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　　9 9

　　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 _____________

　　?

　　0 0

　　? 50

　　?

　　?

　　?

　　?

　　?

　　11/30/2025

　　Perform prolonged walking, sitting, stooping, bending, reaching,pushing, pulling, lifting and

　　carrying of up to 50 lbs. Work in extremely hot, cold and/or wet weather

　　NONE

　　?

　　? 1 10

　　? ? ?

　　None

　　JO-A-300-23360-591594

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