| CASE NUMBER | I-200-25066-755429 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/7/2025 |
| DECISION DATE | 3/14/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | ESL Teacher |
| SOC CODE | 25-3011.00 |
| SOC TITLE | Adult Basic Education, Adult Secondary Education, and English as a Second Language Instructors |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/1/2025 |
| END DATE | 8/31/2028 |
| 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 | Olivet Academy |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 425 Morse Hill Rd |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Amenia |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 12501 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18452870200 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 611110 |
| EMPLOYER POC LAST NAME | Khor |
| EMPLOYER POC FIRST NAME | Jen Yan |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Head of School |
| EMPLOYER POC ADDRESS1 | 425 Morse Hill Rd |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Amenia |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 12501 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18452870200 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | jenyank@olivetacademy.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Anderson |
| AGENT ATTORNEY FIRST NAME | Yen Yi |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 61 Broadway |
| AGENT ATTORNEY ADDRESS2 | Suite 2809 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10006 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16464529982 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | y.anderson@aalawpc.com |
| LAWFIRM NAME BUSINESS NAME | Anderson and Associates Law PC |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Appellate Division |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 425 Morse Hill Rd |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Amenia |
| WORKSITE COUNTY | DUTCHESS |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 12501 |
| WAGE RATE OF PAY FROM | $52,416.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $52,417.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $52,416.00 |
| 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 and Employment |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-09-01 |
