| CASE NUMBER | I-200-24179-153852 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/27/2024 |
| DECISION DATE | 7/5/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Actuarial Associate |
| SOC CODE | 15-2011.00 |
| SOC TITLE | Actuaries |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 6/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| EMPLOYER NAME | Mutual of Omaha Insurance Company |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 3300 Mutual of Omaha Plaza |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Omaha |
| EMPLOYER STATE | NE |
| EMPLOYER POSTAL CODE | 68175 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +14023512564 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 5241 |
| EMPLOYER POC LAST NAME | Towles |
| EMPLOYER POC FIRST NAME | Susan |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Paralegal Specialist |
| EMPLOYER POC ADDRESS1 | 3300 MUTUAL OF OMAHA PLAZA |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | OMAHA |
| EMPLOYER POC STATE | NE |
| EMPLOYER POC POSTAL CODE | 68175 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +14023512564 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | susan.towles@mutualofomaha.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Peck |
| AGENT ATTORNEY FIRST NAME | Amy |
| AGENT ATTORNEY MIDDLE NAME | L. |
| AGENT ATTORNEY ADDRESS1 | 10050 Regency Cir |
| AGENT ATTORNEY ADDRESS2 | Ste 400 |
| AGENT ATTORNEY CITY | Omaha |
| AGENT ATTORNEY STATE | NE |
| AGENT ATTORNEY POSTAL CODE | 68114 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +14023911991 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | angie.baudler@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis PC |
| STATE OF HIGHEST COURT | NE |
| NAME OF HIGHEST STATE COURT | Nebraska Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 8 E. 9th Street |
| WORKSITE ADDRESS2 | Apt. 2610 |
| WORKSITE CITY | Chicago |
| WORKSITE COUNTY | COOK |
| WORKSITE STATE | IL |
| WORKSITE POSTAL CODE | 60605 |
| WAGE RATE OF PAY FROM | 117,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $79,040.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| 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 |
| PREPARER LAST NAME | Baudler |
| PREPARER FIRST NAME | Angie |
| PREPARER MIDDLE INITIAL | K. |
| PREPARER BUSINESS NAME | Jackson Lewis P.C. |
| PREPARER EMAIL | angie.baudler@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2024-01-07 |
