| CASE NUMBER | I-200-24197-195704 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/15/2024 |
| DECISION DATE | 7/22/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Community Development Manager |
| SOC CODE | 11-1021.00 |
| SOC TITLE | General and Operations Managers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/24/2024 |
| END DATE | 7/23/2027 |
| 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 | Hampton Manor of Woodhaven LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 22125 Van Horn Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Woodhaven |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 48183 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +17348185100 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 623312 |
| EMPLOYER POC LAST NAME | Imran |
| EMPLOYER POC FIRST NAME | Shahid |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | CEO and Managing Director |
| EMPLOYER POC ADDRESS1 | 7560 River Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Flushing |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 48433 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +17344962906 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | hmwoodhaven@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Corigliano |
| AGENT ATTORNEY FIRST NAME | Dina |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 20E Vanderventer Ave. |
| AGENT ATTORNEY ADDRESS2 | Suite 105 |
| AGENT ATTORNEY CITY | Port Washington |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 11050 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +12127644222 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | dcorigliano@jeffries-law.com |
| LAWFIRM NAME BUSINESS NAME | Jeffries and Corigliano LLP |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 22125 Van Horn Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Woodhaven |
| WORKSITE COUNTY | WAYNE |
| WORKSITE STATE | MI |
| WORKSITE POSTAL CODE | 48183 |
| WAGE RATE OF PAY FROM | 70,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $56,181.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-12-07 |
