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OMB Approval: Expiration Date:

Agricultural Clearance Order Form ETA-790

U.S. Department of Labor

Form ETA-790 AGRICULTURAL CLEARANCE ORDER Page 1 of 1

IMPORTANT: In accordance with 20 CFR 653.500, all employers seeking U.S. workers to perform agricultural services or labor on a temporary, less than year-round basis through the Agricultural Recruitment System for U.S. Workers, must submit a completed job clearance order (Form ETA-790) to the State Workforce Agency (SWA) for placement on its intrastate and interstate job clearance systems. Employers submitting a job order in connection with an H-2A Application for Temporary Employment Certification (Form ETA-9142A) must complete the Form ETA-790 and attach a completed ETA-790A. All other employers submitting agricultural clearance orders must complete the Form ETA-790 and attach a completed ETA-790B. Employers and authorized preparers must read the general instructions carefully, complete ALL required fields/items containing an asterisk ( * ), and any fields/items where a response is conditional as indicated by the section ( ) symbol.

I. Clearance Order Information

FOR STATE WORKFORCE AGENCY (SWA) USE ONLY Questions 1 through 17

1. Clearance Order Number * 2. Clearance Order Issue Date * 3. Clearance Order Expiration Date *

4. SOC Occupation Code * 5. SOC Occupation Title *

SWA Order Holding Office Contact Information 6. Contacts last (family) name * 7. First (given) name * 8. Middle name(s)

9. Contacts job title *

10. Address 1 *

11. Address 2 (suite/floor and number)

12. City * 13. State * 14. Postal code *

15. Telephone number * 16. Extension 17. Email address *

II. Employer Contact Information 1. Legal Business Name *

2. Trade Name/Doing Business As (DBA), if applicable

3. Contacts last (family) name * 4. First (given) name * 5. Middle name(s)

6. Contacts job title *

7. Address 1 *

8. Address 2 (suite/floor and number)

9. City * 10. State * 11. Postal code *

12. Telephone number * 13. Extension 14. Business email address *

15. Federal Employer Identification Number (FEIN from IRS) * 16. NAICS Code *

III. Type of Clearance Order 1. Indicate the type of agricultural clearance order being placed

with the SWA for recruitment of U.S. workers. (choose only one) *

? 790A (placed in connection with an H-2A application) ? 790B (not placed in connection with an H-2A application)

For Public Burden Statement, see the Instructions for Form ETA-790/790A.

Vermont

Allen Brothers, Inc

Allen Brothers, Inc

Allen Stacey

Co-Owner

6023 US Route 5

Westminster Vermont 05158

+1 (802) 722-3395 stacey@allenbrothersfarm.com

03-0205043 1112

?

1/31/2026 1205-0562

OMB Approval: Expiration Date:

H-2A Agricultural Clearance Order Form ETA-790A

U.S. Departmen

t of Labor

Form ETA-790A FOR DEPARTMENT OF LABOR USE ONLY Page 1 of 8

H-2A Case Number: ____________________ Case Status: __________________ Determination Date: _____________ Validity Period: _____________ to _____________

A. Job Offer Information

1. Job Title *

2. Workers Needed *

a. Total b. H-2A Workers Period of Intended Employment

3. First Date * 4. Last Date * 5. Will this job generally require the worker to be on-call 24 hours a day and 7 days a week? *

If Yes, proceed to question 8. If No, complete questions 6 and 7 below. ? Yes ? No

6. Anticipated days and hours of work per week (an entry is required for each box below) * 7. Hourly Work Schedule *

a. Total Hours c. Monday e. Wednesday g. Friday a. ____ : ____? AM ? PM

b. Sunday d. Tuesday f. Thursday h. Saturday b. ____ : ____ AM ? PM

Temporary Agricultural Services and Wage Offer Information 8a. Job Duties - Description of the specific services or labor to be performed. *

(Please begin response on this form and use Addendum C if additional space is needed.)

8b. Wage Offer *

\$ _____ .___

8c. Per *

? HOUR ? MONTH

8d. Piece Rate Offer

\$ ______.___

8e. Piece Rate Units / Estimated Hourly Rate / Special Pay Information

9. Is a completed Addendum A providing additional information on the crops or agricultural activities to be performed and wage offers attached to this job offer? *

? Yes ? N/A

10. Frequency of Pay: * ?Weekly ? Biweekly ? Other (specify): ___________________________________

11. State all deduction(s) from pay and, if known, the amount(s). * (Please begin response on this form and use Addendum C if additional space is needed.)

Farmworkers & Laborers & Agricultural Equipment Operator

6 6 2/24/2026 12/1/2026 ?

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