Fill Out a Valid Statement of Intent to Employ Minor and Request for Work Permit Form

Fill Out a Valid 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 crucial document in the United States that facilitates the employment of minors by ensuring compliance with labor laws. It acts as a bridge between the young worker, their employer, and the school authorities, helping to maintain a balanced environment where education and work can coexist harmoniously. This form underscores the nation's commitment to protecting the rights and safety of working minors.

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In the journey of a minor's transition into the workforce, the pivotal role played by the Statement of Intent to Employ Minor and Request for Work Permit form cannot be understated. This document serves as a critical bridge, connecting young individuals eager to gain work experience with the legal framework that ensures their safety and rights are protected. It embodies the collective effort of employers, parents, and educational institutions to uphold the balance between employment benefits and the educational commitments of minors. The form seeks to formalize the employment details, including the nature of the work, hours, and conditions, ensuring they conform to regulations designed to prevent exploitation and overwork. By requiring signatures from all parties involved, the form also fosters a mutual understanding and agreement on the minor's role and responsibilities in the workplace. Its completion is a necessary step for minors aiming to step into the working world, reflecting the broader societal commitment to safeguarding their well-being while enabling their personal and professional growth.

Document Example

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 Number Fact Detail
1 The Statement of Intent to Employ Minor and Request for Work Permit is a necessary document for minors seeking employment.
2 This form verifies that a minor is legally allowed to work in a specific job for a designated employer.
3 The document requires information about the minor, the employer, and the proposed job duties.
4 It often necessitates the signature of the minor, the employer, and a parent or guardian.
5 In many states, the form must be submitted to and approved by either a school official or a state labor department before the minor can commence work.
6 Each state has distinct laws and regulations regarding the employment of minors, affecting the use and requirements of this form.
7 Laws ensure the minor's education is not adversely affected by employment and restrict work in hazardous occupations.
8 For instance, in California, the governing law for this form is outlined in the California Education Code sections 49160 and 49162.

Statement of Intent to Employ Minor and Request for Work Permit - Usage Guide

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is a necessary step for young individuals seeking employment. This document is crucial as it helps ensure that the work environment and the terms of employment comply with laws designed to protect minors. It involves a straightforward process that requires attention to detail to provide accurate information about the minor, the employer, and the nature of the work. Below are the steps to fill out the form properly.

  1. Start by collecting the necessary information: the minor's personal information, the potential employer's details, and specifics about the job offer, such as hours of work and duties.
  2. Fill in the minor's full name, date of birth, and address in the designated sections at the top of the form.
  3. Enter the school information including the name, address, and possibly the school district in the relevant section.
  4. The next section is for the employer. Fill in the business name, address, and the supervisor's contact information.
  5. Describe the job position, including the type of work the minor will be performing. Make sure to specify if the work involves any hazardous activities.
  6. Detail the working hours per day and per week. Ensure that they comply with the legal working hours permitted for minors.
  7. The form will require both the minor and the parent or guardian to sign, indicating their agreement with the stated terms of employment.
  8. The employer also needs to sign the form, agreeing to abide by the labor laws relating to employing minors.
  9. Finally, submit the completed form to the appropriate school official or authority designated to issue work permits. They will review the form and, if everything is in order, issue a work permit for the minor.

It's essential to approach this process with care, ensuring all information is accurate and all necessary signatures are obtained. This document not only facilitates the employment of minors but also plays a crucial role in safeguarding their rights and well-being in the workplace. Always check with local authorities or guidance counselors for any additional steps or information required specific to your location.

More About 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?

This form is a document that must be completed by minors who wish to work in the United States. It serves as a formal request for a work permit and outlines the details of the intended employment. The form ensures that both the employment conditions and hours are suitable for the minor and comply with state and federal labor laws.

Who needs to fill out this form?

Any minor seeking employment in the United States is required to complete this form. It is an essential step in the process to legally work before reaching the age of majority. Both the minor and the prospective employer, along with a parent or guardian, have sections to fill out and sign.

