| CASE NUMBER | I-200-25021-630738 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/21/2025 |
| DECISION DATE | 1/28/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Optometrist |
| SOC CODE | 29-1041.00 |
| SOC TITLE | Optometrists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 3/10/2025 |
| END DATE | 3/9/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Katahdin Valley Health Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 529 S Patten Rd |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Patten |
| EMPLOYER STATE | ME |
| EMPLOYER POSTAL CODE | 4765 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12075282285 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Kyllonen |
| EMPLOYER POC FIRST NAME | Carrie |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Human Resources Director |
| EMPLOYER POC ADDRESS1 | 529 S Patten Rd |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Patten |
| EMPLOYER POC STATE | ME |
| EMPLOYER POC POSTAL CODE | 4765 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12075383700 |
| EMPLOYER POC PHONE EXT | 355 |
| EMPLOYER POC EMAIL | carrie.kyllonen@kvhc.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Jaynes |
| AGENT ATTORNEY FIRST NAME | Marcus |
| AGENT ATTORNEY MIDDLE NAME | B |
| AGENT ATTORNEY ADDRESS1 | 90 Bridge Street |
| AGENT ATTORNEY ADDRESS2 | Ste 104 |
| AGENT ATTORNEY CITY | Westbrook |
| AGENT ATTORNEY STATE | ME |
| AGENT ATTORNEY POSTAL CODE | 4092 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | MAINE |
| AGENT ATTORNEY PHONE | 12077756371 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | mbj@landisarn.com |
| LAWFIRM NAME BUSINESS NAME | Landis Arn & Jaynes, P.A. |
| STATE OF HIGHEST COURT | ME |
| NAME OF HIGHEST STATE COURT | Maine Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 5 Lake St |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Lincoln |
| WORKSITE COUNTY | LINCOLN TOWN |
| WORKSITE STATE | ME |
| WORKSITE POSTAL CODE | 4457 |
| WAGE RATE OF PAY FROM | $140,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $72,717.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 | 2025-03-10 |
