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Agricultural and Food Processing Clearance Order

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U.S. Department Labor                                                                                          OMB Control No. 1205-0134
                   Employment and Training Administration                                                                        Expiration Date: April 30, 2019


                                          Agricultural and Food Processing Clearance Order ETA Form 790
                                 Orden de Empleo para Obreros/Trabajadores Agrícolas y Procesamiento de Alimentos

              (Print or type in each field block – To include additional information, go to block # 28 – Please follow Step-By-Step Instructions) (Favor
de usar letra de molde en la solicitud – Para incluir información adicional vea el punto # 28 – Favor de seguir las instrucciones paso-a-paso)

1. Employer’s and/or Agent’s Name and Address (Number, Street, City, State and                     Nos. 4 through 8 for STATE USE ONLY
    Zip Code / Nombre y Dirección del Empleador/Patrón y/o Agente (Número,
    Calle, Ciudad, Estado y Código Postal ):                                                            Números 4 a 8 para USO ESTATAL
                                                                                        4. SOC (O*NET/OES) Occupational               5.Job Order No. / Num. de Orden de
                                                                                           Code / Código Industrial:                    Empleo:


                                                                                          a. SOC (ONET/OES) Occupational
a) Federal Employer Identification Number (FEIN) / Número federal de                         Title / Título Ocupacional
   Identificación del Empleador:

                                                                                        6. Address of Order Holding Office (include Telephone number) / Dirección de la
b) Telephone Number / Número de Teléfono:                                                  Oficina donde se radico la oferta (incluya el número de teléfono ):


c) Fax Number / Número de Fax:
                                                                                          a. Name of Local Office Representative (include direct dial telephone
                                                                                             number) / Nombre del Representante de la Oficina Local (Incluya el
d) E-mail Address / Dirección de Correo Electrónico:                                         número de teléfono de su línea directa).


2. Address and Directions to Work Site / Domicilio y Direcciones al lugar de trabajo:
                                                                                        7. Clearance Order Issue Date / Fecha de Emisión de la Orden de Empleo:



                                                                                        8. Job Order Expiration Date / Fecha de Vencimiento o E xpiración de la Orden de
                                                                                            Empleo:


                                                                                        9. Anticipated Period of Employment / Período anticipado o previsto de Empleo:

                                                                                             From / Desde:                              To / Hasta:
                                                                                        10. Number of Workers Requested I Número de Trabajadores Solicitados:


3. Address and Directions to Housing / Domicilio y Direcciones al lugar de              11. Anticipated Hours of Work per Week / Horas Anticipadas/Previstas de
    vivienda:                                                                               Trabajo por Semana. Total:

                                                                                           Sunday I Domingo                     Thursday /Jueves
                                                                                           Monday / Lunes                       Friday I Viernes
                                                                                           Tuesday / Martes                     Saturday / Sábado
                                                                                           Wednesday / Miércoles

                                                                                        12. Anticipated range of hours for different seasonal activities: / Rango previsto de
a)   Description of Housing / Descripción de la vivienda:
                                                                                            horas par alas diferentes actividades de la temporada:



                                                                                        13. Collect Calls Accepted from: / Aceptan Llamadas por Cobrar de:



                                                                                             Employer / Empleador:                    Yes / Si  No 
14. Describe how the employer intends to provide either 3 meals a day to each worker or furnish free and convenient cooking and kitchen facilities for workers to prepare
     meals / Describa cómo el empleador tiene la intención de ofrecer, ya sea 3 comidas al día a cada trabajador, o proporcionar gratuitamente instalaciones para cocinar.




                                                                                  -2-
15. Referral Instructions and Hiring Information / Instrucciones sobre cómo Referir Candidatos/Solicitantes - (Explain how applicants are to be hired or referred, and the
     Employer’s/Agent’s available hour to interview workers / Explique cómo los candidatos serán contratados o referidos, y las horas disponibles del empleador/agente para
     entrevistar a los trabajadores). See instructions for more details / Vea las instrucciones para más detalles.