Where can I obtain this form?

This form is typically available through school district offices, or it can be downloaded from the website of the state's Department of Labor or the equivalent regulatory body. It's important to ensure you're using the most current version of the form by checking with these sources directly.

What information do I need to provide on the form?

The form requires detailed information including the minor's personal information, the proposed job description, salary, and working hours. It also asks for the employer’s business details and the signature of a parent or guardian to confirm their consent.

Is parental consent always required?

Yes, parental or guardian consent is a critical component of this form. It confirms that the parent or guardian agrees to the minor's employment under the conditions specified. This requirement is to safeguard minors by ensuring their guardians are aware of and agree to their work conditions.

What happens after the form is completed?

Once the form is filled out and signed by all parties, it is submitted to the minor's school or the designated issuing officer for approval. If approved, the work permit is issued, allowing the minor to legally begin employment under the specified conditions. The minor should keep a copy of the permit at their workplace.

Can the work permit be revoked?

Yes, work permits can be revoked or cancelled if the issuing authority finds that the employment is adversely affecting the minor's health, education, or welfare. Employers must also notify the issuing authority if the employment ends or if work conditions change significantly.

Are there any restrictions on the type of work a minor can do?

There are specific state and federal laws that restrict the types of jobs minors can perform, as well as the hours they are allowed to work. These laws are designed to protect minors from hazardous conditions and to ensure that work does not interfere with their education. It's important for both the employer and the minor to be familiar with and adhere to these restrictions.

Common mistakes

Completing the Statement of Intent to Employ Minor and Request for Work Permit form is a crucial step for minors who are entering the workforce. However, some common mistakes can delay or complicate the process. One prevalent error is incomplete information. Every field on the form requires attention, and leaving sections blank can result in delays. It is essential to thoroughly review the form to ensure that all necessary details are provided.

Another frequent mistake is incorrect information, especially with dates and personal details. Minors and their employers must double-check the data entered, such as birth dates, addresses, and social security numbers, to ensure accuracy. Incorrect information can not only delay the process but also cause legal issues down the line.

A third mistake involves the signatures required at the bottom of the form. Many times, minors or their employers forget to sign the document, or the signatures may not match the names listed. It is crucial for both the minor and the employer to provide their signatures to validate the form. Without these signatures, the document is considered incomplete and cannot be processed.

Next, the section regarding parent or guardian approval often causes confusion. A parent or guardian’s signature is mandatory for the form to be processed, signifying their consent for the minor's employment. Occasionally, this section is overlooked or not taken seriously, leading to delays in obtaining the work permit.

Finally, not updating the form when there are significant changes in employment details is a common oversight. If a minor changes employers, job duties, or work hours, the form should be updated and resubmitted. Maintaining current information on the work permit ensures compliance with labor laws and protects all parties involved.

Documents used along the form

When employers consider hiring minors, several important documents complement the Statement of Intent to Employ Minor and Request for Work Permit. These forms and documents ensure compliance with labor laws, protect the rights and well-being of young workers, and verify the details of the intended employment. Each document serves a specific purpose in the hiring process, contributing to a lawful and safe work environment for minors.

  • Age Certificate: This document certifies the minor's age and is often required for employers to comply with state labor laws. It helps verify that the minor meets the minimum age requirements for the type of work they will be doing.
  • Parental Consent Form: A document that must be signed by the minor's parent or guardian, giving their permission for the minor to work. This form is crucial for ensuring that guardians are aware of and agree to the minors' employment.
  • Proof of Education: This can be a report card or a letter from the school confirming the minor is enrolled. It is used to verify that the minor is attending school, as required by law for working minors.
  • Physician's Certificate: A certificate from a physician may be required for certain jobs, certifying that the minor is physically capable of handling the job duties. This helps ensure the minor’s health and safety at work.
  • Employment Agreement or Contract: A document that outlines the terms of employment, including duties, hours, and compensation. This agreement ensures both the employer and the minor understand their rights and obligations.
  • Training Certificates: Any certificates that demonstrate the minor has completed required training for the job, such as food safety courses for restaurant work. This helps ensure the minor is qualified and prepared for the job tasks.
  • Emergency Contact Information: A form that lists contact information for the minor's parents or guardians and other emergency contacts. This information is vital in case of an emergency at the workplace.

