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

Get 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 employers who wish to hire individuals under the age of 18. This form ensures compliance with labor laws and protects the rights of minors in the workforce. To begin the process, fill out the form by clicking the button below.

Structure

When it comes to employing minors, understanding the necessary legal requirements is crucial for both employers and young workers. The Statement of Intent to Employ Minor and Request for Work Permit form plays a vital role in this process. This form serves as a formal request for permission to hire a minor, ensuring that all employment practices adhere to state regulations designed to protect young workers. It outlines the specific details of the employment, including the nature of the job, hours of work, and the minor's age. Additionally, the form requires signatures from both the employer and a parent or guardian, confirming that all parties are aware of and agree to the terms of employment. By completing this form, employers not only comply with legal obligations but also demonstrate their commitment to creating a safe and supportive work environment for minors. Understanding the ins and outs of this form can help facilitate a smooth hiring process while safeguarding the rights and well-being of young employees.

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

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 Data

Fact Name Description
Purpose The Statement of Intent to Employ Minor and Request for Work Permit form is used to obtain permission for a minor to work legally.
Eligibility This form is applicable to minors typically aged 14 to 17, depending on state regulations.
Employer Responsibilities Employers must complete the form and ensure compliance with state labor laws regarding minor employment.
Parental Consent Parental or guardian consent is usually required for the minor to work.
Governing Laws State-specific laws govern the employment of minors, including hours worked and types of jobs permitted.
Work Permit Issuance Upon approval, a work permit is issued, allowing the minor to start employment.
Duration The work permit is typically valid for a specific duration, which may vary by state.
Renewal Process Employers may need to submit a new form for permit renewal if the minor continues employment beyond the permit's expiration.

How to Use 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 an important step for employers looking to hire minors. After completing the form, it will need to be submitted to the appropriate state agency for approval. This process ensures that all legal requirements are met, allowing for a smooth transition into employment for young workers.

  1. Begin by gathering all necessary information about the minor, including their full name, date of birth, and address.
  2. Next, provide details about the employer, such as the business name, address, and contact information.
  3. Specify the type of work the minor will be doing. Be clear and concise about the job responsibilities.
  4. Indicate the hours the minor will be working. Include the days of the week and specific hours for each day.
  5. Complete the section regarding the parent or guardian's information. Include their name, address, and contact details.
  6. Sign and date the form to confirm that all information provided is accurate and complete.
  7. Review the entire form for any errors or missing information before submitting it.

Once the form is filled out and reviewed, it can be submitted to the appropriate state agency. Be sure to keep a copy for your records. This will help ensure that you have all necessary documentation on hand as the employment process moves forward.

Key Facts about Statement of Intent to Employ Minor and Request for Work Permit

What is the 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 document that employers must complete to legally employ individuals under the age of 18. This form ensures that the employment complies with state and federal labor laws designed to protect minors in the workplace.

Who needs to fill out this form?

Employers who wish to hire minors must fill out this form. Additionally, the minor’s parent or guardian may also need to provide their consent, depending on the state’s regulations. This collaborative effort ensures that all parties are aware of the employment terms and conditions.

What information is required on the form?

The form typically requires basic information about the employer, the minor, and the specific job the minor will be performing. This includes the minor’s name, age, the nature of the work, hours of employment, and any other pertinent details that demonstrate compliance with labor laws.

How does the work permit process work?

Once the form is completed, it must be submitted to the appropriate state agency or school district, depending on local regulations. The agency will review the information to ensure it meets legal standards. If approved, a work permit will be issued, allowing the minor to begin employment.

Are there age restrictions for minors seeking employment?

Yes, there are age restrictions. Generally, minors under the age of 14 are limited in the types of jobs they can hold and the hours they can work. As the age increases, the restrictions may lessen, but specific laws vary by state. It is essential to check local regulations for precise age-related employment rules.

What types of jobs can minors perform?

Minors can perform a variety of jobs, but certain hazardous occupations are off-limits. Common jobs for minors include positions in retail, food service, and office work. However, each state has its own list of permissible and prohibited occupations for minors, so it is crucial to consult local labor laws.

What are the consequences of not obtaining a work permit?

Employing a minor without the necessary work permit can result in significant penalties for the employer, including fines and legal repercussions. Additionally, the minor may face restrictions on future employment opportunities. Ensuring compliance with labor laws is essential for protecting both the employer and the minor.

