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0MB Approval: 1205-0466

Expiration Date: 1113012025

Agricultural Clearance Order

Form ETA-790

U.S. Department of Labor

IMPORTANT: In accordance with 20 CFR 653.500, all employers seeking U.S. workers to perform agricultural services or labor on a temporary, less than year-round

basis through the Agricultural Recruitment System for U.S. woncers, must submit a completed job Clearance order (Form ETA-790) to the State Workforce Agency

(SWA) tor placement on its intrastate and interstate job clearance systems. Employers submitting a job order in connection with an H-2A Application for Temporary

Employment Certification (Form ETA-9142A) must complete the Form ETA-790 and attacn a completed ETA-790A. All other employers submitting agricultural

clearance orders must complete the Form ETA-790 and attach a completed ETA-790B. Employers and authorized preparers must read the general instructions

carefully, complete ALL required fields/items containing an asterisk ( ), and any fields/items where a response is conditional as indicated by the section ( ) symbol.

I. Clearance Order Information

1 . Clearance Order Number

4. SOC Occupation Code

6. Contact\'s last (family) name

9. Contact\'s job title

1 O. Address 1

11 . Address 2 (suite/floor and number)

12. City

15. Telephone number

II. Employer Contact Information

FOR STATE WORKFORCE AGENCY (SWA) USE ONLY

Questions 1 through 17

2. Clearance Order Issue Date 3. Clearance Order Expiration Date

5. SOC Occupation Title

SWA Order Holding Office Contact Information

7. First (given) name

13. State

16. Extension 17. Email address

8. Middle name(s)

14. Postal code

ess As (DBA), if applicable

iven) name 5. Middle name(s)

13. Extension

Ill. Type of Clearance Order

1. Indicate the type of agricultural clearance order being placed ? 790A (placed in connection with an H-2A application)

with the SWA for recruitment of U.S. workers. (choose only

one! ? 790B (not placed in connection with an H-2A application)

For Public Burden Statement, see the Instructions for Form ETA-790/790A.

Fo1m ETA-790 AGRICULTURAL CLEARANCE ORDER Pagel ofl

OMB Approval: 1205-0466

Expiration Date:

H-2A Agricultural Clearance Order

Form ETA-790A

U.S. Department of Labor

B. Minimum Job Qualifications/Requirements

1. Education: minimum U.S. diploma/degree required. *

? None ? High School/GED ? Associates ? Bachelors ? Master\'s or higher ? Other degree (JD, MD, etc.)

2. Work Experience: number of months required.

*

3. Training: number of months required. *

4. Basic Job Requirements (check all that apply)

? a. Certification/license requirements ? f. Exposure to extreme temperatures

? b. Driver requirements ? g. Extensive pushing or pulling

? c. Criminal background check ? h. Extensive sitting or walking

? d. Drug screen ? i. Frequent stooping or bending over

? e. Lifting requirement ________ lbs. ? j. Repetitive movements

5a. Supervision: does this position supervise

the work of other employees? * ? Yes ? No 5b. If Yes to question 5a, enter the number

of employees worker will supervise.

6. Additional Information Regarding Job Qualifications/Requirements. *

(Please begin response on this form and use Addendum C if additional space is needed. If