| CASE NUMBER | I-202-24003-610757 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/2/2024 |
| DECISION DATE | 1/9/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B1 Sing |
| JOB TITLE | Visiting Pastor |
| SOC CODE | 21-2011.00 |
| SOC TITLE | Clergy |
| FULL TIME POSITION | Y |
| BEGIN DATE | 3/1/2024 |
| END DATE | 2/28/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Living Word Christian Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 9201 75th Avenue North |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Brooklyn Park |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 55428 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17633157000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 813110 |
| EMPLOYER POC LAST NAME | Williamson |
| EMPLOYER POC FIRST NAME | Barb |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Human Resources Manager |
| EMPLOYER POC ADDRESS1 | 9201 75th Avenue North |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Brooklyn Park |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 55428 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17633157141 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | bwilliamson@lwcc.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Long |
| AGENT ATTORNEY FIRST NAME | Sari |
| AGENT ATTORNEY MIDDLE NAME | Michelle |
| AGENT ATTORNEY ADDRESS1 | 1144 15th Street |
| AGENT ATTORNEY ADDRESS2 | Suite 3400 |
| AGENT ATTORNEY CITY | Denver |
| AGENT ATTORNEY STATE | CO |
| AGENT ATTORNEY POSTAL CODE | 80202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13036073637 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | sari.long@faegredrinker.com |
| LAWFIRM NAME BUSINESS NAME | Faegre Drinker Biddle & Reath LLP |
| STATE OF HIGHEST COURT | CO |
| NAME OF HIGHEST STATE COURT | Colorado Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 9201 75th Avenue North |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Brooklyn Park |
| WORKSITE COUNTY | HENNEPIN |
| WORKSITE STATE | MN |
| WORKSITE POSTAL CODE | 55428 |
| WAGE RATE OF PAY FROM | 46072 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $46,072.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | N/A |
| WILLFUL VIOLATOR | N/A |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-03 |
