Eta Form 9089 PDF Details

Eta Form 9089 is an information return that is used by Employers to report certain types of wages paid to employees. This form must be filed annually and is due on or before January 31st. The purpose of this blog post is to provide a brief overview of Eta Form 9089, as well as some helpful tips on how to complete it accurately. stay tuned for our next post, where we will provide a more detailed walkthrough of the Eta Form 9089 filing process.

Question	Answer
Form Name	Eta Form 9089
Form Length	15 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	3 min 45 sec
Other names	form eta, eta form online, dol eta form 9089 application, eta form 9089

Form Preview Example

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/2021	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor

Please read and review the filing instructions before completing this form. A copy of the instructions can be found at http://www.foreignlaborcert.doleta.gov/pdf/9089inst.pdf

Employing or continuing to employ an alien unauthorized to work in the United States is illegal and may subject the employer to criminal prosecution, civil money penalties, or both.

A. Refiling Instructions

1. Are you seeking to utilize the filing date from a previously submitted
		Yes		No
Application for Alien Employment Certification (ETA 750)?		Yes		No
Application for Alien Employment Certification (ETA 750)?

1A. If Yes, enter the previous filing date

1B. Indicate the previous SWA or local office case number OR if not available, specify state where case was originally filed:

B. Schedule A or Sheepherder Information

1. Is this application in support of a Schedule A or Sheepherder Occupation?	 Yes	 No

If Yes, do NOT send this application to the Department of Labor. All applications in support of Schedule A or Sheepherder Occupations must be sent directly to the appropriate Department of Homeland Security office.

C. Employer Information (Headquarters or Main Office)

1.	Employer’s name

2.	Address 1

	Address 2

3.	City	State/Province	Country			Postal code

4.	Phone number		Extension

5.	Number of employees		6. Year commenced business

7.	FEIN( Federal Employer Identification Number)		8. NAICS Code

9. Is the employer a closely held corporation, partnership, or sole proprietorship in which
the alien has an ownership interest, or is there a familial relationship between the owners,					Yes			No
stockholders, corporate officers, incorporators, or partners, and the alien?

D.Employer Contact Information (This section must be filled out. This information must be different from the agent or attorney information listed in Section E).

1.	Contact’s last name		First name	Middle initial

2.	Address 1

	Address 2

3.	City	State/Province	Country	Postal code

4.	Phone number		Extension

5.	Email address

ETA Form 9089	This Certification is valid from		to		Page 1 of

ETA Case Number:

OMB Approval: 12050451			Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008			ETA Form 9089
			ETA Form 9089
			U.S. Department of Labor
E. Agent or Attorney Information (If applicable)

	1.	Agent or attorney’s last name	First name		Middle initial

	2.	Firm name

	3.	Firm EIN	4. Phone number	Extension

	5.	Address 1

		Address 2

	6.	City	State/Province	Country	Postal code

	7.	Email address

F. Prevailing Wage Information (as provided by the State Workforce Agency)

Prevailing wage tracking number (if applicable)

SOC/O*NET(OES) code

Occupation Title

Skill Level

Prevailing wage

Per:

(Choose only one)



Hour



Week



BiWeekly



Month



Year

Prevailing wage source (Choose only one)



OES



CBA



Employer Conducted Survey



DBA



SCA



Other

6A. If Other is indicated in question 6, specify:

Determination date

Expiration date

G. Wage Offer Information

1. Offered wage
From:	To: (Optional)
$	$

Per:	(Choose only one)

	Hour		Week



BiWeekly



Month



Year

H.Job Opportunity Information (Where work will be performed)

1.Primary worksite (where work is to be performed) address 1

Address 2

2. City

State

Postal code

3. Job title

4. Education: minimum level required:
 None  High School	 Associate’s  Bachelor’s	

4A. If Other is indicated in question 4, specify the education required:

Master’s 

Doctorate 

Other

4B. Major field of study

5.Is training required for the job opportunity?

