Statement of Intent to Employ Minor and Request for Work Permit PDF Form Customize Form Here

Statement of Intent to Employ Minor and Request for Work Permit PDF Form

The Statement of Intent to Employ Minor and Request for Work Permit form is a crucial document designed to ensure the safe and legal employment of minors. It serves as a formal agreement between employers, the youth, and, often, their parents or guardians. This form safeguards the minor's rights and confirms the employer's commitment to adhere to labor laws.

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Overview

In the journey of a minor's employment process, one of the pivotal documents that come into play is the Statement of Intent to Employ Minor and Request for Work Permit form. This essential paperwork serves as a formal request and declaration, paving the way for young individuals to step into the workforce under legal and safe conditions. It functions as a bridge, connecting the employer, the minor, and the educational institution, ensuring that the minor's work experience does not hamper their education. The form requires detailed information about the intended job, including the nature of the work, hours, and responsibilities, alongside personal details of the minor. By submitting this document, employers express their commitment to adhere to labor laws designed to protect minors, while schools play a pivotal role in evaluating whether the work conditions and hours are suitable for the student, keeping their well-being at the forefront. It intricately balances the rights and safety of young workers with the opportunities for gaining early work experience, underlining the importance of compliance and vigilance from all parties involved.

Preview - Statement of Intent to Employ Minor and Request for Work Permit Form

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.

File Specs

Fact Name Description
Form Purpose The form is used to officially request permission for a minor to be employed and ensure the employment is in compliance with state labor laws.
Required Participants Completion requires information and signatures from the employer, the minor seeking employment, and a parent or guardian.
State-Specific Variations Each state may have its own version of the form to comply with its specific labor laws regarding minors.
Governing Laws The form is governed by both federal and state labor laws, particularly those pertaining to the employment of minors.
Age Verification The form often requires proof of the minor's age to ensure compliance with laws related to minor employment.
Work Limitations It highlights the specific hours a minor can work, based on school schedule and state laws, to prevent any form of exploitation.
Process and Approval The form must be submitted and approved by the designated state department or agency before the minor can begin employment.

Detailed Instructions for Filling Out Statement of Intent to Employ Minor and Request for Work Permit

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is a critical step towards securing employment for individuals under the age of 18. This document ensures that the work environment and job duties are suitable and safe for minors, promoting a balance between work and education. The process is straightforward, guiding both the employer and the minor through the necessary legal requirements. By completing this form accurately, minors can confidently step into the workforce with the support of their employers and educational institutions.

To accurately complete the form, simply follow these steps:

  1. Gather all required information including the minor's personal details, the employer's information, and details about the job position.
  2. Enter the minor's full name, date of birth, and social security number in the designated area at the top of the form.
  3. The employer must fill out the section concerning the job description, including the type of work, hours per week, and wage. This confirms the employment conditions meet legal standards for minors.
  4. The minor's parents or legal guardians are required to read the form and provide their consent by signing and dating the designated section. This consent verifies their agreement to the employment terms and understanding of the minor's responsibilities.
  5. The educational institution's representative, usually a counselor or administrator, must complete the school section. This includes verifying the minor's academic standing and suggesting any restrictions on work hours to protect the minor's educational interests.
  6. Finally, the minor seeking employment and the employer must sign the form, acknowledging they understand and agree to comply with the work permit regulations.

After the form is fully completed and signed, it should be submitted to the appropriate local or state labor department, depending on regional requirements. The approval process may take several days, after which the work permit will be issued directly to the minor or the employer. It's essential to keep a copy of all documents for your records. This initial step is vital for the minor's legal entry into the workforce, ensuring that both educational and employment interests are safeguarded.

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

  1. What is the Statement of Intent to Employ Minor and Request for Work Permit form?

    This form serves as a formal request to obtain legal permission for a minor, typically someone under the age of 18, to work in the United States. It's an essential document that outlines the specific details of the minor’s proposed employment, including hours, duties, and conditions, ensuring compliance with child labor laws. The form must be completed by the employer, signed by the minor, and often, the minor's parent or guardian, before being submitted for approval to the appropriate state or local education department.

