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Employing minors comes with its own set of rules and regulations designed to protect young workers. At the center of these rules is the Statement of Intent to Employ Minor and Request for Work Permit form. This crucial document serves several important functions: it officially records a minor's intention to work, ensures the employment opportunity complies with labor laws, and facilitates the process of obtaining a work permit. For employers, understanding and accurately completing this form is essential to remain in compliance with state and federal laws concerning the employment of minors. Meanwhile, for young individuals eager to enter the workforce, it represents a pivotal first step towards gaining valuable work experience. Navigating through the specifics of this form requires attention to detail and an understanding of the applicable legal requirements, making it a key piece in the employment process of minors.

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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.

Document Attributes

Fact Detail
1. Purpose This form serves as a dual function to both declare an employer's intent to hire a minor and to request the necessary work permit allowing the minor to be legally employed.
2. Requirements for Minors Minors must obtain a work permit to legally work, which may require evidence of age, parental consent, and possibly school attendance.
3. Employer's Role Employers must complete their portion of the form, indicating job details and confirming their compliance with labor laws concerning minors.
4. School's Role Schools often act as administrators for the work permit, verifying the minor's eligibility and maintaining records of employed students.
5. Restrictions The form requires acknowledgment of legal working hours, types of employment, and conditions under which minors are allowed to work.
6. State-Specific Forms While the concept is consistent, actual forms and specific requirements can vary significantly between states, each governed by its own labor laws.
7. Filing Process After completion, the form usually needs to be filed with either the school or a designated state department, depending on the state's requirements.

How to Fill 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 for minors seeking employment. This process not only formalizes a minor’s intentions to work but also safeguards their rights and ensures compliance with labor laws. Below are the step-by-step instructions designed to guide through the completion of this important document.

  1. Gather the necessary information: Before starting, ensure you have all required details including the minor’s personal information, potential employer details, and the specifics of the job offer such as hours of work and duties.
  2. Complete the minor's information section: Fill in the minor’s full name, date of birth, and contact details. This section may also require additional identifiers like a student ID number if applicable.
  3. Input employer information: In the designated section, enter the full name and address of the business intending to employ the minor. This includes street address, city, state, and zip code.
  4. Detail the job offer: Clearly describe the job position, including duties the minor is expected to perform. Additionally, specify the wages offered and the proposed schedule, making sure it complies with legal restrictions for working minors.
  5. Parent or guardian consent: A parent or legal guardian must read and approve the minor’s intention to work and the details of the job offer. Their signature is a mandatory requirement to affirm their consent.
  6. Employer’s agreement: The potential employer reviews the job description and schedule agreed upon with the minor. Their signature confirms the job offer and adherence to labor laws in employing a minor.
  7. Signature of the minor: The minor seeking employment must also sign the form, acknowledging their understanding of the job responsibilities and commitment to abide by the rules and regulations governing their employment.
  8. Submit the form to the issuing authority: Once completed and all parties have signed, submit the document to the designated authority—often a school official or a department within local or state government. This entity will review the application, and if compliant, issue the work permit.

After submission, the reviewing authority will evaluate the form for completeness and adherence to legal standards for minor employment. If approved, the minor will receive their work permit, marking an official authorization to begin work under the terms specified. This permit is a crucial document, often required to be kept on file by the employer for the duration of the minor's employment. It is the responsibility of both the employer and the minor to ensure the work experience is conducted safely and within the boundaries of the law.

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 is a document required by law for minors (individuals under 18) who seek to work in the United States. It serves to formally request a work permit, ensuring that the employment is suitable for the minor’s age and does not interfere with their education. Employers, parents or guardians, and the minor must complete it as part of the process.

  2. Who needs to complete the form?

    Three parties are involved in the completion of the form: the employer, the minor seeking employment, and the minor's parent or guardian. The employer provides details about the job, including duties and hours, the minor provides personal information and signs the form, and the parent or guardian must also sign, giving their consent for the minor to work.