Yes  No

5A. If Yes, number of months of training required:

ETA Form 9089	This Certification is valid from		to		Page 2 of

ETA Case Number:

OMB Approval:

12050451

Application for Permanent Employment Certification

Expiration Date: 05/31/202103/31/2008

ETA Form 9089

U.S. Department of Labor

H. Job Opportunity Information Continued

5B. Indicate the field of training:

Is experience in the job offered required for the job?

6A. If Yes, number of months experience required:



Yes



7. Is there an alternate field of study that is acceptable?

Yes



7A. If Yes, specify the major field of study:

8. Is there an alternate combination of education and experience that is acceptable?

Yes



8A. If Yes, specify the alternate level of education required:



None



High School



Associate’s



Bachelor’s



Master’s



Doctorate



Other

8B. If Other is indicated in question 8A, indicate the alternate level of education required:

8C. If applicable, indicate the number of years experience acceptable in question 8:

9. Is a foreign educational equivalent acceptable?

Yes



10.

Is experience in an alternate occupation acceptable?

10A. If Yes, number of months experience in alternate

occupation required:



Yes



10B. Identify the job title of the acceptable alternate occupation:

11. Job duties – If submitting by mail, add attachment if necessary. Job duties description must begin in this space.

12. Are the job opportunity’s requirements normal for the occupation?



Yes



If the answer to this question is No, the employer must be prepared to

provide documentation demonstrating that the job requirements are

supported by business necessity.

13. Is knowledge of a foreign language required to perform the job duties?



Yes



If the answer to this question is Yes, the employer must be prepared to

provide documentation demonstrating that the language requirements

are supported by business necessity.

14. Specific skills or other requirements – If submitting by mail, add attachment if necessary. Skills description must

begin in this space.

ETA Form 9089

This Certification is valid from

Page 3 of

ETA Case Number:

OMB Approval: 12050451

Application for Permanent Employment Certification

Expiration Date: 05/31/202103/31/2008

ETA Form 9089

U.S. Department of Labor

H. Job Opportunity Information Continued

15. Does this application involve a job opportunity that includes a combination of



Yes



occupations?

16. Is the position identified in this application being offered to the alien identified



Yes



in Section J?

17. Does the job require the alien to live on the employer’s premises?



Yes



18. Is the application for a livein household domestic service worker?



Yes



18A. If Yes, have the employer and the alien executed the required employment

Yes



contract and has the employer provided a copy of the contract to the alien?

I. Recruitment Information

a. Occupation Type – All must complete this section.

1. Is this application for a professional occupation, other than a college or



Yes



university teacher? Professional occupations are those for which a bachelor’s

degree (or equivalent) is normally required.

2. Is this application for a college or university teacher?

If Yes, complete questions 2A and 2B below.



Yes



2A. Did you select the candidate using a competitive recruitment and



Yes



selection process?

2B. Did you use the basic recruitment process for professional occupations?



Yes



b.Special Recruitment and Documentation Procedures for College and University Teachers – Complete only if the answer to question I.a.2A is Yes.

3.Date alien selected:

4.Name and date of national professional journal in which advertisement was placed:

5.Specify additional recruitment information in this space. Add an attachment if necessary.

c.Professional/NonProfessional Information – Complete this section unless your answer to question B.1 or

I.a.2A is YES.

Start date for the SWA job order

7. End date for the SWA job order

Is there a Sunday edition of the newspaper in the area of intended employment?

Yes



Name of newspaper (of general circulation) in which the first advertisement was placed:

10.

Date of first advertisement identified in question 9:

11.

Name of newspaper or professional journal (if applicable) in which second advertisement was placed:



Newspaper



Journal

ETA Form 9089

This Certification is valid from

Page 4 of

ETA Case Number:

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor

I. Recruitment Information Continued

12.Date of second newspaper advertisement or date of publication of journal identified in question 11:

d. Professional Recruitment Information – Complete if the answer to question I.a.1 is YES or if the answer to I.a.2B is YES. Complete at least 3 of the items.