  2. Who needs to complete this form?

    Both the employer wishing to hire a minor and the minor seeking employment are required to complete their respective sections of the form. Additionally, the minor’s parent or guardian usually needs to provide their consent by signing the document. Finally, a school official, often a counselor or administrator, will review and sign the form, verifying the minor’s enrollment status and ensuring that the work will not interfere with their education.

  3. Where should the completed form be submitted?

    After completion and gathering all required signatures, the form should be submitted to the designated state or local education department, or a specified work permit office. The exact location can vary depending on the minor's place of residence or where the employment will occur. It's important to verify the submission requirements with local authorities to ensure proper handling and processing.

  4. How long does it take to process this form?

    The processing time can vary significantly, often depending on the jurisdiction and the time of year. During busier periods, such as summer or holidays when many minors seek employment, processing times can be longer. Employers and minors should plan accordingly and submit the form well in advance of the intended start date of employment. Generally, it’s advisable to allow at least two weeks for processing.

  5. Is there an expiration date for the work permit once issued?

    Yes, work permits for minors are typically valid for a set period, which can vary by state. Some permits are valid for as long as the minor remains employed with the same employer, while others expire at the end of the school year or after a certain number of months. It's crucial to check the specific regulations in your state to understand the validity period of the work permit and the requirements for renewal, if applicable.

  6. What happens if a minor changes jobs?

    If a minor changes jobs, a new Statement of Intent to Employ Minor and Request for Work Permit form must be completed and submitted for the new position. The process is the same as the initial request: the form must be filled out and signed by the new employer, the minor, their parent or guardian, and a school official. This ensures that the new employment also complies with labor laws and does not adversely affect the minor’s education.

Common mistakes

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form can seem straightforward, but there are common mistakes people make that can delay the process. One error is not checking for accuracy in the details provided. It's crucial to review all entries for correct spelling, dates, and numerical information. A minor mistake in these areas can lead to unnecessary complications.

Another frequent oversight is failing to complete every required section on the form. Sometimes, sections that might seem irrelevant or optional to the applicant are, in fact, necessary for the form's processing. Leaving these areas blank might not only slow down the application process but can also lead to the rejection of the work permit request.

A third mistake involves misunderstanding the role of the parent or guardian in the application process. Their signature is not just a formality; it represents legal consent for the minor to be employed. Therefore, ensuring that the parent or guardian's signature is obtained and clearly legible is paramount. A missing or illegible signature can invalidate the entire application.

Lastly, applicants often overlook the need for the employer's information and signature to be accurately reflected on the form. This includes the employer's name, address, and the specific nature of the work to be performed. An incomplete or incorrect employer section can lead to questions about the legitimacy of the employment, thereby stalling the permit's issuance.

Documents used along the form

When a minor seeks employment, the Statement of Intent to Employ Minor and Request for Work Permit form is typically just the starting point in a series of necessary documents. This foundational document, often required by state labor departments, verifies an employer's intention to hire a minor and requests the legal authorization to do so. However, this form seldom stands alone in the employment process, especially for individuals under the age of 18. A collection of other forms and documents usually supports the primary request, ensuring compliance with labor laws and safeguarding the rights and safety of the minor.

  • Age Certificate: Certifies the minor's age for the employer, providing verification that the minor is of legal age for employment. This document is often essential for employers to comply with age-specific labor laws.
  • Proof of Minor’s Age: A birth certificate, passport, or state identification card serves as proof of age, a necessary document to accompany the request for a work permit.
  • Parent's Consent Form: A document in which a parent or guardian consents to the employment terms and conditions. This form is crucial for ensuring that the minor's legal guardians are aware of and agree to the employment arrangement.
  • School's Recommendation Form: Some jurisdictions require a recommendation from the minor's school, confirming that employment will not interfere with educational responsibilities.
  • Physician’s Certificate: A health certificate from a doctor stating that the minor is physically capable of undertaking the job. This document might be requested to confirm that the employment will not harm the minor’s well-being.
  • Employment Agreement: Details the terms of employment, including duties, hours, and wages. This agreement between the employer and the minor (with a guardian co-signature) outlines the specific details of the job offer.
  • Emergency Contact Information: A form that lists contact information for immediate reach in case of an emergency. This ensures the safety and welfare of the minor while on the job.
  • Hour Restrictions Compliance Form: A document that outlines the state and federal laws regarding the maximum number of working hours permitted for minors and confirms the employer's commitment to adhere to these laws.
  • Safety Training Certification: Certifies that the minor has received training on job-specific safety practices and emergency procedures. This is particularly important for jobs that involve potential hazards.