How long is the work permit valid?

The validity of a work permit can vary depending on state regulations. Typically, a work permit remains valid until the minor reaches a certain age, changes jobs, or the permit is revoked due to non-compliance with labor laws. Regularly reviewing the permit’s status is advisable to ensure ongoing compliance.

Can the form be submitted electronically?

Many states now allow the submission of the Statement of Intent to Employ Minor and Request for Work Permit form electronically. However, this option may not be available in all jurisdictions. It is important to check with the relevant state agency for specific submission guidelines and options.

Where can I obtain the form?

The form can usually be obtained from the state’s labor department website or the local school district office. Some employers may also have copies of the form available in their human resources department. Ensure that you are using the most current version of the form to avoid any issues during the application process.

Common mistakes

When filling out the Statement of Intent to Employ Minor and Request for Work Permit form, it’s easy to overlook important details. One common mistake is providing inaccurate personal information. This includes the minor's full name, date of birth, and address. If any of these details are incorrect, it can lead to delays in processing the work permit.

Another frequent error is failing to obtain the necessary signatures. Both the employer and the minor’s parent or guardian must sign the form. Without these signatures, the application will be considered incomplete. Always double-check that all required parties have signed before submitting.

Omitting the specific job description is another mistake that can hinder the application process. The form requires a clear description of the job the minor will be performing. Vague or incomplete job descriptions may lead to confusion and potential rejection of the application.

Many people forget to include the correct employer information. This includes the business name, address, and contact details. Providing incorrect or outdated information can cause issues with communication and verification, ultimately delaying the work permit approval.

Some applicants neglect to mention the hours the minor will work. The form requires details about the expected work schedule, including days and hours. If this information is missing, it may raise concerns about compliance with labor laws regarding minors.

Another mistake is not keeping a copy of the completed form for personal records. It’s important to retain a copy for reference. This can be helpful if there are any questions or issues later on regarding the application or the minor’s employment.

Additionally, failing to check for any additional local or state requirements can lead to complications. Each state may have specific regulations regarding the employment of minors. It’s essential to be aware of these rules to ensure full compliance.

Lastly, some individuals rush through the form, leading to careless errors. Taking the time to carefully read each section and verify the information can prevent mistakes. A thorough review can save time and avoid unnecessary complications down the line.

Documents used along the form

When employing minors, several forms and documents are often required alongside the Statement of Intent to Employ Minor and Request for Work Permit. Each of these documents serves a specific purpose in ensuring compliance with labor laws and protecting the rights of young workers.

  • Parental Consent Form: This document is signed by a parent or guardian, giving permission for the minor to work. It typically includes details about the job and the hours the minor is permitted to work.
  • Proof of Age: Employers may require documentation that verifies the minor's age, such as a birth certificate or school identification card. This helps ensure compliance with age-related labor laws.
  • Job Description: A written description of the minor's job duties is often necessary. This document outlines the responsibilities and tasks associated with the position, ensuring clarity for both the employer and the minor.
  • Work Schedule: A detailed work schedule is important to outline the hours and days the minor will be working. This helps prevent any violations of labor regulations regarding working hours for minors.
  • Health and Safety Training Certificate: If applicable, this certificate confirms that the minor has completed any required training related to health and safety in the workplace. It ensures that the minor is aware of potential hazards and knows how to work safely.

Having these documents in order can streamline the process of hiring minors and help ensure a safe and compliant work environment. Always check local laws and regulations, as requirements may vary by state.