13. Dates advertised at job fair

14. Dates of oncampus recruiting

From:

To:

From:

To:

15.

Dates posted on employer web site

16. Dates advertised with trade or professional organization

From:

To:

From:

To:

17.

Dates listed with job search web site

18. Dates listed with private employment firm

From:

To:

From:

To:

19.

Dates advertised with employee referral program

20. Dates advertised with campus placement office

From:

To:

From:

To:

21. Dates advertised with local or ethnic newspaper

22. Dates advertised with radio or TV ads

From:

To:

From:

To:

e. General Information – All must complete this section.

23.

Has the employer received payment of any kind for the submission of this



Yes



application?

23A. If Yes, describe details of the payment including the amount, date and purpose of the payment :

24.

Has the bargaining representative for workers in the occupation in which the



Yes



alien will be employed been provided with notice of this filing at least 30 days

but not more than 180 days before the date the application is filed?

25.

If there is no bargaining representative, has a notice of this filing been posted

for 10 business days in a conspicuous location at the place of employment,



Yes



ending at least 30 days before but not more than 180 days before the date the

application is filed?

26.

Has the employer had a layoff in the area of intended employment in the

occupation involved in this application or in a related occupation within the six



Yes



months immediately preceding the filing of this application?

26A. If Yes, were the laid off U.S. workers notified and considered for the job



Yes



opportunity for which certification is sought?

J.Alien Information (This section must be filled out. This information must be different from the agent or attorney information listed in Section E).

Alien’s last name

First name

Full middle name

Current address 1

Address 2

City

State/Province

Country

Postal code

Phone number of current residence

Country of citizenship

Country of birth

Alien’s date of birth

Class of admission

Alien registration number (A#)

10.

Alien admission number (I94)

11. Education: highest level achieved as required by the requested job opportunity:



None



High School



Associate’s



Bachelor’s



Master’s



Doctorate



Other

ETA Form 9089

This Certification is valid from

Page 5 of

ETA Case Number:

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor

J. Alien Information Continued

11A. If Other indicated in question 11, specify

12.Specify major field(s) of study

13.Year relevant education completed

14.Institution where relevant education specified in question 11 was received

15.Address 1 of conferring institution Address 2

16.

City

State/Province

Country

Postal code

17.

Did the alien complete the training required for the requested job opportunity,



Yes



as indicated in question H.5?

18.

Does the alien have the experience as required for the requested job

opportunity indicated in question H.6?



Yes



19.

Does the alien possess the alternate combination of education and experience

as indicated in question H.8?



Yes



20.

Does the alien have the experience in an alternate occupation specified in

question H.10?



Yes



21.

Did the alien gain any of the qualifying experience with the employer in a

position substantially comparable to the job opportunity requested?



Yes



22.

Did the employer pay for any of the alien’s education or training

necessary to satisfy any of the employer’s job requirements for this position?



Yes



23.

Is the alien currently employed by the petitioning employer?



Yes



K. Alien Work Experience

List all jobs the alien has held during the past 3 years. Also list any other experience that qualifies the alien for the job opportunity for which the employer is seeking certification.

a. Job 1

1.	Employer name

2.	Address 1

	Address 2

3.	City	State/Province	Country	Postal code

4.	Type of business		5. Job title

6.	Start date	7. End date	8. Number of hours worked per week

Job 1 continued on next page

ETA Form 9089	This Certification is valid from		to		Page 6 of

ETA Case Number:

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor

K. Alien Work Experience Continued

9.Job details (duties performed, use of tools, machines, equipment, skills, qualifications, certifications, licenses, etc. Include the phone number of the employer and the name of the alien’s supervisor.)

b. Job 2

	1.	Employer name

	2.	Address 1

		Address 2

	3.	City	State/Province		Country	Postal code

	4.	Type of business		5.	Job title

	6.	Start date	7. End date	8.	Number of hours worked per week

	9.	Job details (duties performed, use of tools, machines, equipment, skills, qualifications, certifications, licenses, etc.
	Include the phone number of the employer and the name of the alien’s supervisor.)

