| CASE NUMBER | I-200-24353-553994 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/18/2024 |
| DECISION DATE | 12/27/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Manager, Systems Development & Maintenance |
| SOC CODE | 11-3021.00 |
| SOC TITLE | Computer and Information Systems Managers |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/20/2025 |
| END DATE | 1/19/2028 |
| 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 | Medical Mutual of Ohio |
| TRADE NAME DBA | Medical Mutual of Ohio |
| EMPLOYER ADDRESS1 | 100 American Rd. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Brooklyn |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 44144 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12166877000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Shinn |
| EMPLOYER POC FIRST NAME | Lydia |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Director, Talent Acquisition |
| EMPLOYER POC ADDRESS1 | 100 American Rd. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Brooklyn |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 44144 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12166877802 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | lydia.shinn@medmutual.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Oza |
| AGENT ATTORNEY FIRST NAME | Rishi |
| AGENT ATTORNEY MIDDLE NAME | P |
| AGENT ATTORNEY ADDRESS1 | 1101 Slater Rd |
| AGENT ATTORNEY ADDRESS2 | Suite 205 |
| AGENT ATTORNEY CITY | Durham |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27703 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12168614414 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | roza@brown-immigration.com |
| LAWFIRM NAME BUSINESS NAME | Robert Brown LLC |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | North Carolina Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 100 American Rd. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Brooklyn |
| WORKSITE COUNTY | CUYAHOGA |
| WORKSITE STATE | OH |
| WORKSITE POSTAL CODE | 44144 |
| WAGE RATE OF PAY FROM | $156,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $143,811.00 |
| 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 and Employment |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-01-20 |
