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ETA FORM 9141 - PREVAILING WAGE DETERMINATION EDIT MODE
Case #: | Employer:
Job Title: | Location: , | Wage:
A. CASE INFORMATION (Editable)
Case Number
Case Status
Visa Type
Visa Class
Date Received
Date of Determination
PWD Expiration Date
Date Redetermination
Date Withdrawal
Date Center Review
B. EMPLOYER INFORMATION (Editable)
Legal Business Name
Trade Name/DBA
FEIN
NAICS
Address 1
Address 2
City
State
Zip
Country
Province
Phone
Ext
E. JOB OPPORTUNITY & PRIMARY WORKSITE (Editable)
Job Title
Supervisor Job Title
Supervise Others
Travel Req
Primary Worksite Address 1
Primary Worksite Address 2
City
State
County
Zip
Job Duties
I. PREVAILING WAGE DETERMINATION (Editable)
PWD Wage Rate
Unit of Pay
OES Wage Level
Wage Source
Wage Source Requested
BLS Area
Survey Name
Survey Publication Date
Prev Wage Determ Date
⚠️ Note: Full EspoCRM API integration coming soon. Currently showing editable interface. Remaining sections (Attorney, Education, SOC Codes, etc.) will be added in next iteration.