These documents, used alongside the Statement of Intent to Employ Minor and Request for Work Permit, create a comprehensive framework for the lawful and safe employment of minors. Employers must ensure they have collected and verified all necessary documents to maintain compliance with labor laws and safeguard the welfare of young workers.

Similar forms

The Statement of Intent to Employ Minor and Request for Work Permit form shares similarities with the Employment Eligibility Verification Form I-9. Like the form for minors, the I-9 is a pivotal document used across the United States to verify an employee's legal authority to work in the country. Both these forms play a crucial role in the hiring process, requiring employers to confirm the eligibility and age of potential employees. However, while the I-9 applies to all employees irrespective of age, the Statement of Intent to Employ Minor is specifically designed for those under the legal age for employment.

Another comparable document is the Child Labor Work Permit, which is required in some states for minors seeking employment. This permit often serves a dual purpose: ensuring that work does not interfere with the education of the minor and that the work environment is safe and appropriate. Both the Child Labor Work Permit and the Statement of Intent to Employ Minor necessitate the involvement of a parent or guardian in the process, reinforcing the safeguarding of minors' rights and well-being in the workplace.

The Occupational Safety and Health Administration (OSHA) Form 300 is somewhat akin to the Statement of Intent to Employ Minor as well. The OSHA Form 300 is used for recording and tracking work-related injuries and illnesses within a workplace. Though their primary focuses differ—safety versus employment eligibility—the underlying connection is their emphasis on protecting individuals within the workplace. Both forms recognize the importance of monitoring and providing a safe and legal working environment, particularly for potentially vulnerable groups such as minors.

The W-4 form, or Employee's Withholding Certificate, also bears resemblance to the Statement of Intent to Employ Minor in its purpose of managing tax obligations. When a minor gets employed, they often must fill out a W-4 form to determine the amount of taxes to be withheld from their paycheck, just as any other employed person in the U.S. would. This process signifies the minor's entry into the workforce, requiring them to consider financial responsibilities and taxation, aspects that are facilitated by the initial employment documentation process.

Understanding these documents emphasizes how integral they are to the employment onboarding process, each serving to ensure workers—especially minors—are correctly verified, safe, and lawfully employed while also managing their financial and health records from the point of hire.

Dos and Don'ts

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is an important step for employers and young workers alike. It ensures that the employment is legal and that the minor is protected under labor laws. To help with the process, here are some do's and don'ts to consider:

Do:

  1. Read the instructions carefully before starting to fill out the form. This ensures you understand every requirement.
  2. Use black ink or type the information electronically if possible for clear readability.
  3. Provide accurate information about the minor’s age, work hours, and job duties to ensure compliance with labor laws.
  4. Ensure both the employer and the minor’s parent or guardian sign the form. Their signatures are essential for the form's validity.
  5. Keep a copy of the completed form for your records. It's important to have proof of the agreement and compliance.
  6. Check for any state-specific requirements. Different states may have additional requirements or forms.
  7. Submit the form before the minor begins work. Proper timing is crucial for legal compliance.
  8. Update the form if there are any changes in the minor's job duties or work hours.
  9. Seek clarification from the issuing officer if you have any questions. They can provide guidance and help avoid mistakes.
  10. Ensure the form is filled out completely. Incomplete forms may result in processing delays.

