Statement of Intent to Employ Minor and Request for Work Permit Template Access Statement of Intent to Employ Minor and Request for Work Permit Editor Now

Statement of Intent to Employ Minor and Request for Work Permit Template

The Statement of Intent to Employ Minor and Request for Work Permit form is a crucial document for young individuals seeking employment before reaching adulthood. This form ensures that the employment of minors complies with legal standards, safeguarding their rights and well-being. For those ready to take the step towards gaining work experience, filling out this essential form is the first action to take—click the button below to start the process.

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Table of Contents

Navigating the legal landscape of youth employment can often seem daunting. Both employers and young workers are required to adhere to specific regulations designed to ensure the safety, welfare, and educational opportunities for minors. In this context, the Statement of Intent to Employ Minor and Request for Work Permit form emerges as a crucial document. This form serves multiple purposes; it is not only a declaration by employers of their intent to hire a young person but also acts as an application for the necessary legal authorization for minors to engage in work. Key sections of this form require information about the minor’s personal details, the prospective job description, hours of work, and a signature from a legal guardian or parent acknowledging the work engagement. Additionally, it demands a certification by the minor’s school, indicating that the employment will not adversely affect their education. This process underscores a collective responsibility towards maintaining a balance between work and education for minors, aiming to protect minors’ rights while fostering a healthy work environment.

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Statement of Intent to Employ Minor and Request for Work Permit

Not a work permit —Print all information except signatures

For Minor to Complete

 

Write number in after printing

 

 

 

 

 

 

 

 

 

Minor’s name (last name first)

 

Social security number

Date of birth

Age

Grade

 

 

 

 

 

Street address

City

ZIP Code

Home telephone

 

 

 

 

 

 

 

School name

 

 

 

 

 

 

 

 

 

 

Street address

City

ZIP Code

School telephone

 

For Employer to Complete (Please review rules for employment of minors on reverse.)

Name of business

Street address

City

ZIP Code

Business telephone

 

 

 

 

Minor’s work duties

 

 

Hourly wage

Maximum number of hours of employment when school is in session:

Mon.

 

Tues.

 

Wed.

 

Thurs.

 

Fri.

 

Sat.

 

Sun.

 

Weekly = 0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

In compliance with California labor laws, this employee is covered by worker’s compensation insurance. This business does not discriminate 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.

Supervisor’s signature

Supervisor’s name (print or type)

For Parent or Guardian to Complete

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, the information herein is correct and true. I request that a work permit be issued.

In addition to this employer, my child is working for:

Name of business

Signature of parent or legal guardian

Date

 

 

For School to Complete

Type: Regular

Evidence of minor’s age

Vacation

Year-Round

Signature of verifying authority

Work Experience Education

Other (specify)

CALIFORNIA DEPARTMENT OF EDUCATION FORM B1-1 (revised 6/03)

IMPORTANT: See reverse side for additional information.

General Summary of Minors’ Work Regulations

If federal laws, state laws and school district policies conflict, the more restrictive law (the one most protective of the employee) prevails.

Generally, minors must attend school until age 18 unless they are 16 years or older and have graduated from high school or received a state Certificate of Proficiency.

Employers of minors required to attend school must complete a “Statement of Intent to Employ Minor and Request for Work Permit” (form B1-1) for the school district of attendance for each such minor.

Employers must retain a “Permit to Employ and Work” (form B1-4) for each such minor.

Work permits (B1-4) must be retained for three years and be available for inspection by sanctioned authorities at all times.

A work permit (B1-4) must be revoked whenever the issuing authority determines the employment is illegal or is impairing the health or education of the minor.

Minors under the age of 18 may not work in environments declared hazardous or dangerous for young workers as listed below:

1.Explosive exposure

2.Motor vehicle driving/outside helper

3.Coal mining

4.Logging and sawmilling

5.Power-driven woodworking machines

6.Radiation exposure

7.Power-driven hoists/forklifts

8.Power-driven metal forming, punching, and shearing machines

9.Other mining

10.Power-driven meat slicing/processing machines

11.Power-baking machines

12.Power-driven paper products/paper bailing machines

13.Manufacturing brick, tile products

14.Power saws and shears

15.Wrecking, demolition

16.Roofing

17.Excavation operation

For more complete information about hazardous occupations, contact the U.S. Department of Labor (Child Labor Bulletins 101 and 102) and the California Department of Industrial Relations, Division of Labor Standards Enforcement. Regional offices are located in several California cities. They are listed in the “Government Listings” sections of telephone directories.