16. Job description and requirements / Descripción y requisitos del trabajo:




1. Is previous work experience preferred? / Se prefiere previa experiencia? Yes / Si  No  If yes, number of months preferred: / Si es así, numero de meses
   de experiencia: ______




2. Check all requirements that apply:

 Certification/License Requirements / Certificación/Licencia Requisitos           Criminal Background Check / Verificación de antecedentes penales
 Driver Requirements / Requisitos del conductor                                   Drug Screen / Detección de Drogas
 Employer Will Train / Empleador entrenará o adiestrará                           Extensive Pushing and Pulling / Empujar y Jalar Extensamente
 Extensive Sitting / Estar sentado largos ratos                                   Extensive Walking / Caminar por largos ratos
 Exposure to Extreme Temp. / Expuesto a Temperaturas Extremas                     Frequent Stooping / Inclinándose o agachándose con frecuencia
 Lifting requirement / Levantar o Cargar ______lbs./libras                        OT/Holiday is not mandatory / Horas Extras (sobre tiempo) / Días Feriados no
 Repetitive Movements / Movimientos repetitivos                                     obligatorio




                                                                                 -3-
17. Wage Rates, Special Pay Information and Deductions / Tarifa de Pago, Información Sobre Pagos E speciales y Deducciones (Rebajas)
    Crop Activities       Hourly Wage                 Piece Rate /     Special Pay                   Deductions*      Yes/Sí           No     Pay Period /
                                                         Unit(s)       (bonus, etc.)                                                        Período de Pago
       Cultivos           Salario por Hora                             Pagos Especiales              Deducciones
                                                                         (Bono, etc.)                                                          /          /
                                                 Pago por Pieza /
                                                   Unidad(es)
                           $                     $                                            Social Security /                           Weekly / Semanal
                                                                                              Seguro Social
                           $                      $                                           Federal Tax /                                         
                                                                                              Impuestos
                                                                                              Federales
                           $                      $                                           State Tax                                          Bi-weekly/
                                                                                              /Impuestos                                           Quincenal
                                                                                              Estatales
                           $                      $                                           Meals / Comidas                                       

                           $                      $                                           Other (specify) /                            Monthly/Mensual
                                                                                              Otro (especifica)
                                                                                                                                                      

                                                                                                                                                   Other/Otro

                                                                                                                                                      

18. More Details About the Pay / Mas Detalles Sobre el Pago:




19. Transportation Arrangements / Arreglos de Transportación




                                                                              -4-
20. Is it the prevailing practice to use Farm Labor Contractors (FLC) to recruit, supervise, transport, house, and/or pay workers for this (these) crop activity (ies)?
      / ¿Es la práctica habitual usar Contratistas de Trabajo Agrícola para reclutar, supervisar, transportar, dar vivienda, y/o pagarle a los trabajadores para
      este(os) tipo(s) de cosecha(s)?                Yes / Si               No 

      If you have checked yes, what is the FLC wage for each activity? / Si contesto "Si," cuál es el salario que le paga al Contratista de Trabajo Agrícola por cada
      actividad?




21.    Are workers covered for Unemployment Insurance? / ¿Se le proporcionan Seguro de Desempleo a los trabajadores?                         Yes/Si  No 



22.    Are workers covered by workers' compensation? / ¿Se le provee seguro de compensación/indemnización al trabajador:                     Yes/Si  No 


23.    Are tools, supplies, and equipment provided at no charge to the workers? / ¿Se les proveen herramientas y equipos sin costo algun o a los trabajadores?

                                                                                                                                                Yes/Si No 

24. List any arrangements which have been made with establishment owners or agents for the payment of a commission or other benefits for sales made to
      workers. (If there are no such arrangements, enter "None".) / Enumere todos los acuerdos o convenios hechos con los propietarios del establecimiento o
      sus agentes para el pago de una comisión u otros beneficios por ventas hechas a los trabajadores. (Si no hay ningún acuerdo o convenio, i ndique
      "Ninguno".)




25. List any strike, work stoppage, slowdown, or interruption of operation by the employees at the place where the workers will be employed. (If there are no such incidents,
      enter "None".) / Enumere toda huelga, paro o interrupción de operaciones de trabajo por parte de los empleados en el lugar de empleo. (Si no hay incidentes de este
      tipo, indique "Ninguno".)




                                                                                   -5-
26. Is this job order to be placed in connection with a future Application for Temporary Employment Certification for H–2A workers? / ¿Esta orden de empleo ha sido puesta
      en conexión con una futura solicitud de certificación de empleo temporal para trabajadores H-2A?


         Yes/Si No 




27. Employer's Certification: This job order describes the actual terms and conditions of the employment being offered by me and contains all the material terms
     and conditions of the job. / Certificación del Empleador: Esta orden de trabajo describe los términos y condiciones del empleo que se le ofrece, y contiene
     todos los términos y condiciones materiales ofrecidos.