  3. Where can I obtain the form?

    The form is typically available from the minor’s school, through the school district’s website, or at the state or local department of labor. It's important to ensure you're using the most current form, as requirements may change.

  4. Is there a fee to apply for a work permit?

    Generally, there is no fee to apply for a work permit for minors. However, it's always a good idea to check with the issuing body, such as the school or the department of labor, in case there are any processing fees or other requirements.

  5. Can the form be submitted electronically?

    Whether the form can be submitted electronically depends on the state's regulations. Some states may allow or require online submission, while others may require a hard copy with original signatures. Check with the local department of labor or the minor's school for specific submission guidelines.

  6. What happens after the form is submitted?

    After submission, the form will be reviewed by an authorized issuer, often at the minor’s school or a state department of labor office. If approved, a work permit will be issued to the minor, allowing them to legally begin work. The minor might need to present the work permit to their employer before they can start.

  7. Are there restrictions on the types of work minors can do?

    Yes, there are restrictions. The law is designed to protect minors from working in dangerous or unhealthy environments and to ensure that work does not interfere with their education. Restrictions vary by age, and the type of work minors are allowed to do may be limited. Additionally, the hours minors can work during the school year versus during school breaks differ. For specific restrictions, it’s best to consult the local department of labor or the minor’s school.

Common mistakes

  1. Not checking for accuracy. People often fill out the form in a hurry and fail to verify the information for accuracy. This includes misspellings of names, incorrect dates of birth, and inaccurately reporting hours of availability for work.

  2. Leaving sections incomplete. Some sections may seem non-applicable or confusing, leading to them being left blank. However, every section is important and must be filled out unless specifically stated otherwise.

  3. Using incorrect identification. A common error is using the wrong type of identification number, such as a school ID instead of a government-issued ID. This could invalidate the entire form.

  4. Forgetting parental or guardian consent. The form requires a signature from a parent or guardian for minors. This step is crucial and often overlooked, leading to delays in processing.

  5. Failing to include employer information. Employers must provide detailed information, including employer name, address, and type of business. Leaving this information out can lead to processing delays.

  6. Not specifying the nature of work. Clearly outline the type of work, the duties involved, and the hours. Vague descriptions can hold up the approval process.

  7. Incorrectly reporting school status. It is important to accurately report the minor's school attendance status, including the name of the school and attendance records. Mistakes here can affect eligibility.

  8. Omitting emergency contact information. An emergency contact must be provided. This information is critical and must be accurate and up-to-date.

  9. Not updating the form when changes occur. If there are any changes to the minor's availability, school status, or if the minor changes employers, a new form must be completed. Failing to do so means operating under outdated permissions.

Documents used along the form

When navigating the employment of minors, pairing the Statement of Intent to Employ Minor and Request for Work Permit form with other essential documents is crucial for ensuring both compliance with labor laws and the safeguarding of the minor’s rights and well-being. These documents not only facilitate the employment process but also serve to protect all parties involved. Below is a list of documents that are often used alongside the Statement of Intent to Employ Minor and Request for Work Permit form, each serving a unique and important function in the employment of minors.

  • Age Certificate: This document serves as official verification of the minor's age and is typically required for employment in states that have age restrictions for workers. It helps employers to comply with state labor laws by confirming the minor's eligibility for work.
  • Parental Consent Form: A document that must be signed by the minor's parent or legal guardian, granting permission for the minor to work. This form is crucial for ensuring that the minor has parental support in their employment decision.
  • Proof of Eligibility to Work: It's required for all employees in the United States, including minors. This document verifies the minor's legal right to work in the country, typically through the presentation of a Social Security card, birth certificate, or passport.
  • School Attendance Verification: Often necessary for minors who are still attending school, this form confirms that the minor is enrolled in school and attending regularly. It's important for employers to ensure that the minor's employment does not adversely affect their education.
  • Health Assessment Certificate: In some cases, a minor may be required to undergo a health assessment to verify that they are physically capable of performing the job without risking their health. This document is especially relevant for jobs that may require physical labor or operate in environments that could be considered hazardous.

