| LCA CASE NUMBER | I-200-22047-907115 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2022-02-16 |
| DECISION DATE | 2022-07-28 |
| ORIGINAL CERT DATE | 2022-02-24 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Industrial Engineer |
| SOC CODE | 17-2112.00 |
| SOC TITLE | Industrial Engineers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-08-15 |
| END DATE | 2025-08-14 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | St Dominic Jackson Memorial Hospital |
| EMPLOYER ADDRESS1 | 969 Lakeland Drive |
| EMPLOYER CITY | Jackson |
| EMPLOYER STATE | MS |
| EMPLOYER POSTAL CODE | 39216 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16012002000 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Lenior |
| EMPLOYER POC FIRST NAME | Frank |
| EMPLOYER POC JOB TITLE | Vice President of Human Resources |
| EMPLOYER POC ADDRESS1 | 969 Lakeland Drive |
| EMPLOYER POC CITY | Jackson |
| EMPLOYER POC STATE | MS |
| EMPLOYER POC POSTAL CODE | 39216 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16012006585 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Nichols |
| AGENT ATTORNEY FIRST NAME | Samira |
| AGENT ATTORNEY ADDRESS1 | POBOX 9 |
| AGENT ATTORNEY CITY | Gallatin |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37066 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16154738812 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Law office of Samira Nichols |
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 969 Lakeland Drive |
| LCA CASE WORKLOC1 CITY | Jackson |
| WORKSITE COUNTY | HINDS |
| LCA CASE WORKLOC1 STATE | MS |
| WORKSITE POSTAL CODE | 39216 |
| LCA CASE WAGE RATE FROM | 28.47 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 22.96 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Nichols |
| PREPARER FIRST NAME | Samira |
| PREPARER BUSINESS NAME | Law office of Samira Nichols |
| PREPARER EMAIL | [email protected] |
