or print your explanation, 9. Have you ever previously fled a noniunigrant petition for this benefTeiary? Yes. tryee, proceed to ut 9. and type oF print your explanation, 10, Ifyou are fling for an entertainment group, has any beneficiary i this petition not been with the group fr atleast one year? 1 Yes. yes. neve Part 9. an type a prin your explana 11a, Has any beneficiary in this petition ever boon a J-1 exchange visitor o J-2 dependent of a JI exchaige visitor? 1 Yes. Ifyes. proceed to ttem Number 11.b. 11Lb. fyou checked yes in Item Number LL.a., provide the dates the beneficiary maintainad status asa J-l exchange visitor of +2 dependent, Also, provide evidence of this satus by attaching a copy of either a DS-2019, Cerificate of Eligibility for Exchange ‘Visitor (Je1) Status, a Form IAP-66, oF a copy of the passport that includes the J visa stamp. Part §. Basic Information About the Proposed Employment and Employer Atel dhe Fon 1-129 supplement relevant w the classification of the worker{s) you are requesting, 1. Job Title 2. LCA or ETA Case Number [MEDICAL TECHNOLOGIST T-200-23168- 121879 Form 129 Baition 1102222 To Tl Page of 36Part 8, Basie Information About the Proposed Employment and Employer (continued) 3. Aduvess where ine beneftclary(les) will work If diferent from address in Fart 1. Street Number and Name Apt. Ste, Flr, Number [3010 15TH AVENUE SOUTH Oog City or Town _ State ZAP Code GREAT FALLS wt |[59405 4. Did you inelude an itinerary with the petition? Will te beneficiaryties) work tor you offsite at another company or organizations location’? by Yes LJ No 6. Will the beneficiary(ies) work exchisively in the Commonwealth of the Northern Mariana Islands (CNMI)? [] Yes 7. Isthisa full-time position? 8. the answer {tems Number 7. is uw, how nuty hours per week forthe position?» Wages: $[30.00 per (Specify hour, week, month, or year) > [HOUR 10, Other Compensation (Explain) USUAL CORPORATE BENEFITS 11. Dates af intended employment From: (mim/ddlyyyy)[10/07 72008 rT (men/dt/yyyy) [00/20/2036 1% typeof Risin i 13, Your Habla TAPPING AND REGRUETING AGENCY "] [peas 1M. Cu Nunta mplayes inte United Set 18. Gros Annual Isom 16, Net Awa! sm a $722,927.19 | [eserevn ne Form F129 Eition 1/0222 UBL IERNEAC IRE ER VCR RE SEPA. Pape Sof 36ear EE CSE Part 6. Certification Regarding the Release of Controlled Technology or Technical Data to Foreign ‘Persons in the United States (This seetion ofthe form is required only for IIB, [1-11 Chite/Singapore, L-1, and O-1A petitions, {is not required for any other classifications. Please review the Form [-129 General Filing Instructions before completing this section.) Select Item Number 1. or Item Number 2. as appropriate, DO NOT select both boxes. With respect tothe technology of technical data the petitioner wil release or otherwise provide access to the beneficiary. the petitioner certifies that it has reviewed the Export Adininistration Regulations (EAR) and the International Traffic in Arms Regulations (ITAR) and has determined that A Tixause i nt reyuited foun either die U.S, Deparunen of Commerce oF the U.S. Department of State to release stich technology or technical data to the foreign person; ot (7A ticense is required ftom the U.S. Department of Commerce andor the U.S, Departinent of State to release such technology or fechnical data tothe beneficiary an the petitioner will prevent access to the controlled technology or techincal dats by the beneficiary until and unless the petitioner has reccived the required license or ther aullorization to release it to the beneficiary. Part 7. Declaration, Signature, and Contact Information of Petitioner or Authorized Signatory (Read the infimuratiou on penalties in the instructions before completing this section.) ‘Copies of any documents submitted are exset photocopies of unaltered, original document, and [understand that, as the petitioner, | may be required to submit original documents to 1. Citizenship and Immigration Services (LISCIS) ata ater date 1 authorize the release of any information ftom my records. or from the petitioning erpanization’s recoils that LISCIS needs to ‘dctermine eligibility forthe immigration benefit sought. | recognize the authority of USCIS to conduct audits ofthis petition using publicly available open source information, 1 ulso recognize chat any supporting evidence submitted in support of this petition may be verified by USCIS through any means determined appropriate by USCIS. including but not limited t0, on-site cempliance reviews If filing this petition on behalf of an organization, 1 certify that | am authorized to do so by the organization. I cettfy, under penalty of perjury, that I have reviewed this petition and that all of the information contained in the petition. including all responses to specific questions, and in the supporting documents, is complete, true, and correct, ‘Name and