Minors younger than 16 years are allowed to work only in limited, specified occupations that exclude baking, manufacturing, processing, construction, warehouse, and transportation occupations.

In addition to safety regulations, labor laws applicable to adult employees also generally apply to minor employees, including workers’ compensation insurance requirements.

Child labor laws do not generally apply to minors who deliver newspapers or work at odd jobs, such as yard

work and baby-sitting, or in private homes where the minor is not regularly employed.

A day of rest from work is required if the total hours worked per week exceed 30 or if more than 6 hours are worked on any one day during the week.

Ages

Hours of Work

16 – 17 When school is in session: Daily maximum of 4 hours, Monday through Thursday. May work up to 8 hours on any non-school day or on any day that precedes a non-school day. May be permitted to work up to 48 hours per week. Students in Work Experience Education or cooperative vocational education programs may be permitted to work a maximum of 8 hours on a school day.

When school not in session: May work up to 48 hours per week but no more than 8 hours in any one day.

Work must be performed no earlier than 5 a.m. or later than 10 p.m. except that work may extend to 12:30 a.m. on nights preceding non- school days. Students in Work Experience Education or cooperative vocational education programs may be authorized to work until 12:30 a.m. on nights preceding school days with specified written permission.

14 – 15 When school is in session: On school days daily maximum 3 hours. On non-school days may work 8 hours. Weekly maximum of 18 hours. Students in Work Experience Education and career exploration programs may work up to 23 hours per week.

When school is not in session: Daily maximum 8 hours and weekly maximum 40 hours.

May not work during public school hours except students in Work Experience Education or career exploration programs.

Work must be performed no earlier than 7 a.m. nor later than 7 p.m. any day of the week. From June 1 to Labor Day work hours may be extended to 9 p.m.

Younger Labor laws generally prohibit nonfarm than 14 employment of children younger than 14.

Special rules apply to agricultural work, domestic work and the entertainment industry.

Form Breakdown

Fact Name Detail
Purpose Serves as formal documentation to declare an employer’s intention to hire a minor and to request the necessary work permit.
Applicability Required for employers in certain states when hiring individuals under the age of 18 to ensure compliance with child labor laws.
State-Specific Variations While many states use a similar form, each state may have its own specific version, governed by local labor laws.
Governing Laws Typically governed by each state’s Department of Labor or equivalent, following the Fair Labor Standards Act on a federal level.

Guidelines on Filling in Statement of Intent to Employ Minor and Request for Work Permit

After a minor finds employment, the next step is to legally secure their right to work. This process involves completing the Statement of Intent to Employ Minor and Request for Work Permit form. This document is crucial as it formalizes the employment arrangement and ensures that all parties comply with labor laws designed to protect young workers. Below are the step-by-step instructions to correctly fill out the form.

  1. Start by gathering all necessary information, including the minor's personal information (full name, date of birth), the employer's details (company name, address), and the specifics of the job (job title, duties, hours of work).
  2. Enter the minor's full name, date of birth, and social security number in the designated fields at the top of the form.
  3. Fill in the address and contact information of the minor, including their phone number and email address.
  4. Next, provide details about the employer, such as the company's name, address, and the supervisor's contact information.
  5. Describe the job the minor will be performing, including the job title, duties, and the department or location where the work will take place.
  6. Specify the salary or wage the minor will be receiving, alongside the proposed hours and schedule, including start and end times for each workday.
  7. The parent or guardian must read the Parent's Statement section, which outlines the commitment to the minor's education and well-being, and sign to give their consent.
  8. The employer is required to sign the form, agreeing to abide by child labor laws and confirming that the work does not involve any prohibited duties for minors.
  9. The minor then signs the form, affirming their intention to work under the conditions laid out and acknowledging their responsibility to maintain their education.
  10. Finally, submit the completed form to the minor's school or the appropriate issuing office, where a school official will review it. If everything is in order, they will issue the Work Permit.

Once the form is submitted and reviewed by the school official or issuing authority, the minor and the employer will be notified of the permit's status. If approved, the minor is legally allowed to start working under the conditions specified in the permit. It's essential to keep a copy of the completed form and the work permit for records and future reference. Both the employer and the minor should be aware of any restrictions or limitations stated in the permit to ensure compliance with labor laws.

