Employment Permit Application for 14- through 17-Year-Olds
Name of Minor: Name of Employer: Business Address: Job Title and primary duties: Number of hours per day Minor is to be employed: The undersigned agrees to
Minor (Ages 14 -17) Employment Permit Process - Mass.gov
Doctor must complete. Certificate of. Health section of Work. Permit Application. Minor must obtain School Record from school they last attended. Form can.
STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST
A “STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR A WORK PERMIT–CERTIFICATE OF AGE” form (CDE Form B1-1) shall be completed in accordance with
workpermit.pdf
The minor may then begin work. 5. Employer must return a copy of the completed work permit to the department within seven (7)
Application for Minors Work Permit
APPLICATION FOR MINOR WORK PERMIT. Name of Student / Applicant in full: Date Address of Student /Applicant's Place of Employment Job Site
Application for Work Permit (PDF)
To be completed by parent or guardian unless minor is a high school graduate (please attach proof of graduation). Signature of parent
Arkansas Department of Labor
NOTE: A WORK PERMIT IS NOT REQUIRED FOR A MINOR 16 YEARS OF AGE. HOWEVER REMINDER: Proof of age must be attached to application or permit will not be issued.
Completing an Employment Certificate (Youth Work Permit) for
Minor will access the minor application for a Youth Work Permit at this link: https://www.dol.state.ga.us/WS4-MW5/cics.jsp?TRANSID=WP17&FRMNAME=WP17. • The
PERMISSIBLE HOURS OF EMPLOYMENT FOR APPYING FOR A
Special permits may be issued to minors of any age to be employed as a model performer
PROCEDURES FOR OBTAINING A CHILD LABOR CERTIFICATE
Under the Hawaii Child Labor Law a child labor certificate or "work permit" is required for working minors until they reach 18 years of age. There is no
STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST
A “STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR A WORK PERMIT–CERTIFICATE OF AGE” form (CDE Form B1-1) shall be completed in accordance with
Application for Minor Work Permit
THE UNDERSIGNED HEREBY AGREES TO EMPLOY THE ABOVE NAMED CHILD IN ACCORDANCE WITH LAWS REGULATING THE. EMPLOYMENT OF MINORS. THE EMPLOYER FURTHER AGREES TO
Employment Permit Application for 14 through 17 Year-Olds
school official authorized to issue work permits do not need a signed work permit
statement of intent to employ a minor and request for work permit
STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR WORK PERMIT–. CERTIFICATE OF AGE. CDE B1-1 (Rev. 07-10) Special rules apply to agricultural work.
Arkansas Department of Labor
APPLICATION FOR EMPLOYMENT OF A. MINOR. Mail To: Arkansas Dept of Labor and Licensing NOTE: A WORK PERMIT IS NOT REQUIRED FOR A MINOR 16 YEARS OF AGE.
PERMISSIBLE HOURS OF EMPLOYMENT FOR APPYING FOR A
Special permits may be issued to minors of any age to be employed as a model performer
Maine.gov
During summer school vacation minors may have two active work permits. Permits should not be submitted until minors have the promise of a job. Work permits do
APPLICATION FOR MINOR WORK PERMIT
APPLICATION FOR MINOR WORK PERMIT. 3331 02 ORC. 4109 02 ORC. STUDENT / APPLICANT INFORMATION. Name of Student / Applicant in full: Sex: Grade Level:.
workpermit.pdf
3 Employer verifies minor's age agrees to keep a copy of the Employer submits work permit to Wage and Hour office. 3. The approved duties are returned ...
PROCEDURES FOR OBTAINING A CHILD LABOR CERTIFICATE
Under the Hawaii Child Labor Law a child labor certificate or "work permit" is required for working minors until they reach 18 years.
General
STATE OF CALIFORNIA DEPARTMENT OF EDUCATION
STATEMENT OF INTENT TO EMPLOY
AMINOR AND REQUEST FOR
AWORK PERMIT
CERTIFICATE OF AGE CDE Form B1-1 (Rev. 02-14)
A "STATEMENT OF INTENT
TO EMPLOY A MINOR AND REQUEST FOR
AWORK PERMIT
CERTIFICATE OF AGE
form ( CDE Form B11) shall be completed in accordance with California
Education Code
49162 and 49163 as notification of intent to
employ a minor. This form is also a Certificate of Age pursuant to CaliforniaEducation Code
49114.
(Print Information)Minor's Information
Minor's Name (First and Last) Home Phone Grade
Home Address City Zip Code
Birth Date
School Information
Social Security Number
Age Student's Signature
School Name School Phone
School Address City Zip Code
To be filled in and signed by parent or legal guardian This minor is being employed at the place of work described with my full knowledge and consent.I hereby certify that to the best of
my knowledge and belief, the information herein is correct and true. Parent's Name (Print First and Last) Parent's Signature Date
To be filled in and signed by employer
Business Name or Agency of
Placement
Business Phone Supervisor's Name
Business Address
City Zip Code
Employer"s Maximum Expected Work Hours: _________ hours per day ________ hours per weekDescribe nature of work to be performed:
In compliance with California labor laws, this employee is covered by workers compensation insurance. T his business does notdiscriminate unlawfully on the basis of race, ethnic background, religion, sex, sexual orientation, color, national origin, ancestry, age,
physical handicap, or medical condition. I hereby certify that, to the best of my knowledge, the information herein is correct and true. Employer's Name (Print First and Last) Employer's Signature DateFor authorized work permit issuer use ONLY
Maximum number of work hours when school is in session:Mon Tues Wed Thur Fri Sat Sun Total
______________________________________________Proof of Minor's
A ge (Evidence Type _____________________________________________Verifying Authority's Name and Title
(Print) ______________________________________________Verifying Authority's Signature
Maximum number of work hours when school is not in session:Mon Tues Wed Thur Fri Sat Sun Total
Check Permit Type:
Full timeRestricted
Work Experience
Education, Vocational
Education, or Personal
Attendant
Workability
For more information about child labor laws, contact the U.S. Department of Labor at http://www.dol.gov/, and the State of
California Department of Industrial Relations, Division of Labor Standards E nforcement at http://www.dir.ca.gov/DLSE/dlse.htmlquotesdbs_dbs11.pdfusesText_17[PDF] application for work permit made outside of canada
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