    Employer's Printed Name & Title / Nombre y Título en Letra de Molde/Imprenta del Empleador




    Employer's Signature / Firma y Título del Empleador                                  Date / Fecha


 READ CAREFULLY, In view of the statutorily established basic function of the Employment Service as a no -fee labor exchange, that is, as a forum for bringing
 together employers and job seekers, neither the Employment and Training Administration (ETA) nor the State agenci es are guarantors of the accuracy or
 truthfulness of information contained on job orders submitted by employers. Nor does any job order accepted or recruited upon by the American Job Center
 constitute a contractual job offer to which the American Job Center, ETA or a State agency is in any way a party.

 LEA CON CUIDADO, En vista de la función básica del Servicio de Empleo establecida por ley, como una entidad de intercambio laboral sin comisiones, es decir, como un
 foro para reunir a los empleadores y los solicitantes de empleo, ni ETA ni las agencias del estado pueden garantizar la exactitud o veracidad de la información contenida en
 las órdenes de trabajo sometidas por los empleadores. Ni ninguna orden de trabajo aceptado o contratado en el Centro de Carreras (American Job Center) constituyen una
 oferta de trabajo contractuales a las que el American Job Center, ETA o un organismo estatal es de ninguna manera una de las partes.


 PUBLIC BURDEN STATEMENT
 The public reporting burden for responding to ETA Form 790, which is required to obtain or retain benefits (44 USC 3501), is estimated to be approximately 60 minutes per
 response, including time for reviewing instructions, searching existing data sources, gathering and reviewing the collection. The public need not respond to this collection of
 information unless it displays a currently valid OMB Control Number. This is public information and there is no expectation of confidentiality. Send comments regarding this
 burden estimate or any other aspect of this collection, including suggestions for reducing this burden, to the U.S. Department of Labor, Employment and Training
 Administration, Office of Workforce Investment, Room C-4510, 200 Constitution Avenue, NW, Washington, DC 20210.

 DECLARACION DE CARGA PÚBLICA
 La carga de información pública para responder a la Forma ETA 790, que se requiere para obtener o retener beneficios (44 USC 3501), se estima en aproximadamente 60
 minutos por respuesta, incluyendo el tiempo para revisar las instrucciones, buscar fuentes de datos existentes, recopilar y revisar la colección. El público no tiene por qué
 responder a esta recopilación de información a menos que muestre un número de control OMB válido. Esta información es pública y no hay ninguna expectativa de
 confidencialidad. Envíe sus comentarios acerca de esta carga o cualquier otro aspecto de esta colección, incluyendo sugerencias para reducir esta carga, al U.S.
 Department of Labor, Employment and Training Administration, Office of Workforce Investment, Room C-4510, 200 Constitution Avenue, NW, Washington, DC 20210.


                                                                                    -6-
28. Use this section to provide additional supporting information (including section Box number). Include attachments, if necessary. / Utilice esta sección para proporcionar
    información adicional de apoyo; incluya el numero de la sección e incluya archivos adjuntos, si es necesario.




                                                                                     -7-
                                                20 CFR 653.501
                                                  Assurances

                            INTRASTATE AND INTERSTATE CLEARANCE ORDER

       The employer agrees to provide to workers referred through the clearance system the number of
       hours of work per week cited in Item 11 of the clearance order for the week beginning with the
       anticipated date of need, unless the employer has amended the date of need at least 10 working
       days prior to the original date of need by so notifying the Order-Holding Office (OHO). If the
       employer fails to notify the OHO at least 10 working days prior to the original date of need, the
       employer shall pay eligible workers referred through the intrastate/interstate clearance system the
       specified hourly rate or pay, or in the absence of a specified hourly rate or pay, the higher of the
       Federal or State minimum wage rate for the first week starting with the original anticipated date of
       need. The employer may require workers to perform alternative work if the guarantee is invoked
       and if such alternative work is stated on the job order.

       The employer agrees that no extension of employment beyond the period of employment shown
       on the job order will relieve the employer from paying the wages already earned, or specified in
       the job order as a term of employment, providing transportation or paying transportation expenses
       to the worker’s home.

       The employer assures that all working conditions comply with applicable Federal and State minimum
       wage, child labor, social security, health and safety, farm labor contractor registration and other
       employment-related laws.

       The employer agrees to expeditiously notify the OHO or State agency by telephone immediately
       upon learning that a crop is maturing earlier or later, or that weather conditions, over recruitment,
       or other factors have changed the terms and conditions of employment.

       The employer, if acting as a farm labor contractor, has a valid farm labor contractor registration
       certificate.

       The employer assures the availability of no cost or public housing which meets applicable Federal
       and State standards and which is sufficient to house the specified number of workers requested
       through the clearance system.

       The employer also assures that outreach workers shall have reasonable access to the workers in
       the conduct of outreach activities pursuant to 20 CFR 653.107.