Learn More on Statement of Intent to Employ Minor and Request for Work Permit

What is a Statement of Intent to Employ Minor and Request for Work Permit form?

The Statement of Intent to Employ Minor and Request for Work Permit form is a legal document required for individuals under the age of 18 who wish to work in the United States. This form must be completed and submitted to obtain a work permit, officially known as a Certificate of Employment. The form gathers detailed information about the prospective employment, including the minor's personal information, the employer's details, and the specifics of the job offer, such as hours of work and duties.

Who needs to complete the form?

The form must be filled out by both the minor seeking employment and the prospective employer. Initially, the minor completes their portion, providing personal information and educational status. Subsequently, the employer fills out their section, detailing the job's specifics including nature of work, wages, and work hours. Completion of the form requires the endorsement of the minor's parent or legal guardian to ensure they are aware and approve of the employment opportunity.

Where can I obtain the form?

The form is typically available from a few key sources:

  • Schools: The minor’s school, usually through a career center or guidance counselor’s office, can provide the form.
  • Department of Labor: Either through their website or a local office, depending on the state.
  • Online: Some states or organizations might offer a downloadable PDF of the form on their websites.
It's important to ensure that the form is specific to the state where the minor will be employed, as requirements can vary.

How is the form submitted?

After the form has been filled out and signed by all necessary parties (the minor, the employer, and the minor’s parent or guardian), it must be submitted to the appropriate authority. This can vary but is generally one of the following:

  1. The minor's school: The school then processes the form and issues the work permit.
  2. A state labor department or designated office: In some cases, the form is submitted directly to the labor department or a specific office tasked with issuing work permits for minors.
The issuing body will review the application for compliance with state labor laws before issuing the work permit.

Are there any restrictions on the type of work and hours for a minor?

Yes, both federal and state laws impose restrictions on the types of jobs minors can perform and the hours they are allowed to work, with the specifics varying by age. Generally, these laws are designed to ensure that work does not interfere with a minor’s education and is not hazardous. For example, individuals under 16 are typically not allowed to work in manufacturing or mining, or during school hours. Older minors may have slightly more flexibility but still face restrictions on working hours during the school year. Employers must comply with these regulations when offering employment to minors.

What happens after the work permit is issued?

Once the work permit is issued, the minor is allowed to start their employment under the conditions specified in the permit. The employer should keep a copy of the permit on file. It's important to note that the work permit can be revoked if the employment is found to be in violation of labor laws, such as non-compliance with the permitted hours of work or the nature of employment being hazardous. Both the employer and the minor should ensure ongoing compliance with all relevant labor laws and regulations to maintain the validity of the work permit.

Common mistakes

When completing the Statement of Intent to Employ Minor and Request for Work Permit form, many people overlook key details or make mistakes that can hinder the process. It's important to approach this form carefully to ensure that minors are permitted to work in accordance with local laws. Here are nine common mistakes to be mindful of:

  1. Not reviewing the entire form before starting: Many people jump straight into filling out the form without first reviewing all the sections. This can lead to missing critical information that is required later on.

  2. Incorrect information: Sometimes there's a rush to complete the form, which leads to typos or incorrect information. Every piece of information, from the minor’s name and date of birth to the employer's contact details, must be accurate.

  3. Leaving sections blank: It’s common to encounter sections that may seem irrelevant but skipping any part of the form can result in processing delays. If a section does not apply, it’s better to enter “N/A” than to leave it blank.

  4. Failure to obtain necessary signatures: The form typically requires signatures from the minor, the parent or guardian, and the employer. Forgetting any of these signatures can invalidate the entire request.

  5. Not checking local laws and regulations: The requirements for employing minors can vary greatly by location. Not checking local laws and regulations related to work permits can lead to legal issues later on.

  6. Omitting details about the work schedule and duties: Specifics about the minor's work duties and schedule are often required to assess the request's legality and suitability. Failing to provide detailed information can cause unnecessary back-and-forth.

  7. Using outdated forms: Government forms are updated periodically. Using an outdated version of the form can result in automatic rejection.

  8. Not providing supplemental documents: Sometimes, additional documents are required alongside the form. Overlooking or assuming they aren’t needed without double-checking can delay the process.