Gathering and managing these documents efficiently is a testament to a commitment towards lawful employment and the well-being of young workers. Employing minors not only involves understanding the mutual benefits but also entails a deep appreciation for the legal and ethical obligations involved. While the Statement of Intent to Employ Minor and Request for Work Permit form begins the process, the thorough completion of accompanying documents ensures a smooth employment experience for all parties involved. This careful preparation supports a productive and beneficial work relationship, safeguarding the interests and safety of minors in the workplace.

Similar forms

  • Employment Eligibility Verification Form (I-9): Just like the Statement of Intent to Employ Minor and Request for Work Permit, the Form I-9 is a necessary document for employment in the United States. It's used to verify the identity and employment authorization of individuals hired for employment in the U.S. Both forms are required by the government to ensure legal work practices.

  • W-4 Form (Employee’s Withholding Certificate): Similar to the work permit for minors, the W-4 form is filled out by employees to indicate their tax situation to the employer, dictating how much tax to withhold from an employee’s paycheck. Both documents are key to the employment process and handling of remunerations.

  • Child Labor Laws Notice: This document, often posted by employers, outlines the laws governing the employment of minors. It's akin to the Statement of Intent to Employ Minor in that both ensure compliance with regulations on working minors, including hours and types of work permitted.

  • Job Offer Letter: A job offer letter is a formal invitation to a position in a company, similar to the statement of intent in its function to initiate an employment agreement, albeit for workers of all ages. Both documents formalize the intent to employ and outline initial job terms.

  • Minor's Work Release: Certain states require a work release form that authorizes underage individuals to work, similar to the work permit request. This document typically requires school and parental approval, ensuring the minor's employment does not interfere with their education.

  • Volunteer Agreement Form: For volunteer work, this agreement outlines the volunteer’s role and responsibilities. It's similar to the work permit for minors as it represents an agreement to perform work, although without financial remuneration. Both forms help clarify the terms of the work involved.

  • Apprenticeship Agreement: This document formalizes the relationship between an apprentice and a training provider or employer, akin to the Statement of Intent for minors starting work. Both documents outline the responsibilities of each party and the terms of employment or training.

  • Employment Contract: An employment contract is a detailed agreement between an employer and employee. Like the Statement of Intent to Employ Minor, it formalizes employment terms, but it is used for employees of all ages and can be more detailed regarding job roles, salary, and terms.

  • Working Papers/Certificate of Age: Required in some states for minors, these documents serve as proof of age and eligibility to work, paralleling the work permit's function to verify the minor's ability to legally work under child labor laws.

  • Non-disclosure Agreement (NDA): While focused on confidentiality, an NDA is similar to the Statement of Intent and work permit in its role as a foundational document in an employment relationship. It protects sensitive information, just as work permits aim to protect the minor’s welfare in the workplace.

Dos and Don'ts

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is an important step for young workers to legally secure employment. Below are nine essential dos and don'ts to guide both minors and their employers through this process smoothly.

  • Do read the instructions carefully before filling out the form. Ensure you understand all the requirements to avoid any mistakes that could delay the process.
  • Don't rush. Take your time to fill out each section accurately. An incomplete or incorrectly filled-out form can lead to unnecessary complications.
  • Do ensure that all information is current and accurate. This includes personal information, job description, and employer details. Misinformation can result in the rejection of the work permit.
  • Don't forget to get the necessary signatures. The form typically requires signatures from the minor, the employer, and sometimes a parent or guardian. Missing signatures can invalidate the whole form.
  • Do keep a copy of the form for your records. After the form is submitted and processed, it's useful to have a copy for reference in case any issues arise down the line.
  • Don't ignore the legal working hours and conditions specified for minors. It's important that both the employer and the minor adhere to these laws to avoid legal complications.
  • Do consult with a legal guardian or advisor if you have any questions. They can offer valuable guidance and ensure everything is completed correctly.
  • Don't use white-out or make corrections on the form without initialing them. If mistakes are made, it's better to start with a fresh form to ensure readability.
  • Do make sure the job description and duties are clearly understood and accurately represented in the form. This ensures that the work permit accurately reflects the work to be performed and helps protect the minor from being assigned inappropriate tasks for their age.

