| CASE NUMBER | I-200-23272-393985 |
| CASE STATUS | Certified |
| RECEIVED DATE | 9/29/2023 |
| DECISION DATE | 10/6/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Senior Software Solutions Designer |
| SOC CODE | 15-1252.00 |
| SOC TITLE | Software Developers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/23/2024 |
| END DATE | 1/22/2027 |
| 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 | Jackson National Life Insurance Company |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1 Corporate Way |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Lansing |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 48951 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15173674710 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524113 |
| EMPLOYER POC LAST NAME | Davis |
| EMPLOYER POC FIRST NAME | William |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Business Consultant I |
| EMPLOYER POC ADDRESS1 | 1 Corporate Way |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Lansing |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 48951 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15173674599 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | william.davis@jackson.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Pacis |
| AGENT ATTORNEY FIRST NAME | Reginald |
| AGENT ATTORNEY MIDDLE NAME | A. |
| AGENT ATTORNEY ADDRESS1 | Butzel Long, a professional corporation |
| AGENT ATTORNEY ADDRESS2 | 150 W. Jefferson Avenue, Suite 100 |
| AGENT ATTORNEY CITY | Detroit |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 48226 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13139836929 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | pacis@butzel.com |
| LAWFIRM NAME BUSINESS NAME | Butzel Long, a professional corporation |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | MICHIGAN SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1 Corporate Way |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Lansing |
| WORKSITE COUNTY | INGHAM |
| WORKSITE STATE | MI |
| WORKSITE POSTAL CODE | 48951 |
| WAGE RATE OF PAY FROM | 123781 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $164,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $104,062.00 |
| 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 | 2 |
| 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 |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-11-01 |