	c. Job 3

	1.	Employer name

	2.	Address 1

	Address 2

	3.	City	State/Province		Country	Postal code

	4.	Type of business		5.	Job title

	6.	Start date	7. End date	8.	Number of hours worked per week

	Job 3 continued on next page

ETA Form 9089			This Certification is valid from	to		Page 7 of

ETA Case Number:

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor

K.Alien Work Experience Continued

L. Alien Declaration

I declare under penalty of perjury that Sections J and K are true and correct. I understand that to knowingly furnish false information in the preparation of this form and any supplement thereto or to aid, abet, or counsel another to do so is a federal offense punishable by a fine or imprisonment up to five years or both under 18 U.S.C. §§ 2 and 1001. Other penalties apply as well to fraud or misuse of ETA immigration documents and to perjury with respect to such documents under 18 U.S.C. §§ 1546 and 1621.

In addition, I further declare under penalty of perjury that I intend to accept the position offered in Section H of this application if a labor certification is approved and I am granted a visa or an adjustment of status based on this application.

1.	Alien’s last name	First name	Full middle name

2.	Signature	Date signed

Note – The signature and date signed do not have to be filled out when electronically submitting to the Department of Labor for processing, but must be complete when submitting by mail. If the application is submitted electronically, any resulting certification MUST be signed immediately upon receipt from DOL before it can be submitted to USCIS for final processing.

M. Declaration of Preparer

1.Was the application completed by the employer? If No, you must complete this section.



Yes



I hereby certify that I have prepared this application at the direct request of the employer listed in Section C and that to the best of my knowledge the information contained herein is true and correct. I understand that to knowingly furnish false information in the preparation of this form and any supplement thereto or to aid, abet, or counsel another to do so is a federal offense punishable by a fine, imprisonment up to five years or both under 18 U.S.C. §§ 2 and 1001. Other penalties apply as well to fraud or misuse of ETA immigration documents and to perjury with respect to such documents under 18 U.S.C. §§ 1546 and 1621.

2. Preparer’s last name

First name

Middle initial

3.Title

4.Email address

5. Signature

Date signed

ETA Form 9089	This Certification is valid from		to		Page 8 of

ETA Case Number:

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor

N. Employer Declaration

By virtue of my signature below, I HEREBY CERTIFY the following conditions of employment:

1.The offered wage equals or exceeds the prevailing wage and I will pay at least the prevailing wage.

2.The wage is not based on commissions, bonuses or other incentives, unless I guarantees a wage paid on a weekly, biweekly, or monthly basis that equals or exceeds the prevailing wage.

3.I have enough funds available to pay the wage or salary offered the alien.

4.I will be able to place the alien on the payroll on or before the date of the alien’s proposed entrance into the United States.

5.The job opportunity does not involve unlawful discrimination by race, creed, color, national origin, age, sex, religion, handicap, or citizenship.

6.The job opportunity is not:

a.Vacant because the former occupant is on strike or is being locked out in the course of a labor dispute involving a work stoppage; or

b.At issue in a labor dispute involving a work stoppage.

7.The job opportunity’s terms, conditions, and occupational environment are not contrary to Federal, state or local law.

8.The job opportunity has been and is clearly open to any U.S. worker.

9.The U.S. workers who applied for the job opportunity were rejected for lawful jobrelated reasons.

10.The job opportunity is for fulltime, permanent employment for an employer other than the alien.

I hereby designate the agent or attorney identified in section E (if any) to represent me for the purpose of labor certification and, by virtue of my signature in Block 3 below, I take full responsibility for the accuracy of any

representations made by my agent or attorney.

