OMB Approval No.: 1205-0457
Expiration Date: 02/28/2019
Foreign Labor Certification Quarterly Activity Report
ETA Form 9127
U.S. Department of Labor
State Name: _________________________ Preparer Name: _______________________Fiscal Year: __________
Report for (c
heck one): ______ (Q1 - Oct-Dec) ______ (Q2 - Jan-Mar) ______ (Q3 - Apr-Jun) ______ (Q4 - Jul-Sep)
H-2B Workload
H-2B REGULAR
1. Total number of active job orders from previous report
2. Total number of new job orders received
3. Total number of job orders processed
4. Total number of SWA staff assisted intrastate referrals
5. Total number of SWA staff assisted interstate referrals
6. Total number of interstate job orders transmitted to other SWAs
7. Total number of interstate job orders received from other SWAs
8. Total number of union contacts made
9. Total number of active job orders remaining at the end of the quarter
10. List the most common deficiencies noted on job orders.
11. Provide comments or other issues noted during quarter.
H-2A Workload
H-2A REGULAR
1. Total number of active job orders from previous report
2. Total number of new job orders received
3. Total number of job orders processed
4. Total number of SWA staff assisted intrastate referrals
5. Total number of SWA staff assisted interstate referrals
6. Total number of interstate job orders transmitted to other SWAs
7. Total number of interstate job orders received from other SWAs
8. Total number of active job orders remaining at the end of the quarter
9. Total number of prevailing wage surveys completed
10. Total number of employment practice surveys completed
11. Total number of housing inspections completed by SWA staff
12 Total number of housing inspections completed by alternative method
13. Total number of sleeping units inspected
14. Total capacity of sleeping units inspected
15. Total number of housing self-certifications received from employers
16. List the most common deficiencies noted on job orders.
17. Provide comments or other issues noted during quarter.
Public Burden Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid
OMB control number. Public reporting burden for this collection of information is estimated to average 2 hours per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The
obligation to respond to this collection is mandatory (20 CFR 653.112) Send comments regarding the burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Foreign Labor Certification, Room C-4312, 200
Constitution Avenue, NW, Washington, D.C. 20210, or by email to
ETA.OFLC.Forms@dol.gov and reference the OMB Control Number 1205-0457. Note:
Please do not return the completed ETA-9127 form to this address.