Title of Authorized Signatory oxo [ramet CHIRF EXECUTIVE OFFICER 2. Signature and Date Signature of Auhoriaga Signatory Date of Signature (mmvyyyy) Z 1 =» ][ d]23jera | 3. Signatory's Contac¢infofmation Daytime Telephone Number Email Address (any) neK072980 [van abmindotaéingcom NOTE: Ifyou do not fully complete this form or fail to submit the required documents listed in the instructions, a final decision on ‘your petition may be delayed or the petition may be denied, Form 429 Baiion 110222 DU IREERAneC eeruEDNHTARI SESE I Page 6oF 36Part 8. Declaration, Signature, and Contact Information of Person Preparing Form, If Other Than Petitioner F Provide the folowing information concerning the prepare: 1. Name of Preparer anily Name (Lest Name) founisenoencn = SSSSS~i Rosi tion Name (iFany) 2 Prepare (af applicable, provide the name of your accredited organization recognized by the Board of Immigration Appeals (BIA).) |SURISPRUDENCIA LAW OFFICE 3. Preparer's Malling Address Street Number and Name Apt. Ste. Fle, Number tei Argent [Po Box 6e3005 a Jane [ ity Tom a ile Swe -ZIPCode [novsion on l= | freee Postal Code ‘country i TT) TET TT 4 Daytime Telephone Number Fax Number _ | Email Addeess ifany) [raa0904 7] [eser700059 ehysthotmatll.om Preparer's Declaration By my signature, I certify, swear, or affirm, under penalty of perjury that | prepared this petition on behalf of tthe request of, and with the express consent of the petitioner or authorized signatory. The petitioner has reviewed this completed petition az propared by ‘me and inforoned me that all ofthe information inthe form and in the supporting documents, is conmlete, tue, and correct 5. Signature and Date Signatyre of Preparer _ Date of Signaturemm/dd/yyyy) hl e/a 2023 Form 1-129 tion 1170222 BRFSS PHI PSS ARCS PaiPart 9, Addi mal Information About Your Petition For Nonimmigrant Worker Ifyou require more space to provide any additional information within this petition, use the space below. if you require more space than what is provided to complete this petition, you may make a copy of Part 9.10 complete and file with this petition. In order to assist usin reviewing your response, you must identify the Page Number, Part Number and Item Number corresponding to the additional information, 1. AsNumber > A= 2. Page Number Part Number tem. umber Page Number Part Number 4 Page Number Part Numbor FonmI129 Eaition 1702222 Ut EES SS SSE CARRE A fainH Classification Supplement to Form 1-129 uscis Form F129 Department of Homeland Security ‘OMB No, 1615-0009 U.S. Citizenship and immigration Services Expies 11/30/2025 1. Name uf the Petitioner [LABMINDS STAFFING AND RECRUITING LLC Name of the beneficiary or if this petition includes stu 2a, Name of the Beneficiar [CAMILLE ROSENAS oR 22h Penwide the tata mimbor oF bene! 3. List each beneficiary's priar periods of stay in H or | classifieaion in the United States for the last six years (beneficiaries Fequesting H-2A or H-26 classification need only list the last three years). Be sure fo only ist those periods in which each Denericiary was actually n the United States in an H or L. classification. Do not include periods in which the beneficiary was in a dependent status. for example, H-4 or L-2 status. NOTE: Submit photocopies af Forms 1-94 1-797, andior other TISCIS issued dneuments nating these periods of stay in the H ion, (If more space is needed, attach an additional sheet.) Period of Stay (mm/ddiyyyy) From To. zy 4. Cloccification sought (select only one bon) a. HLLB Specialty Occupation Db IRI Chilo and Singapore C1 & H-1B2 Exceptional services relating to a cooperative research and development project administered by the U.S, Department of Defense (DOD) C7 4. W183 Fashion model of distinguished merit and ability CO & 2A Agricul worker 1 &. 4-28 Non-agricutural worker CO gi Trainee (1h. 1 Special education exchange visitor program 5. ced a. ord. in Item Number 4,, and are filing an 1-1B cap petition (including a petition under the U.S. advanced cemption), provide the beneficlary Confirmation Number from the 11-118 Registration Selection Notice for the beneficiary named inthis petition (if applicable), 2024-6588-b043-356e 6. Ate you filing this petition on behalf of a beueficiayy subject to dhe Guam-CNMI cap exemption under Public Law 110-229? P71 Yes BX No Formi-i29. Baton 11/0222 Hl IRENEKMERR, ENE PLE RE RT. Page 130836tficiary previously subject tothe Guam-CNME cap exemption under a change of eumployer anu was the b 2097 No 7. Are you requ Public Law 11 1 Yes 8a, Docs any beneficiary in this petition have ownership interest in the petitioning organization? LL Yes. Ifyes, please explain in Kem Number 8. 