Together, these documents form a comprehensive framework that supports the employment of minors. By meticulously filling out and submitting these forms, employers, guardians, and the minors themselves contribute to a safe and legally compliant work environment. Managing these documents with care ensures that the minor’s foray into the workforce is both legally sound and enriching for their personal and professional development.

Similar forms

  • Employment Eligibility Verification Form (I-9): Similar to the Statement of Intent to Employ Minor, the I-9 form is a requirement for all U.S. employers to verify the identity and employment authorization of individuals hired for employment. Both forms serve to ensure legal compliance in the employment process.

  • Child Labor Work Permit: Issued by state governments, this permit is similar to the Statement of Intent to Employ Minor in that it focuses specifically on the employment of minors, detailing restrictions and rights, and ensuring that the work does not interfere with the minor's education or well-being.

  • W-4 Form (Employee’s Withholding Certificate): While the W-4 form is primarily used for tax withholding purposes, it is similar to the Statement of Intent to Employ Minor by being integral to the employment onboarding process, collecting necessary information from employees.

  • Application for Employment: This document collects personal and professional information from a prospective employee, akin to how the Statement of Intent to Employ Minor obtains information about the minor and the intended employment specifics.

  • Occupational Safety and Health Administration (OSHA) Compliance Forms: These forms ensure a safe and healthful working environment, paralleling the concern for minors’ safety and welfare inherent in the Statement of Intent to Employ Minor.

  • Minor’s Consent to Work Form: Required in some states, this form explicitly requires a minor's consent to work and is similar to the Statement of Intent as another layer of protection and acknowledgment of the minor's rights and responsibilities.

  • Internship Agreement Forms: Used to outline the specifics of an internship role, these agreements share similarities with the Statement of Intent to Employ Minor by detailing the scope of work, duration, and educational aspects of the position.

  • Volunteer Agreement Forms: Although focusing on unpaid roles, these agreements are similar as they include details on the duties, expectations, and limitations of a volunteer position, akin to how the Statement of Intent outlines the employment of a minor.

  • Non-Disclosure Agreements (NDA): Used to protect company confidentiality, NDAs, like the Statement of Intent to Employ Minor, are part of the employment process, ensuring that sensitive information is safeguarded.

  • Independent Contractor Agreement: This document governs the relationship between a contractor and a company. It is similar to the Statement of Intent to Employ Minor in that it specifies the terms of work, although it is used for non-employee roles.

Dos and Don'ts

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is an important step in the employment process for minors. It ensures that the work is suitable and does not interfere with their education or wellbeing. Below are essential dos and don'ts to consider when completing this form:

  • Do read the entire form carefully before beginning to fill it out. Understanding every section will ensure that all necessary information is provided accurately.
  • Don't rush through the process. Taking your time can help prevent mistakes that might delay the approval of the work permit.
  • Do ensure that both the employer and the minor (along with their parent or guardian) fill out their respective sections completely. Each part is crucial for the validity of the permit.
  • Don't leave any fields blank. If a section does not apply, consider writing "N/A" (not applicable) instead of leaving it empty to indicate that you did not overlook the section.
  • Do double-check the minor's information, including their full legal name, date of birth, and school information, for accuracy. Errors in personal information can cause unnecessary complications.
  • Don't forget to get the required signatures before submitting the form. The minor, their parent or guardian, and the employer must sign the form to affirm that the information is accurate and that they agree to adhere to the work permit's terms.
  • Do pay attention to any specific state or local regulations that may impact the employment of minors. These can vary and might have additional requirements beyond the federal standards.
  • Don't ignore the expiration date of the work permit. Be aware of how long the permit lasts and the process for renewal if the minor plans to continue working beyond the permit’s expiration date.
  • Do keep a copy of the completed form for your records. Having a record can be helpful for reference and in case any disputes or questions arise concerning the minor's employment.