  9. Forgetting to check for specific state or local requirements: In addition to the general form, some states or municipalities may have additional requirements or forms that need to be completed. Failing to include these can mean your application is incomplete.

Being diligent, detailed, and informed are key aspects of successfully completing the Statement of Intent to Employ Minor and Request for Work Permit form. Taking the time to avoid these common mistakes can make the process smoother for everyone involved.

Documents used along the form

When a minor is gearing up to enter the workforce, there's a significant step to take that involves more than just ambition and finding the right job: paperwork. Among the essential documents is the Statement of Intent to Employ Minor and Request for Work Permit form, a crucial piece that kickstarts the employment process for young workers. This form, however, is often just one piece of a larger puzzle. To complete the picture, there are several additional forms and documents that are frequently needed. Let's dive into what these are and what they represent.

  • Proof of Age: Whether it's a birth certificate, passport, or state ID, employers need to verify a minor's age to ensure they comply with labor laws.
  • Parental Consent Form: This document is a parent or guardian's written approval for their child to work. It's a key part of safeguarding the rights and well-being of the minor in the workplace.
  • School Authorization Form: To balance education and work, schools may need to give the green light, ensuring that employment does not interfere with a minor's schooling.
  • Pre-Employment Physical Examination Form: Some jobs may require a physical to ensure the minor is fit for the tasks they will undertake, especially if the job requires manual labor.
  • Emergency Contact Information: Employers should always have a record of who to contact in the event of an emergency involving the minor employee.
  • Social Security Card: Needed for payroll purposes, this is essential for tax reporting and verification of the employee's legal right to work in the United States.
  • Training Certificates: If the job requires specific skills or safety knowledge, certificates from completed training courses may need to be presented.
  • School Records: Certain jobs or internships might ask for a minor's school records to confirm they are a student and to gauge their ability to balance work and school responsibilities.

Entering the workforce as a minor is an exciting step towards independence and responsibility. However, it's accompanied by a significant responsibility for both the minor and their employer to ensure all legal and safety requirements are met. These forms and documents, together with the Statement of Intent to Employ Minor and Request for Work Permit form, create a framework that supports a young worker's journey in the workforce, ensuring their rights are protected and their work experience is positive and lawful.

Similar forms

When discussing the paperwork associated with employing minors, it's essential to understand the Statement of Intent to Employ Minor and Request for Work Permit form. This document is crucial in the employment process for minors, ensuring that the work they undertake is suitable and does not interfere with their education or well-being. There are several other documents, similar in nature, that serve parallel purposes in different contexts. Here are six documents that share similarities:

  • Employment Eligibility Verification (Form I-9): Like the work permit form, the I-9 form is a staple in the hiring process, ensuring that employees are legally allowed to work in the United States. Both forms verify the individual's eligibility for work, though the I-9 focuses on authorization regardless of age.
  • Child Actor Work Permit: Various states require child actors to obtain a specific work permit, much like the general work permit for minors. These specialized permits ensure the child's education is not disrupted by their employment in the entertainment industry.
  • Employment Application: This is a standard form for job seekers, highlighting their qualifications and experience. Similar to the Statement of Intent to Employ Minor, it's a preliminary step in the hiring process, though it is used for candidates of all ages.
  • Minor’s Release Agreement: Often used in contexts where minors will be photographed, filmed, or otherwise recorded, this document is similar to a work permit in that it requires parental consent. It ensures the minor’s legal guardians agree to the terms of their child’s participation and employment.
  • Volunteer Agreement Forms for Minors: These documents are necessary when a minor wishes to volunteer, especially in roles that could pose risk. They require parental consent, like the work permit, and ensure that the volunteer work is appropriate for the minor’s age.
  • Apprenticeship Agreement Forms: These forms are used when a minor enters an apprenticeship. They outline the terms and conditions of the apprenticeship, including duties, hours, and sometimes educational requirements, paralleling the work permit's role in safeguarding the minor’s working conditions and learning opportunities.

All these documents, while serving different purposes, share a common goal: they are designed to ensure the safety, well-being, and rights of minors in various professional and educational settings. Each, in its way, requires careful consideration and often parental or guardian oversight, underscoring the importance of protecting those who are not yet of legal age.