       Employer’s Name                                                  Date:



       Employer’s Signature




Besides the material terms and conditions of the employment, the employer must agree to these assurances if
the job order is to be placed as part of the Agricultural Recruitment System. This assurance statement must be
signed by the employer, and it must accompany the ETA Form 790.




                                                      -8-
                  Step-By-Step Instructions for Completing Form ETA-790

These instructions will help employers understand the information that is being requested. Please read the
instructions carefully and follow them to minimize the chances of your application package being returned due
to incomplete information. Please try to include as much detail as possible on the face of the form
itself. Even if attachments are necessary, the essential terms and conditions must be spelled out on
the face of this form. Compliance with the disclosure requirements of the Migrant and Seasonal Farmworker
Protection Act and all assurances required by Federal regulations are the responsibility of the employer.

   •   Box 1 - Enter full name of individual employer or agent; the complete address; the Federal Employer
       Identification Number (FEIN) of the employer; and the complete phone number, fax number, and e-mail
       address.

   •   Box 2 - Provide the address of and directions to your work site or intended place of employment. Use
       commonly understood street or highway numbers and accurate distances.

   •   Box 3 - Provide the address of and directions to the housing. Use commonly understood street or
       highway numbers and accurate distances. Enter the capacity of the housing and a brief description of
       the housing in English and Spanish. Describe housing facilities such as: a) structures provided, e.g.,
       camp, cabin, barracks or house. Describe general composition of the living quarters such as wood or
       concrete; b) the number of persons for whom housing is available. Note the number of barracks, family
       units and/or, single rooms available, and the total capacity of these types of units; c) furnishings and
       equipment supplied by the employer, e.g., furniture, eating and cooking utensils; d) utilities available,
       such as gas, electricity, heat; e) parking spaces for trailers, arrangements for utility hookups and
       charges; f) medical and recreational facilities available for worker's benefit and their locations; g)
       whether or not public housing is provided; and, h) are any charges required of workers to use the
       housing.

   •   Boxes 4 through 8 are for State Agency use only – 4 for Occupational Code, 4a for Occupational
       Title, 5 for Job Order number, 6 for Order Holding Office address, 6a for name of local office
       representative, 7 for Clearance Order Issue date, and 8 for the job order expiration date.

   •   Box 9 - Enter the anticipated period of employment or the date when work is scheduled to begin or is to
       be performed by these workers. Enter date when work is expected to be completed.

   •   Box 10 - Enter total number of workers that you are requesting. Also, state total number of workers to
       be employed in this activity or service for the period of time involved.

   •   Box 11 - Enter anticipated total hours of work per week. Enter normal hours worker is expected to work
       each day of the week. Describe any special work schedule situations in Box 31.

   •   Box 12 – Enter the anticipated range of hours for different seasonal activities.

   •   Box 13 -Indicate if employer accepts or does not accept collect calls from job applicants.

   •   Box 14 - Describe how the employer intends to provide either three meals a day to each worker or
       furnish free and convenient cooking and kitchen facilities so that workers can prepare their own meals.
       The charge for three meals must be within the approved range unless the regional administrator has
       approved a higher charge. Where the employer provides facilities for cooking, explain how the workers
       will have access to stores where they can purchase groceries.

   •   Box 15- Explain how applicants are to be interviewed, hired or referred. Indicate, for example, the hours
       that the employer or agent will be available to interview workers by telephone and whether anybody
       different from the employer has hiring authority.

                                                      -9-
•   Box 16 - Provide a detailed summary of the job description and requirements inside the box. Even if
    additional information is to be provided in an attachment, the summary must be provided in the box and
    must be as complete as possible. In the box provided list all major crop activities, summarize the major
    duties associated with those duties and estimate the percentage of time that will be spent doing them.
    Describe the duties (work tasks) which make up the job, in step-by-step detail, as appropriate. Avoid
    technical terms when possible, or define them where usage is necessary. Describe use of any equipment
    necessary to carry out tasks (e.g. harvesting onions – pull onions from the ground, snip off the tops
    using a sniper, deposit onions in a 50 pound sack, (80%); harvest tomatoes – detach green tomatoes
    from plants and deposit them in a 20 pound bucket, carry bucket to a truck to be located at the edge of
    the field, throw bucket up to the person on the truck (20%)).

    Indicate the extent of work experience required for the job and other specific job-related experience,
    requirements or required qualifications.

    Provide whatever additional detail is required to explain the full range of tasks and duties required.
    Explain any worker performance standards that will apply. Describe any training provided. Describe any
    experience that is required. Describe any licenses or permits that are required. Describe what level of
    supervision will be provided. Explain the provision of necessary tools and equipment.