8.b. Explanation ‘Section 1. Complete This Section If Filing for H-1B Classification 1. Describe the proposed dutioe. PLEASE SEE ATTACHED COMPANY SUPPORT LETTER 2. eserihe the heneficiary’s present accnpation and gimmary of prior work experience PLEASE SEE ATTACHED COMPANY SUPPORT LETTER Statement for H-1B Specialty joy and H-1B1 By Gling thi petition, { agree to, anu will abide by, ce terms oF the labor condition application (LUA) tor the duration of the beneficiary's authorized period of stay for H-1B employment, 1 certify that [will maintain a valid employeremplayee relationship with the beneficiary at all tines. Ifthe beneficiary is assigned fo position in a new location, 1 will obtain and post an LCA for that site prior to evaseiganust | further understand that I cannot charge the beneficiary the ACWIA fee, and that any other required reimbursement will be concidored an offet againt wagea and benefit paid relative to the LCA, SiguatureetPettioper Name of Petioner Date rid») Sn eee anita BoNTOS de fas ror Statement for H-IB Spesalty Occupations — Projects As an authorized official of the employer, I certify that the employer will be liable forthe reasonable costs of return transportation of the alien abroad ifthe beneficiary is dismissed from employment by the employer hetore the end of the period of authorized stay. Sagnature of Authorized OMe! of Emplayer Name ot Authorized Oficial of Employer Date (mmvdiyyyy) = [VANNIELON BONTOC Ju 12023] eerily thatthe beneficiary will be working on a cooperative research and development project or a co-production project under @ reciprocal govemment-o-government agreement administered by the US. Departinent of Defense Signature of DOD Project Manager Name of DOD Project Manager Date (mmidd'yyyy) Fea Fake 11 Re EE RE PARED ire aia2 ero RSS ES oa SSS SE [Section 2, Complete This Section If Filing for H-2A or H-2B Classification (continued) 1 Sa. Sb. 6. 6. Form Employment is: (select only one box) 1 a Seasonal 1 b. Peak load Cletmermitent 7] d. One-time occurrence Temporary need is: (select onty ome box) [la Unpredictable [1] & Periodic = Recurron analy Explain your temporary need for the workers services (Attach a separate set iTaidiiunal space is needed), List the countries of citizenship for the H.2A or H.2B workers you plan to hire ‘You must provide all of the requested information for Item Numbers 5.» 6. for ech H-2A ot H-2B worker you plan to hire who is nat from a conntry that hac heen designated a participating county in accordance with 8 CFR. 214.208)S\3)E\I) of 214.2(hM6VIE)(1}. See sw w.nscis.gov forthe list of participating countries. (Attach a separate sheet if additional space is needed.) ‘amily Name (Last Name) ‘Given Name (First Name) Middle Name Provide all ullier nare(s) used Fauily Nase (Last Nae) ‘Given Name (First vamey Middle Name Date of Birth (movidelyyyy) Sud Country of Bint Country of Citizenship of Nationality Have any of the workers listed in Item Number §, above ever been admitted to the United States previously in 1-2A/11-2B status? [Fy Voc. Iryeo, go to Part 9. of Form 1 129 and write your explanation. [C] No Visa Classification (H-2A or 1-2} ‘OTE: [any of the H-2A or H-2B workers you are requesting are nationals of a couniry that is not onthe eligible countries list, you must also provide evidence showing: (1) that workers with the requited skills are not avaie trom a country currently ‘on the eligible countries list*; (2) whether the beneficiaries have been admitted previously to the United States in H-PA or HIB status; (3) that there is no potential for abuse, fraud, or other harm tothe integrity of the H-2A or H-2B visa programs through the potential admission of the interuled workers; and (4) any other factors that may serve the United States interest. * For I-24 petitions only: You must also show that workers with the required skills are not available trom among United States workers. 1129. Bulton 11/02/22 Pe Th Page 15 of 36eer re sc A EIT ETE Section 2. Complete This Section If Filing for H-2A or H-2B Classification (continued) 7.4, Did you or do you plan to use a stalTing, recruiting, or similar placement service or agent (o locate the H-2A/MI-2B workers that ‘you intend to hire by filing this petition? Ove [)r Lye, list the name and address of service or agent used below. Please use Part 10, of Form 1-129 if you need to inchide the naine and address ef more than one service or agent. ‘ub. ‘Name Te. Aires Sireat Number and Name Apt. Ste Fr. Number qaeatH ooo| Cy Tome state pie $a, Did any of the H-2VH-2B workers that you are requesting pay you, oran agent, jb placement fee or other fom }¥eg E]No ‘oF compensation (ether ulrec or intect as a condition af the employment, or do they have an agreement to pay you or the service such fees a a later date? The phrase “Tees or other compensation” ince, bat és not limited ta, petition fees, atorney fes, recruitment costs, and any other fees that are a condition ofa beneficiary's employment {at dae cimpluyer is probibived fom passing un ihe 1-24 or H-2B Worker under Inv under U.S, Department ot Labor rules. This