Dos and Don'ts

When filling out the Statement of Intent to Employ Minor and Request for Work Permit form, it’s crucial to pay attention to detail. This document is an important step in the employment of minors, ensuring that work does not interfere with their education and health. Below are things you should and shouldn't do to make sure the process goes smoothly for both the employer and the minor.

Things You Should Do
  • Read the instructions carefully before beginning. They contain valuable information that will guide you through the process.
  • Ensure all information is accurate and complete. Double-check details like the minor’s name, date of birth, and the employer's contact information.
  • Have the minor and their parent or guardian sign the form if required. Their signatures are necessary for the form to be valid.
  • Consult with the minor’s school if you’re unsure about legal working hours or restrictions. Schools often provide guidance on these matters.
  • Retain a copy of the completed form for your records. It’s important to have a backup for reference or in case of an audit.
Things You Shouldn't Do
  • Avoid leaving sections blank. If a section does not apply, write "N/A" (not applicable) instead of leaving it empty.
  • Do not guess information. If you’re unsure about certain details, verify them first. Incorrect information can lead to processing delays or the rejection of the form.
  • Refrain from using white-out or making messy corrections. If you make a mistake, it’s better to start over with a new form to ensure legibility.
  • Don’t submit the form without reviewing it for mistakes. A quick review can catch errors that might have been missed during the initial filling.
  • Do not disregard state-specific requirements. Some states have additional rules about employing minors. Make sure to comply with these as well.

Misconceptions

In understanding the processes and regulations involving the employment of minors, the Statement of Intent to Employ Minor and Request for Work Permit form plays a central role. There are, however, several misconceptions about this document that need clarifying:

  • It’s Only Needed for Official Work Settings: A common misconception is that the form is only required for formal employment contexts, such as in offices or retail stores. In reality, it applies to all kinds of paid work, including casual or odd jobs like babysitting or lawn mowing, emphasizing the broad scope of employment it covers.

  • Minors Can Submit the Form Themselves: While minors play a crucial role in the process, they cannot submit the form independently. It must be completed jointly by the employer and the minor, then submitted by the employer, showcasing the collaborative approach between employer, minor, and often the minor's school.

  • Approval Is Guaranteed: Submission of the form does not automatically lead to approval. The application goes through a review process where several factors are considered, such as the minor's age, the job position, and compliance with labor laws, highlighting the meticulous scrutiny involved.

  • One Permit Covers All Jobs: Another misunderstanding is thinking that one work permit is sufficient for multiple jobs. Minors need a separate permit for each job they plan to undertake, underscoring the need for specific approvals tailored to each employment situation.

  • There Are No Restrictions Once Approved: Even with a work permit, there are ongoing restrictions regarding the hours and types of work minors can do. These restrictions vary by age and are in place to ensure the working conditions are safe and do not impede education, reflecting the protective intent behind the legislation.

  • It’s the Same Nationwide: Lastly, there's a false assumption that the process and form are uniform across all states. In reality, requirements can vary significantly from state to state, indicating the importance of understanding local laws and regulations.

Understanding these misconceptions can ensure compliance with the law and protect the rights and well-being of young workers.

Key takeaways

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is an important step for young individuals seeking employment. It's essential to understand the process to ensure compliance with employment laws for minors. Here are key takeaways to help guide you through this process:

  • Before starting work, minors must obtain a completed work permit. This form serves as the official document providing authorization for minors to be employed.
  • Both the employer and the minor's parent or guardian need to fill out the form. The employer provides details about the job, such as duties and hours, while the parent or guardian authorizes the minor's employment.
  • Accuracy is important. Ensure that all information provided on the form is accurate and comprehensive to avoid any potential delays in processing the work permit.
  • Educational institutions play a role. After the employer and parent sections are completed, the form often requires approval and verification from the minor’s school. This ensures the employment does not interfere with the minor's education.
  • Limitations on work hours. The form helps in ensuring that the employment adheres to state laws regarding working hours for minors. These laws are designed to protect minors from working too much, especially during school days.
  • Renewal may be necessary. If the minor continues employment after a certain period, such as the following school year, a new work permit might be needed. Always check the expiration date and renew the permit as required.
  • Keep a copy for your records. Once the work permit is issued, it’s a good practice for both the employer and the minor to retain a copy of the form for their records.

By following these steps and ensuring all parties contribute to the completion of the Statement of Intent to Employ Minor and Request for Work Permit form, young workers can embark on their employment journey responsibly and in compliance with local labor laws.

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