Navigating the controls and regulations around youth employment demonstrates a commitment to legality and safety. Following these guidelines can make the process of obtaining a work permit smooth and straightforward, laying a solid foundation for a minor’s entry into the workplace.

Misconceptions

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is a crucial step for young individuals who are eager to enter the workforce. However, several misconceptions can cause confusion and potentially delay the process. By shedding light on these common misunderstandings, the path to employment can be made smoother for minors.

  1. All minors can self-certify their eligibility to work. This is not the case. Actually, the form requires approval from the minor's parent or guardian, the prospective employer, and the issuing authority, often a school official. This multi-step approval process ensures the minor's work does not interfere with their education and welfare.

  2. The form grants permission to work in any job. Not exactly. The Statement of Intent to Employ Minor form is job-specific, detailing the minor's work hours, job duties, and employment location. If the job changes, a new form must be completed and approved.

  3. Once approved, the work permit has no expiration. In reality, work permits are valid for a specific period, typically aligned with the school year, and must be renewed for continued employment. This ensures that the minor's work conditions and eligibility are periodically reviewed.

  4. Employers are solely responsible for obtaining the work permit. While employers play a crucial role in the process, minors are equally responsible for ensuring all parts of the form are completed and submitted for approval. Both parties must work together to fulfill the requirements.

  5. The process is the same in all states. This is a common misconception. The requirements for minor work permits can vary significantly from one state to another. It's important for both the employer and the minor to review their specific state's labor laws to ensure compliance.

  6. The form is unnecessary if the minor is not paid. This is incorrect. Even unpaid internships or volunteer positions often require a work permit, as the focus is on the minor's safety and education, regardless of compensation. The form helps ensure the work experience is appropriate for the minor's age and development.

Understanding and addressing these misconceptions about the Statement of Intent to Employ Minor and Request for Work Permit form can help streamline the employment process for young individuals. Remember, the goal is to ensure that work opportunities for minors are both enriching and compliant with legal standards. When in doubt, it's always best to seek clarity from the issuing authority or a legal advisor specialized in employment law.

Key takeaways

The Statement of Intent to Employ Minor and Request for Work Permit form is an essential document for young workers and their employers. Understanding its purpose and the process of filling and using this form correctly is crucial for ensuring compliance with labor laws and protecting the rights and safety of minors in the workforce. Below are seven key takeaways that highlight the most important aspects of this process:

  • Eligibility: Before filling out the form, ensure that the minor meets the age and other eligibility requirements for working in your state. These requirements vary and are designed to protect young workers.
  • Accurate Information: It's critical to provide accurate and complete information on the form. This includes the minor's personal information, the prospective job details, and the employer's information. Errors or omissions could delay the issuance of the work permit.
  • Parental or Guardian Approval: A signature from the minor's parent or guardian is typically required to validate the form. This step ensures that guardians are informed of and consent to the minor's employment.
  • School Approval: The form often requires approval from the minor's school. This process ensures that the job does not interfere with the minor's education and that the minor is in good academic standing.
  • Understand Restrictions: The form will specify any work restrictions placed on the minor, such as permitted work hours, prohibited duties, and breaks. Both employers and employees should familiarize themselves with these restrictions to prevent any legal violations.
  • Keep Records: Once the work permit is issued, both the employer and the minor should keep copies of the form. Employers are typically required to keep the permit on file for as long as the minor is employed.
  • Periodic Renewal: Be aware that work permits are not indefinite. They will need to be renewed periodically, usually at the start of a new school year or if the minor changes jobs. Staying on top of renewal deadlines ensures continuous compliance with employment regulations.

Adhering to these guidelines helps ensure a smooth and legally compliant process for employing minors. It's a shared responsibility among employers, parents or guardians, schools, and the young workers themselves to uphold these standards for the benefit of all parties involved.

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