Form Eta 750 - Application For Alien Employment Certification

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OMB Approval No. 44-R1301
IMPORTANT: READ CAREFULLY BEFORE COMPLETING THIS FORM
U.S. DEPARTMENT OF LABOR
PRINT legibly in ink or use a typewriter. If you need more space to
Employment and Training Administration
answer questions on this form, use a separate sheet. Identify each
answer with the number of the corresponding question. SIGN AND DATE
APPLICATION
each sheet in original signature.
FOR
To knowingly furnish any false information in the preparation of this form
ALIEN EMPLOYMENT CERTIFICATION
and any supplement thereto to aid, abet, or counsel another to do so is a
felony punishable by $10,000 fine or 5 years in the penitentiary, or both
(18 U.S.C. 1001).
PART A. OFFER OF EMPLOYMENT
1. Name of Alien
(Family name in capital letters, First, Middle, Maiden)
2. Present Address of Alien
(Number, Street, City and Town, State, ZIP Code or Province, Country)
3. Type of Visa
(If in U.S.)
The following information is submitted as evidence of an offer of employment.
4. Name of Employer
(Full name of organization)
5. Telephone
(Area code
and Number)
6. Address
(Number, Street, City or Town, Country, State, ZIP Code)
7. Address Where Alien Will Work
(if different from Item 6)
8. Nature of Employer's Business
9. Name of Job Title
10. Total Hours Per Week
11. Work
12. Rate of Pay
Activity
Schedule
a. Basic
b. Overtime
a. Basic
b. Overtime
(Hourly)
$
$
a.m.
per
per hour
p.m.
13. Describe Fully the Job to be Performed
(Duties)
14. State in detail the
MINIMUM
education, training, and experience for a
15. Other Special Requirements
worker to perform satisfactorily the job duties described in Item 13 above.
(specify)
Grade
High
College College Degree Required
EDU-
School
School
CATION
(Enter number
Major Field of Study
of years)
No. Yrs.
No. Mos.
Type of Training
TRAINING
Related Occupation
(specify)
Related
Job Offered
Occupation
EXPERI-
Number
ENCE
Yrs.
Mos.
Yrs.
Mos.
17. Number of Employees
16. Occupational Title of Person Who
>
>
Alien will Supervise
Will Be Alien's Immediate Supervisor
(Make no entry in section -
<
ENDORSEMENTS
for government use only)
Date Forms Received
L.O.
S.O.
R.O.
N.O.
Ind. Code
Occ. Code
Occ. Title
Replaces MA 7-50A, B and C (Apr. 1970 edition) which is obsolete.
ETA 750 (Oct. 1979)
CONFIDENTIAL RECORD Pursuant to IC 22-4-19-6, IC 4-1-6

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