| CASE NUMBER | I-200-23347-565033 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/13/2023 |
| DECISION DATE | 12/20/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | STAFF DATA ENGINEER |
| SOC CODE | 15-1252.00 |
| SOC TITLE | Software Developers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/1/2024 |
| END DATE | 12/31/2026 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | 15Five Inc |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 305 Church at N Hills St |
| EMPLOYER ADDRESS2 | Suite 1150 |
| EMPLOYER CITY | Raleigh |
| EMPLOYER STATE | NC |
| EMPLOYER POSTAL CODE | 27609 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +18556615700 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 5415 |
| EMPLOYER POC LAST NAME | IVANIV |
| EMPLOYER POC FIRST NAME | NAZAR |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | CHIEF TECHNOLOGY OFFICER |
| EMPLOYER POC ADDRESS1 | 305 CHURCH AT N HILLS ST |
| EMPLOYER POC ADDRESS2 | SUITE 1150 |
| EMPLOYER POC CITY | RALEIGH |
| EMPLOYER POC STATE | NC |
| EMPLOYER POC POSTAL CODE | 27609 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +18556615700 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | nazar@15five.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | FRIDMAN |
| AGENT ATTORNEY FIRST NAME | NATALIA |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 2980 NE 207 ST |
| AGENT ATTORNEY ADDRESS2 | SUITE 507 |
| AGENT ATTORNEY CITY | AVENTURA |
| AGENT ATTORNEY STATE | FL |
| AGENT ATTORNEY POSTAL CODE | 33180 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +13052491202 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | natalia@fridmanlaw.net |
| LAWFIRM NAME BUSINESS NAME | LAW OFFICES OF NATALIA FRIDMAN P.A. |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | NEW YORK COURT OF APPEALS |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 100 SPRING ST |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | METUCHEN |
| WORKSITE COUNTY | MIDDLESEX |
| WORKSITE STATE | NJ |
| WORKSITE POSTAL CODE | 08840 |
| WAGE RATE OF PAY FROM | 170000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $200,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $169,229.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business and Employment |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-01 |
