| CASE NUMBER | I-200-25008-604818 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/8/2025 |
| DECISION DATE | 1/16/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Quality Assurance Engineer III |
| SOC CODE | 15-1253.00 |
| SOC TITLE | Software Quality Assurance Analysts and Testers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/27/2025 |
| END DATE | 1/26/2028 |
| 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 | CMFG Life Insurance Company |
| TRADE NAME DBA | TruStage |
| EMPLOYER ADDRESS1 | 5910 Mineral Point Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Madison |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 53705 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16086658719 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 5241 |
| EMPLOYER POC LAST NAME | Ayers |
| EMPLOYER POC FIRST NAME | Maria |
| EMPLOYER POC MIDDLE NAME | Louise |
| EMPLOYER POC JOB TITLE | Law Specialist III |
| EMPLOYER POC ADDRESS1 | 5910 Mineral Point Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Madison |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 53705 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16086658719 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | maria.ayers@trustage.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Schaeffer, Jr. |
| AGENT ATTORNEY FIRST NAME | Gene |
| AGENT ATTORNEY MIDDLE NAME | Thomas |
| AGENT ATTORNEY ADDRESS1 | 1 E. Main Street |
| AGENT ATTORNEY ADDRESS2 | Suite 500 |
| AGENT ATTORNEY CITY | Madison |
| AGENT ATTORNEY STATE | WI |
| AGENT ATTORNEY POSTAL CODE | 53703 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16082573911 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | gschaeffer@gklaw.com |
| LAWFIRM NAME BUSINESS NAME | Godfrey & Kahn, S.C. |
| STATE OF HIGHEST COURT | WI |
| NAME OF HIGHEST STATE COURT | Wisconsin Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3029 Tophill Drive |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Celina |
| WORKSITE COUNTY | COLLIN |
| WORKSITE STATE | TX |
| WORKSITE POSTAL CODE | 75009 |
| WAGE RATE OF PAY FROM | $121,190.85 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $106,517.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| 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 | 2025-01-27 |