Don't:

  1. Guess information. If you're unsure about something, it's better to ask for clarification than to risk inaccuracies.
  2. Use pencil or erasable ink, as these can lead to alterations and questions regarding the document's integrity.
  3. Ignore labor law guidelines regarding minor employment; this form is part of complying with those laws.
  4. Forget to obtain the necessary signatures, as the form is not valid without them.
  5. Discard the form after submission. Retaining a copy is crucial for record-keeping purposes.
  6. Assume one form covers all employment situations. Each job may require a new form depending on state laws and employment changes.
  7. Submit the form late. Delays can affect the minor's ability to start work on time.
  8. Overlook any section of the form. Every part is important for a comprehensive understanding of the employment terms.
  9. Be hesitant to ask for help. When in doubt, seeking assistance can prevent errors.
  10. Leave blank spaces if a section does not apply. Instead, fill in with “N/A” to indicate it’s not applicable.

Misconceptions

The process surrounding the Statement of Intent to Employ Minor and Request for Work Permit form often leads to a number of misconceptions. Clearing these up ensures that both the minor aspiring to work and the employer looking to hire understand their responsibilities and the process accurately.

  • Minors can work without a work permit if they have parental consent. This is incorrect. Regardless of parental consent, minors are required to obtain a valid work permit before they can legally begin working. This ensures that their employment complies with state labor laws, ensuring their safety and well-being.

  • Employers do not need to keep a minor's work permit on file. Actually, employers must keep a minor’s work permit on file for as long as the minor is employed. This is crucial for compliance checks and to verify that the minor is legally permitted to work.

  • All minors need a work permit regardless of their age. This is a misconception. The requirement for a work permit typically applies to minors under a certain age, which varies by state. For example, minors above a certain age may not need a work permit, but specific rules can vary, so it's essential to check local regulations.

  • Getting a work permit is a lengthy and difficult process. While it does require certain documentation and approval, the process isn't necessarily lengthy or difficult. It is designed to protect minors by ensuring their work does not interfere with their education or welfare.

  • A work permit is valid across all states. This is not true. Work permits are typically issued by the state and are only valid within that state. If a minor intends to work in a different state, they must obtain a work permit that is valid in that specific state.

  • The work permit automatically renews. Work permits do not automatically renew. When a work permit expires or if the minor changes jobs, they must apply for a new one. This ensures that their employment remains in compliance with state labor laws.

  • Academic performance does not affect a minor's ability to obtain a work permit. In some states, the minor's academic performance can indeed influence their eligibility for a work permit. This is to ensure that work does not negatively impact the student’s education.

  • Only the minor needs to fill out the Statement of Intent to Employ Minor and Request for Work Permit form. In reality, this form usually requires information and signatures from the minor, their parent or legal guardian, and the prospective employer. This collaborative process ensures that all parties are aware of and agree to the employment terms.

  • Once issued, a work permit allows a minor to work any number of hours. The number of hours a minor can work is restricted and varies by age, whether or not it is a school day, and state laws. The work permit stipulates these conditions to ensure that work does not interfere with the minor’s education and well-being.

Key takeaways

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is a critical step for employers and minors wishing to engage in employment in accordance with the law. Here are four key takeaways to ensure the process is handled correctly and efficiently:

  1. Accuracy is essential when completing the form. Every detail, from the minor's personal information to the specifics of the intended employment, such as job duties and hours, must be accurately reported to prevent any legal issues or delays.

  2. Both the minor and the employer have responsibilities in the process. The minor must provide proof of age and consent from a parent or guardian, and the employer must verify the minor's right to work, as well as the job’s compliance with labor laws.

  3. There are time constraints involved. Once the form is submitted, there is a period during which it must be processed and the work permit issued. Understanding these time frames is crucial to avoid any interruption in the minor's employment.

  4. Compliance with labor laws is non-negotiable. The form is a part of ensuring that the employment of minors does not interfere with their education or violate any labor laws intended to protect them. Employers must adhere to these laws, and filling out this form correctly is a part of that compliance.

By following these guidelines, employers and minors can ensure that the employment relationship begins on solid legal ground, with respect for the rights and responsibilities of all parties involved.

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