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Get DoL ETA 9141 2012

Instructions carefully before completing this form and print legibly. A copy of the instructions can be found at http://www.foreignlaborcert.doleta.gov/. A. Employment-Based Visa Information 1. Indicate the type of visa classification supported by this application (Write classification symbol): * B. Requestor Point-of-Contact Information 1. Contact’s last (family) name * 2. First (given) name * 3. Middle name(s) * 4. Contact’s job title * 5. Address 1 * 6. Address 2 7. City * 8. State *.

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