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　　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 extremetemperatures

　　? 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 additionalspace is needed. If no additional skills or requirements, enter NONEbelow)

　　C. Place of Employment Information

　　1. Place of Employment Address/Location *

　　2. City * 3. State * 4. Postal Code * 5. County *

　　6. Additional Place of Employment Information. (If no additionalinformation, enter NONE below) *

　　7. Is a completed Addendum B providing additional information on theplaces of employment and/or

　　agricultural businesses who will employ workers, or to whom the employerwill be providing workers,

　　attached to this job order? *

　　? Yes ? N/A

　　D. Housing Information

　　1. Housing Address/Location *

　　2. City * 3. State * 4. Postal Code * 5. County *

　　6. Type of Housing (check only one) *

　　? Employer-provided ? Rental or public

　　(including mobile or range)

　　7. Total Units * 8. Total Occupancy *

　　9. Identify the entity that determined the housing met all applicablestandards: *

　　? Local authority ? SWA ? Other State authority ? Federal authority ?Other (specify): _________________

　　10. Additional Housing Information. (If no additional information,enter NONE below) *

　　11. Is a completed Addendum B providing additional information onhousing that will be provided to

　　workers attached to this job order? * ? Yes ? N/A

　　Form ETA-790A FOR DEPARTMENT OF LABOR USE ONLY Page 2 of 8

　　H-2A Case Number: ____________________ Case Status:__________________ Determination Date:_____________ Validity Period: _____________to _____________

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　　1 0

　　? 50

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　　11/30/2025

　　Exposure to extreme temp, lifting 50 lbs, repetitive movements,extensive pushing and pulling,

　　extensive walking, frequent stooping.

　　NONE

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　　? 2 8

　　? ? ? ?

　　NONE

　　No tenancy in employer-provided housing is created by this arrangement.The employer retains possession

　　and control of the housing premises at all times. Workers providedhousing under the terms of this Clearance

　　Order shall vacate the housing promptly upon termination of employmentwith the employer.

　　JO-A-300-24010-630099

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