Form Eta 9142b - Appendix B - Foreign Labor Certification - H-2b Application For Temporary Employment Certification
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3OMB Approval: 1205-0509
Expiration Date: 12/31/2018
H-2B Application for Temporary Employment Certification
Form ETA-9142B – APPENDIX B
U.S. Department of Labor
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For Use in Filing Applications Under the H-2B Non-Agricultural Program ONLY
A. Attorney or Agent Declaration
I hereby declare under penalty of perjury that I am an attorney for the employer, or that I am an employee of, or hired by, the
employer listed in Section C of the Form ETA-9142B, and that I have been designated by that employer in accordance with 20
CFR 655.8 to act on its behalf in connection with this application, as evidenced by the attached agency agreement. I also
certify that to the best of my knowledge the information contained herein is true and accurate, including the employer’s
declaration regarding activities I have undertaken on the employer’s behalf in connection with this application. I understand
that to knowingly furnish false information in the preparation of this form and any supplement hereto or to aid, abet, or counsel another
to do so is a felony punishable by a $250,000 fine or 5 years in a Federal penitentiary or both (18 U.S.C. 1001).
1. Attorney or Agent’s last (family) name
2. First (given) name
3. Middle initial
4. Firm/Business name
5. E-Mail address
6. Signature
7. Date signed
B. Employer Declaration
By virtue of my signature below, I HEREBY CERTIFY my knowledge of and compliance with the following conditions of employment
applicable to H-2B workers and/or U.S. workers who are hired during the recruitment period for positions covered by this application,
including any approved extension thereof:
1.
The job opportunity is a bona fide, full-time temporary position (of at least 35 hours per workweek), the qualifications and
requirements for which are consistent with the normal and accepted qualifications and requirements imposed by non-H-2B
employers in the same or comparable occupations and area of intended employment. The employer has listed all
qualifications and requirements in the job order.
There is no strike or lockout at any of the employer’s worksites within the area of intended employment for which the employer
2.
is requesting an H-2B certification.
3.
The job opportunity was/is open to any qualified U.S. worker regardless of race, color, national origin, age, sex, religion, disability, or
citizenship. U.S. workers who apply for the job will be rejected only for lawful, job-related reasons, and the employer will retain
records of all rejections.
4.
The employer has not/will not offer terms, wages, and working conditions to U.S workers that are less favorable than those
offered or will be offered to H-2B workers or impose restrictions or obligations on U.S. workers that are not imposed on H-2B
workers. This does not relieve the employer from providing H-2B workers with at least the minimum benefits, wages, and
working conditions that must be offered to U.S. workers under 20 CFR 655.18, except for those required by 20 CFR
655.18(b)(17).
5.
The offered wage equals or exceeds the highest of the most recent prevailing wage for the occupation that is or will be issued
by the Department to the employer for the time period the work is performed, or the applicable Federal, State, or local minimum
wage, and the employer will pay at least the offered wage, free and clear, either in cash or in a negotiable instrument payable
at par, during the entire period of this application. The employer guarantees to supplement a piece rate wage if at the end of
the workweek, the piece rate does not result in average hourly piece rate earnings during the workweek at least equal to the
offered wage.
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(“2016 DOL Appropriations Act”), provides that
The Department of Labor Appropriations Act, 2016, Division H, Title I of Public Law
114-113
the Department of Labor (“Department”) may not use any funds to enforce the definition of corresponding employment found in 20 CFR 655.5
or the three-fourths guarantee rule definition found in 20 CFR 655.20, or any reference thereto. See Sec. 113. Therefore, in order to comply
with the 2016 DOL Appropriations Act, the Department has removed references to these provisions from the Form ETA-9142B – Appendix B.
However, the 2016 DOL Appropriations Act did not vacate these regulatory provisions, and they remain in effect, thus imposing a legal duty on
H-2B employers, even though the Department will not use any Fiscal Year 2016 funds to enforce them.
Form ETA-9142B – Appendix B TO BE COMPLETED BY EMPLOYER FROM A CERTIFIED ETA FORM 9142B
Page B.1 of B.3
Case Number: ___________________ Case Status: __________________ Period of Employment: ______________ to _______________
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