I declare under penalty of perjury that I have read and reviewed this application and that to the best of my knowledge the information contained herein is true and accurate. I understand that to knowingly furnish false information in the preparation of this form and any supplement thereto or to aid, abet, or counsel another to do so is a federal offense punishable by a fine or imprisonment up to five years or both under 18 U.S.C. §§ 2 and 1001. Other penalties apply as well to fraud or misuse of ETA immigration documents and to perjury with respect to such documents under 18 U.S.C. §§ 1546 and 1621.

1.	Last name	First name	Middle initial

2.	Title

3.	Signature	Date signed

O. U.S. Government Agency Use Only

Pursuant to the provisions of Section 212 (a)(5)(A) of the Immigration and Nationality Act, as amended, I hereby certify that there are not sufficient U.S. workers available and the employment of the above will not adversely affect the wages and working conditions of workers in the U.S. similarly employed.

This Certification is valid from

Signature of Certifying Officer

Date Signed

Case Number

Filing Date

ETA Form 9089	This Certification is valid from		to		Page 9 of

ETA Case Number:

OMB Approval: 12050451	Application for Permanent Employment Certification
Expiration Date: 05/31/202103/31/2008	ETA Form 9089
	ETA Form 9089
	U.S. Department of Labor
P. OMB Information	Paperwork Reduction Act Information Control Number 12050451

Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number.

Respondent’s reply to these reporting requirements is required to obtain the benefits of permanent employment certification (Immigration and Nationality Act, Section 212(a)(5)). Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate to the Office of Foreign Labor Certification * U.S. Department of Labor * 200 Constitution Ave., NW, Box 12200 * Washington, DC * 20210. Do NOT send the completed application to this address.

Q. Privacy Statement Information

In accordance with the Privacy Act of 1974, as amended (5 U.S.C. 552a), you are hereby notified that the information provided herein is protected under the Privacy Act. The Department of Labor (Department or DOL) maintains a System of Records titled Employer Application and Attestation File for Permanent and Temporary Alien Workers (DOL/ETA7) that includes this record.

Under routine uses for this system of records, case files developed in processing labor certification applications, labor condition applications, or labor attestations may be released as follows: in connection with appeals of denials before the DOL Office of Administrative Law Judges and Federal courts, records may be released to the employers that filed such applications, their representatives, to named alien beneficiaries or their representatives, and to the DOL Office of Administrative Law Judges and Federal courts; and in connection with administering and enforcing immigration laws and regulations, records may be released to such agencies as the DOL Office of Inspector General, Employment Standards Administration, the Department of Homeland Security, and the Department of State.

Further relevant disclosures may be made in accordance with the Privacy Act and under the following circumstances: in connection with federal litigation; for law enforcement purposes; to authorized parent locator persons under Pub. L. 93647; to an information source or public authority in connection with personnel, security clearance, procurement, or benefitrelated matters; to a contractor or their employees, grantees or their employees, consultants, or volunteers who have been engaged to assist the agency in the performance of Federal activities; for Federal debt collection purposes; to the Office of Management and Budget in connection with its legislative review, coordination, and clearance activities; to a Member of Congress or their staff in response to an inquiry of the Congressional office made at the written request of the subject of the record; in connection with records management; and to the news media and the public when a matter under investigation becomes public knowledge, the Solicitor of Labor determines the disclosure is necessary to preserve confidence in the integrity of the Department, or the Solicitor of Labor determines that a legitimate public interest exists in the disclosure of information, unless the Solicitor of Labor determines that disclosure would constitute an unwarranted invasion of personal privacy.

ETA Form 9089	This Certification is valid from		to		Page 10 of

ETA Case Number:

Addendum

H. 11. Job duties

ETA Form 9089

This Certification is valid from

Page

ETA Case Number:

Addendum

H. 14. Specific skills or other requirements

ETA Form 9089

This Certification is valid from

Page

ETA Case Number:

Addendum

I. 5. Specify additional recruitment information in this space

ETA Form 9089

This Certification is valid from

Page

ETA Case Number:

Addendum

K. 9. Job	Job Details

ETA Form 9089

This Certification is valid from

Page

ETA Case Number:

Addendum

K.Alien Work Experience Continued

1.Employer name

2.Address 1

Address 2

3.	City	State/Province		Country	Postal code

4.	Type of business		5.	Job title

6.	Start date	7. End date	8.	Number of hours worked per week

9.	Job details (duties performed, use of tools, machines, equipment, skills, qualifications, certifications, licenses, etc.
Include the phone number of the employer and the name of the alien’s supervisor.)