Similar forms

  • Employment Application - This document collects information from potential employees, including minors, to assess their qualifications for a job. It often requires similar parental consent and information about the applicant's age.
  • Parental Consent Form - This form is used to obtain permission from a parent or guardian for a minor to engage in work activities. It parallels the Statement of Intent by emphasizing the need for parental approval.
  • Work Experience Agreement - This document outlines the terms of a minor's work experience. It is similar in that it requires agreement from both the employer and the minor’s guardian, ensuring that all parties understand the work conditions.
  • Minor Work Permit Application - This application is specifically for obtaining a work permit for minors. It shares the goal of ensuring that minors are legally allowed to work and often includes similar information about the minor's age and working hours.
  • Job Offer Letter - This letter formally offers a position to a candidate. It may require parental acknowledgment for minors, similar to the Statement of Intent, which also seeks formal recognition of employment.
  • Health and Safety Agreement - This document ensures that minors understand the safety protocols at their workplace. It aligns with the Statement of Intent by promoting the welfare of minors in employment settings.
  • School Work Release Form - This form allows students to leave school early for work. It resembles the Statement of Intent in its focus on balancing education and employment for minors.
  • Child Labor Law Compliance Form - This form ensures that employers adhere to child labor laws. It is similar in purpose to the Statement of Intent, as both documents aim to protect minors in the workforce.
  • Employer's Liability Insurance Declaration - This document affirms that the employer has insurance coverage for potential workplace incidents. It relates to the Statement of Intent by emphasizing the employer's responsibility for the minor's safety.
  • Training Agreement for Minors - This agreement outlines the training a minor will receive in their job. It is akin to the Statement of Intent in that both documents seek to establish clear expectations for the minor's role and responsibilities.

Dos and Don'ts

When completing the Statement of Intent to Employ Minor and Request for Work Permit form, there are important guidelines to follow. Here’s a helpful list of things to do and avoid:

  • Do ensure all information is accurate and complete.
  • Do check that the minor meets the age requirements for employment.
  • Do provide a valid reason for hiring the minor.
  • Do include the signature of a parent or guardian where required.
  • Don't leave any sections of the form blank.
  • Don't submit the form without reviewing it for errors.
  • Don't forget to include the employer’s contact information.
  • Don't ignore local labor laws regarding minor employment.

Misconceptions

Understanding the Statement of Intent to Employ Minor and Request for Work Permit form is crucial for both employers and parents. However, several misconceptions can lead to confusion. Here are eight common misunderstandings:

  • Only employers need to fill out the form. Many believe that only the employer is responsible for completing this form. In reality, both the employer and the minor's parent or guardian must be involved in the process.
  • Minors can work any hours they want. Some think that once the form is submitted, minors can work unlimited hours. However, there are strict regulations on the number of hours and types of work minors can perform, depending on their age.
  • The form is only necessary for summer jobs. A common misconception is that this form is only required for summer employment. In truth, any employment of a minor, regardless of the season, requires this form.
  • Once the form is submitted, it cannot be changed. Some believe that any errors on the form cannot be corrected after submission. In fact, if mistakes are found, the form can often be amended or resubmitted.
  • All minors need a work permit regardless of their age. Many think that every minor must obtain a work permit. However, the requirement can vary based on the minor's age and the type of work being performed.
  • Only certain types of jobs require this form. There is a belief that only specific jobs, like those in entertainment or hazardous work, require this form. In reality, most jobs held by minors will require the completion of this form.
  • The process is overly complicated. Some people feel that the process of obtaining a work permit is too complex. While it may seem daunting, the steps are straightforward and designed to protect minors.
  • Employers are not held responsible for not submitting the form. There’s a misconception that employers won’t face consequences for failing to submit the form. In fact, employers can face legal repercussions for hiring minors without the proper documentation.

By clearing up these misconceptions, both employers and parents can better navigate the process and ensure compliance with labor laws protecting minors.

Key takeaways

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form is a crucial step for employers looking to hire minors. Here are some key takeaways to keep in mind:

  1. Eligibility: Ensure that the minor meets the age requirements for employment in your state.
  2. Complete Information: Fill out all required fields accurately to avoid delays in processing.
  3. Parental Consent: Obtain the necessary signatures from a parent or guardian, as their consent is mandatory.
  4. Job Description: Clearly outline the job duties to provide transparency about the work the minor will perform.
  5. Hours of Work: Specify the hours and days the minor will work, adhering to state regulations regarding minors' work hours.
  6. Workplace Safety: Ensure the work environment complies with safety regulations to protect the minor.
  7. Submit Promptly: Submit the form to the appropriate authority without delay to avoid any legal issues.
  8. Keep Records: Maintain a copy of the completed form for your records and future reference.
  9. Renewals: Be aware of any expiration dates or renewal requirements for the work permit.
  10. Compliance: Stay informed about state and federal labor laws to ensure ongoing compliance when employing minors.

These takeaways are essential for a smooth hiring process and to ensure that you are following the law when employing minors.