OMB No. 1205-0309
Expiration Date: 01/31/2020
Employers’ Attestation to Use Alien Crewmembers for
Longshore Activities in U.S. Ports
Form ETA 9033
U.S. Department of Labor
Form
ETA 9033 FOR DEPARTMENT OF LABOR USE ONLY Page 3 of 4
Case Number: ________________ Case Status: __________________Validity Period: ______________ to _______________
GENERAL INSTRUCTIONS
IMPORTANT: Please read these instructions carefully before completing the form. These instructions contain full explanations of the questions and
attestations that make up the Form ETA 9033. In accordance with Federal Regulations, incomplete or obviously inaccurate applications will
not be accepted by the Department of Labor.
Form ETA 9033 with required accompanying documentation must be filed for each port. An employer may file an attestation only when there is no
collective bargaining agreement in effect in the local port covering at least 30 percent of the number of individuals employed in performing longshore
work. Submit the completed original Form ETA 9033 along with two copies of the form and two sets of accompanying documentation. Attestations
must be received by the Employment and Training Administration, Office of Foreign Labor Certification no later than 14 days before the first
performance of the longshore activity unless the employer is claiming an unanticipated emergency. Attestations must be submitted to the Office of
Foreign Labor Certification, Employment and Training Administration, U.S. Department of Labor, 11 West Quincy Court, Chicago, IL 60604-2105.
Anyone, who knowingly and willingly furnishes any false information in the preparation of Form ETA 9033 and any supporting documentation, or
aids, abets, or counsels another to do so is committing a federal offense, punishable by fine or imprisonment up to five years or both (18 U.S.C. §§
2, 1001). Other penalties apply as well to fraud or misuse of this immigration document and to perjury with respect to this form (18 U.S.C. §§ 1546,
1621).
Section A. Employer Information
1.
Enter full legal name of business, firm or organization, or if an
individual, enter name used for legal purposes on
documents.
2.
Enter the full trade name or “Doing Business As” (DBA)
name, if
applicable, of th
e business, person, association, firm, corporation,
or organization, i.e., the employer filing this applicat
ion.
3.
Enter the street address of the employer’s principal place of
business.
4.
If additional space is needed for the street address, use this line to
complete the employer’s street address.
5. Enter the city of the employer’s principal place of business. If the
city and country are the same, the name must still be entered in
both fields.
6.
Enter the state of the employer’s principal place of business.
7.
Enter the postal (zip) code of the employer’s principal place of
business.
8.
Enter the country of the employer’s principal place of business. If
the city and country are the same, the name must still be entered in
both fields.
9.
Enter the province of the employer’s principal plac
e of business, if
applicable.
10.
Enter the area code and telephone number for the employer’s
principal place of business. Include country code
, if applicable.
11.
Enter the e-mail address of the employer point of contact in th
e
format name
@em
ailaddress.top-level domain.
12. Enter name of the employer point of contact. An employer point of
contact is an employee of the employer whose position
authorizes
the emplo
yee to provide information and supporting documentation
concerning this Employer’s Attestation to Use Alien Crewmember
s
for Longsho
re Activities in U.S. Ports and to communicate with t
he
Departme
nt of Labor on behalf of the employer. The employer poi
nt
of contact should
be the individual most familiar with the content of
this application and circumstances of the foreign worker
’s
emplo
yment.
13.
Enter the job title of the employer
point of contact.
Sectio
n B. Employer’s U.S. Agent or Representative Information (if
applicable)
Note: The U.S. agent/representative information in this Section,
specifically the name, telephone number, and e-mail address, must be
different from the employer point of contact information in Section A.
1.
Enter the full name of the agent/representative.
2.
Enter the street address of the attorney/agent (add
ress must be a
U.S. address).
3.
Enter the city of the attorney/agen
t.
4.
Enter the state of the attorney/age
nt.
5.
Enter the postal (zip) code of the attorney
/agent.
6.
Enter the area code and telephone number of the attorney/agent.
7.
Enter the extension of the telephone number of the attorney/agent
,
if applicable.
8.
Enter the e-mail address of the attorney/agent.
Section C. Location and Job Information
1.
Enter the name of the port, and the city and state in wh
ich the port
is located.
2.
Enter the date on which the longshore activity will
begin.
3.
Check appropriate box if claiming an unanticipated emergenc
y.
4.
Enter an estimate of the total number of crewmembers that the
employer anticipates requesting for the activity s
pecified for this
attestation.
5.
Longshore work is defined as activity relating to (1) loading of
cargo, (2) unloading of cargo, (3) operation of cargo-related
equipment, and (4) handling of mooring lines on the dock when a
vessel is made fast or let go. The employer must check each
activity it intends the alien crewmembers to perform
.
Sectio
n D. Employer Attestation
An employer must attest to the conditions listed in elements 1 through 4.
The attestation will only be accepted for filing if the required
documentation supporting the first three elements is attached to the
Form ETA 9033. See §655.510(d) through (f) of the regulations for
guidance on the documentation that must be attached to the Form ETA
9033 to support each of the elements.
1.
Prevailing Practice. The employer must attest
that it is the
prevailing practice to use alien crewmembers for the particular
activity or activities of longshore work at U.S port where the
employer intends to employ alien
crewmembers.
2.
No Strike or Lockout; No Intention or Design to Influence
Bargaining Representative Election. The employer must attest that,
at the time of submitting the attestation, there is not a strike or
lockout in the course of labor dispute covering the employ
er’s
activity
, and that it will not use alien crewmember
s during a strike
or lockout after filing the attestatio
n. The employer must also attest
that the employment of such aliens is not
intended or designed to
influence an elec
tion for a bargaining representative for worker
s in
the local port.
3.
Notice of filing. The employer must attest that at
the time of filing
the attestation, notice of filing has been provided to the bargaining
representative of the longshore workers in the local port, or, where
there is no such bargaining representative, notice of filing has been
provided to the port authority for distribution to the public on
request and to the longshore workers employed at the local port
through a posting in conspicuous locations. The notice must
comply with the requirements of 20 CFR 655.10(f). . The employer
must check the appropriate box u
nder D.3.
4.
In order to be eligible to use alien crewmembers for longshor
e
activit
ies at a U.S. port, an employer must attest that there is no
collective bargaining agreement in effect in the lo
cal port covering
at least 30 percent of individuals
employed in performing longshor
e
w
ork. An employer is not required to submit documentation to
support this condition.