•   Box 17 - Enter appropriate wage rate information for each distinct activity. In no event may rate be less
    than the applicable FLSA or State minimum, or the applicable prevailing hourly wage rate, whichever is
    higher. Piece rates may not be less than those prevailing in the area and occupation. Include an
    attachment explaining your handling of this Box. H-2A Agricultural Workers must be paid the highest of
    the (a) Adverse Effect Wage Rate (AEWR), (b) the prevailing rate for a given crop/area or (c) the Federal
    or the State’s minimum wage. The law also contains requirements regarding employer-provided meals
    and transportation of workers and restricts the deductions that may be legally made from workers'
    wages. If H2A workers are requested, the Adverse Effect Wage Rate (AEWR)
    http://www.foreignlaborcert.doleta.gov/adverse.cfm is the guaranteed minimum unless FLSA or State
    minimum, or the applicable prevailing hourly wage rate is higher. Enter the unit used when piece rates
    are being paid. Describe the unit size that governs how the piece rate is paid, such as tree size/spacing,
    weight/size/number of boxes picked/packed, dimensions of bags or boxes filled. For example: 5/8
    bushel, 90 pound bag or box, 10 box bin.

    Hourly Rate Equivalent
    The piece rate must be expressed in estimated hourly wage rate equivalents for each activity and unit
    size, i.e., what a worker might expect to earn per hour at this rate. The estimated hourly equivalent is
    not guaranteed. However, the estimated hourly equivalent can be no less than the highest of the
    applicable Federal or State minimum (or AEWR if applicable) or the prevailing hourly wage rate. See web
    link to DOL’s Adverse Effect Wage Rate Chart 2007-2012
    http://www.dol.gov/opa/media/press/eta/ETA20111794fs.pdf .

    Box 18 - Other details about pay may include: 1) Any bonus or incentives aside from the flat rate or
    piece rate, e.g., garden space, milk, eggs, meat, health insurance; 2) Special conditions on guaranteed
    weeks of work, under what conditions bonuses or incentives are to be paid, if any; 3) If the activity is
    covered by a “schedule of rates,” indicate conditions under which each of the rates on the schedule
    applies; 4) Describe frequency of pay arrangements, e.g., daily, weekly, biweekly; 5) Indicate
    deductions to be made from workers’ wages, such as Social Security, workers' compensation, health
    insurance, Federal or State tax. If applicable, note whether employer of record or farm labor contractor
    will be responsible for deductions.




                                                   - 10 -
•   Box 19 - Describe how the employer intends to reimburse transportation costs or advance or provide for
    the cost of transportation and subsistence, when such is the prevailing practice in the area. Describe in
    detail transportation arrangements, if any, such as: any arrangement whereby employer will provide
    transportation for workers from the place of recruitment to the place of employment; whether employers
    will reimburse workers for their travel expenses in getting to the job or arrange for charter by transport
    for group of workers; any arrangement whereby employers advance transportation costs to workers;
    instructions to workers on what to do in case of emergencies, accidents, breakdowns; and the name of
    the contact person when such events occur.

•   Box 20 – This box applies only if a farm labor contractor was ever used to provide you with workers or if
    it is a common or prevailing practice in the area of intended employment to pay farm labor contractors
    to recruit, hire, transport, or supervise the sorts of workers requested. If so, state the wage that you
    have paid in the past and/or would be willing to pay a farm labor contractor for providing you with the
    quantity of workers that you are requesting and performing the duties that are prevailing.

•   Box 21 - Indicate whether the employer pays unemployment insurance taxes and therefore the worker
    is covered for Unemployment Insurance benefits.

•   Box 22 - Indicate whether the employer has a valid workers’ compensation insurance policy that will
    cover the workers requested.

•   Box 23 - Indicate whether tools, supplies, and equipment are going to be provided to the worker at no
    cost to the worker.

•   Box 24 - Question is self explanatory.

•   Box 25 – Question is self explanatory.

•   Box 26 - Indicate whether this form is being filed in connection to a future filing for H-2A workers.

•   Box 27 - Read the employer's certification statement before signing. To be signed and dated by the
    employer. Type or print full name and title.

•   Box 28 - Use this section to provide additional supporting information (include section Box number) and
    include attachments, if necessary. / Utilice esta sección para proporcionar información adicional de
    apoyo; incluya el número de la sección e incluya archivos adjuntos, si es necesario.




                                                   - 11 -

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Agricultural and Food Processing Clearance Order
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