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OMB Approval 1205-0509 Expiration Date 03/31/2016 H-2B Application for Temporary Employment Certification ETA Form 9142B APPENDIX B U.S. Department of Labor For Use in Filing Applications Under the H-2B Non-Agricultural Program ONLY A. Attorney or Agent Declaration I hereby certify that I am an employee of or hired by the employer listed in Section C of the ETA Form 9142B and that I have been designated by that employer to act on its behalf in c.

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