Form Wh-4 - Nonimmigrant Worker Information Form (Page 3 of 3) in pdf

(p)

H-1B dependent/willful violator employer failed to hire a U.S. worker who applied and was equally or better qualified for

the job for which the H-1B worker was sought. Complaints alleging failure to offer employment to an equally or better

qualified U.S. worker, or a misrepresentation regarding such offer(s) of employment, may be filed with the U.S.

Department of Justice, Office of Special Counsel for Immigration-Related Unfair Employment Practices, 950 Pennsylvania

Avenue, NW., Washington, DC 20530.

(q)

Other: ____________________________________________________________________________________________

_________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

Date(s) of Alleged Violation(s): _____________________________________________________________________________________

Location of Worksite(s) where Alleged Violation(s) occurred: ___________________________________________________________

Basis of Knowledge of Alleged Violation(s): __________________________________________________________________________

Description of facts and circumstances which support allegations in Section 4, items (a) through (q). Use additional sheets of paper,

if necessary.

________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

Notice. Persons are not required to respond to an information collection unless it displays a currently valid OMB control number These

reporting instructions have been approved under the Paperwork Reduction Act. Obligations to reply are voluntary. Immigration and Nationality

Act, section 212(n)(G)(ii). Public reporting burden for this collection of information is estimated to average 20 minutes per response, including

the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of

information. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for

reducing this burden, to the U.S. Department of Labor, Room S-3502, 200 Constitution Ave., NW, Washington, DC 20210.

_____________________________________________________________________________________________________________________

FOR DOL USE ONLY

Complaint Received/Taken By:

Date:

Source of Complaint is:

Aggrieved party

Credible source

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Form WH-4

Rev. October 2008

Form Wh-4 - Nonimmigrant Worker Information Form Page 3