phrase does not include reasonable travel expenses and certain government-mandated fs (ch as passport fes) thet are not prohibited from being passed tothe H-2A or H-2B worker by statute, regulations, oF any laws, 8b. yea, lat the types and amounts of Fees thatthe woshea(a) ail ut will pay” ye wypes 8. Ihe workers paid any fee or compensation, were they rembursed? Cves No 8d, the workers agreed to pay a fe that they have not yer been pei has their agreement been emminated —F}yeg No before the workers paid the fee? (Submit evidence of termination or reimbursement with this petition.) ©. Have you mada reasonable inquirior to datormina that to the hoot of your knowledge the reeruiter, vee | [Na facilitator, or similar employment service that you used has not collected, and will not collec, dreetly or “!Y®8 LI indirectly, any fees or other compensation from the H-2 workers ofthis petition as a condition of the H-2 ‘workers’ emplayment? NOTE: IFLSCIS determines that you knew, of should have known, that the workers requested in ‘connection with this petition paid any fees or other compensation at any time as a condition of ‘employment, your petition may be denied or revoked, 4a. Have you evr had an H-2A oF 1-28 petition denied or revoked because an employee paid ajob placement yas No fee or other similar compensation as a condition ofthe job offer ar emplayment” Wat Iyes, when? W.a.2. Receipt Number: 10.b. Were the workers reimbursed For such fees and compensation? (Submit evidence of reimbursement.) If ‘you answered no because you were unable to locale the war kets, include evidence of your efforts to locate ithe workers. Tes FNo Form 129 Edition 1170222 eT Page 16 0836ese Rca SE TET Section 2. Complete This Section If Filing for H-2A or H-2B Clas: jeation (continued) 1. Have any ofthe workers you ae requesting experienced an iterupied stay associated with their entry as Jes CJNo aan LL-2A or 1-28? (Sce form instuctions for more information on interrupted stays.) Ii'ysa, document the workers! periods of atay inthe table on the First page of ths suppenvent, Subtnit evidence of each entry and each exit, with the petition, as evidence of the interrupted stays. you arean H.2A petitioner, are you a parsieipant in the F-Verify program? Live [No I'yes, provide the F-Verily Company ID of Client Company ID. yen ‘he H-2A/H-28 petitioner and each employer consent to allow Government access (othe site where the labor is being performed for the purpase af determining cnmplianee with H.IAIHIR requirements, The paitioner further agrovs to notify DHS beginning on a date and in a manner specified in notice published in the Federal Register within 2 workdays if an H1-2A\H-2B worker fails to report for work within 5 workdays after the employment start date stated on the petition or, applicable to H-2A petitioners only, within workdays ofthe start date established hy the petitioner, whichaver is later: the agrivnltural labor or seeviees for which HAT 2B. workers were hired is completed more than 30 days early; or the H-2A/H-2B worker absconds from the worksite or is terminated prior ‘o the completion of agricultural Iabor or services for which he or she was hired, The petitioner agrees to retain evidence of such notification and make it available for inspection by DHS officers fora one-year period "Warkday” means the porind hetwaen the time on any particular day when such employee commences his or her principal activity and the time on that day at which he or she ‘ceases such principal activity or activities, ‘The petitioner must execute Part A. IFthe peioner i the employers agent, the employer must execute Part B. 1 there ae joint employers, thy: must ach oxaoute Part C. For H-2A petitioners only: The petitioner agrees o pay $10 in liquidated damages for each instance where it cannot demonstrate itis in compliance with the notification requirement. Part A. Petitioner iy Filing thie petition, T agree to the conditiono of HI 211-20 employment and agree to the notification reyuiinents. Fur H-2A, petitioners: [also agree to the liquidated damages requirements defined in 8 CFR 214.2(h\5)vi}(B)Q3). Signature of Petitioner =» Part B. Employer who i not the pettioner Date (mmi/ddivyyy) T certify that I have authorized the party filing this petition to act as my agent in this regard, TI assume full responsibility for all representations macle hy this agent an my hehalf and agree ta the canltians of H.7A/MLOB eligibility Signature of Employer Name of Employer Date (mmiddiyyyy) Part C, Joint Employers J agree tothe conditions of H-2A eligibility [Signature of Joint Employer ame of Forat Employer Date TTT) [Signature of Joint Employer Namie of Saint Enuployer Date mmlayyyyy ‘Signature of Jatni Employer ame of Forat Employer Dae mnie) ‘Sigoature of Joint Employer Namie of Jatat Employer Date CamldTyyy Fon 129 Baivion 110222 To esi BES | Page 17 of 36