1. Employer name

2. Address 1

	Address 2

3. City		State/Province	Country		Postal code

4.	Type of business		5.	Job title

6.	Start date	7. End date	8.	Number of hours worked per week

9. Job details (duties performed, use of tools, machines, equipment, skills, qualifications, certifications, licenses, etc. Include the phone number of the employer and the name of the alien’s supervisor.)

ETA Form 9089	This Certification is valid from		to		Page	of

ETA Case Number:

How to Edit Eta Form 9089 Online for Free

Making use of the online PDF editor by FormsPal, you are able to fill in or change form 9089 here. To retain our tool on the forefront of convenience, we work to implement user-oriented capabilities and enhancements on a regular basis. We are routinely glad to get feedback - help us with remolding how you work with PDF documents. Here's what you'd have to do to get going:

Step 1: First of all, open the editor by pressing the "Get Form Button" above on this webpage.

Step 2: The editor will allow you to customize PDF documents in a variety of ways. Enhance it with customized text, adjust what is already in the file, and put in a signature - all doable in minutes!

With regards to the fields of this precise form, here is what you need to know:

1. The form 9089 usually requires specific details to be inserted. Ensure that the subsequent fields are completed:

2. After this selection of fields is done, go on to type in the suitable details in these: City, Phone number, Number of employees, StateProvince, Country, Postal code, Extension, Year commenced business, FEIN Federal Employer, NAICS Code, Is the employer a closely held, Yes No, D Employer Contact Information, agent or attorney information, and Contacts last name.

StateProvince, Phone number, and D Employer Contact Information of 9089

3. This next portion is related to Agent or attorneys last name, First name, Middle initial, Firm name, Firm EIN, Address, Address, City, Email address, Phone number, Extension, StateProvince, Country, Postal code, and F Prevailing Wage Information as - fill out each of these blanks.

Be extremely careful while filling out Firm EIN and Phone number, as this is the part in which most users make mistakes.

4. To go ahead, the following step involves completing several fields. Examples include Determination date, Expiration date, G Wage Offer Information, Offered wage, From, To Optional, Per Choose only one, our, Week BiWeekly Month Year, H Job Opportunity Information, Primary worksite where work is to, Address, City, Job title, and St a te, which you'll find essential to moving forward with this document.

9089 writing process clarified (stage 4)

5. To wrap up your document, the final segment features a couple of additional blanks. Entering B Indicate the field of training, Is experience in the job offered, A If Yes number of months, Yes, Is there an alternate field of, Yes, A If Yes specify the major field, Is there an alternate combination, Yes, A If Yes specify the alternate, None, High School, Associates Bachelors, Masters, and B If Other is indicated in should conclude the process and you're going to be done in a tick!

Step 3: Prior to moving forward, double-check that blank fields were filled out the proper way. Once you are satisfied with it, click on “Done." Get hold of the form 9089 after you register at FormsPal for a free trial. Readily view the document inside your FormsPal cabinet, along with any modifications and adjustments all kept! When using FormsPal, you can fill out forms without the need to be concerned about data breaches or records being distributed. Our protected software helps to ensure that your personal data is stored safely.

Eta Form 9089 – Fill Out and Use This PDF

Eta Form 9089 PDF Details

Form Preview Example

How to Edit Eta Form 9089 Online for Free

Eta Form 9089 isn’t the one you’re looking for?

Eta Form 9089 – Fill Out and Use This PDF

Eta Form 9089 PDF Details

Form Preview Example

How to Edit Eta Form 9089 Online for Free

Eta Form 9089 isn’t the one you’re looking for?

Related Documents