Misconceptions

In the discussion about employment for minors, the Statement of Intent to Employ Minor and Request for Work Permit form plays a pivotal role. However, several misconceptions surround its purpose and requirements. Understanding these misconceptions is key to navigating the employment process for minors effectively. Here are nine common misunderstandings:

  • Only the minor needs to complete the form: In reality, this form requires information and signatures from not just the minor, but also the employer and the minor’s parent or guardian. It’s a collaborative document that ensures all parties are informed and agree to the terms of employment.

  • The form grants immediate permission to work: Submitting the form is just a step in the process. The minor cannot start working until the form is approved and the work permit is officially issued by the issuing officer at the school or the school district.

  • Any school official can approve the form: Not all school officials are authorized to issue work permits. Only designated officials, often within the guidance office or administrative department, have the authority to approve and issue work permits.

  • The form is universal for all states: Work permit requirements vary by state. This form is specific to certain states, and others may have their own forms and procedures. Always check with state labor departments for the correct forms and processes.

  • Minors can work as many hours as the job requires: Even with a work permit, employment for minors is subject to state and federal labor laws, which include restrictions on working hours. These laws are designed to ensure that work does not interfere with education.

  • A new form is needed for each job change: Generally, a new work permit is required for each new employer. This ensures that all employment conditions are reviewed and approved for the specific job and workplace.

  • The form is only for high school students: Middle school students and sometimes even younger children can require a work permit for employment, depending on state laws. The requirement is based on age, not school level.

  • Completing the form guarantees a job: The form is part of the employment process but does not guarantee employment. It’s merely a necessary step for minors who have been offered a job or are seeking employment.

  • The process is the same year-round: During the school year, the process may involve more steps and take longer due to academic commitments. During summer or school breaks, the process might be expedited. It's crucial to plan accordingly and allow ample time for the work permit to be issued.

Clearing up these common misconceptions can streamline the employment process for minors and help all involved parties understand their roles and responsibilities better. Knowledge and preparation are key to a smooth, successful work experience for young workers.

Key takeaways

The process of employing minors—individuals under the age of 18—in the United States requires strict adherence to legal documentation, especially when it comes to the Statement of Intent to Employ Minor and Request for Work Permit form. Here is a list of five key takeaways to guide you through the proper completion and use of this form.

  • Understanding State and Federal Laws: Before filling out the form, it is crucial to be aware of both state and federal laws regarding the employment of minors. These laws dictate the types of jobs minors can perform, the hours they are allowed to work, and the necessary breaks they are entitled to. Compliance with both sets of laws ensures the lawful employment of minors.
  • Accurate Information: Every section of the form must be completed with accurate information. This includes the minor’s personal information, details about the employer, and the specifics of the job offer. Accuracy ensures the swift processing of the work permit and helps avoid potential legal issues.
  • Parent or Guardian Consent: A signature from the minor’s parent or guardian is typically required on the form. This signifies their consent for the minor to be employed and acknowledges their understanding of the work conditions and hours. Ensuring this consent is documented is a critical step in the process.
  • School Authorization: The form often requires verification and authorization from the minor's school. This step confirms that the minor's employment will not interfere with their education. The school’s authorization may include verifying the minor’s academic standing and attendance records.
  • Renewal and Expiry: The work permit issued upon the approval of this form is not indefinite. It is important to note the conditions under which the permit may need to be renewed or may expire. For example, work permits often expire at the end of the school year or when the minor’s employment situation changes, necessitating the submission of a new form.

By carefully navigating these key steps, employers, minors, and their guardians can ensure compliance with the law, promoting a safe and lawful work environment for minors. Always remember to consult with legal counsel if you are unsure about any aspect of employing minors or using the Statement of Intent to Employ Minor and Request for Work Permit form.

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