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Navigating the legal framework that ensures the safe and fair employment of minors can be a complex process both for employers and the young workers they wish to employ. Central to this process is the Statement of Intent to Employ Minor and Request for Work Permit form, an essential document that bridges the gap between youthful ambition and employment law compliance. This form not only serves as a formal request for a work permit but also specifies the nature of the intended employment, outlining the duties involved, hours of work, and the employer's commitment to adhering to labor laws designed to protect minors. By requiring detailed information about the proposed job, this document plays a vital role in safeguarding the well-being and educational opportunities of young workers. It thus acts as a cornerstone in the collaborative effort among schools, employers, parents, and minors themselves to ensure that work experiences are beneficial and do not detract from the minor's education.

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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.

File Attributes

Fact Detail
Definition The Statement of Intent to Employ Minor and Request for Work Permit form is a legal document required for minors who wish to work, detailing the nature of the intended employment and requiring approval from both a guardian and a school authority.
Purpose This form ensures that the employment of minors complies with state labor laws, protects their educational opportunities, and safeguards their health and well-being.
Who needs to complete it? Both the employer planning to hire a minor and the minor seeking employment must fill out the form. It must then be endorsed by the minor's parent or guardian and a school official.
Governing Law(s) The specific requirements and governing laws vary by state, but they generally adhere to the Fair Labor Standards Act (FLSA) on the federal level, which sets standards for the employment of individuals under 18 years of age.
Usage Conditions Conditions under which the minor is employed, such as hours of work and type of work, are strictly regulated by state laws, and any employment offered cannot interfere with the minor's schooling.

How to Fill Out Statement of Intent to Employ Minor and Request for Work Permit

Once a minor has found a job opportunity, taking the next step involves legally formalizing the employment process. This is where the Statement of Intent to Employ Minor and Request for Work Permit comes into play. It's a crucial document that bridges the gap between a young person's eagerness to work and the legal requirements needed to ensure their employment is legitimate and above-board. This form is meticulously designed to collect all necessary details about the minor’s prospective employment arrangement, ensuring that work conditions comply with regional labor laws designed to protect young workers. Below, you'll find a step-by-step guide to fill out this form accurately, paving the way for a smooth transition into the workforce for minors.

  1. Start by gathering basic information, including the minor's full name, birthdate, and school details. This helps to verify the age and educational status of the minor.
  2. Fill in the section reserved for the employer's information. This includes the business name, address, and the supervisor's name who will be directly responsible for the minor. Accurate details here are crucial for any follow-up or verification needed.
  3. Describe the specific job duties that the minor will be undertaking. Be clear and concise to avoid any ambiguity about the work involved.
  4. Indicate the number of hours per day and per week the minor is expected to work. This is important for compliance with laws regulating minor work hours.
  5. Detail the salary the minor will earn. This transparency helps in ensuring that the remuneration meets minimum wage standards and fair labor practices.
  6. Both the employer and the minor must sign and date the form, signifying mutual agreement and understanding of the employment terms outlined. This also includes any parent or legal guardian signatures if required.
  7. The form must then be submitted to the minor's school or the designated authority handling work permits. The school official’s role includes reviewing the form, possibly liaising with the employer to confirm details or clarify any queries, and then issuing the work permit.

Once submitted, the form undergoes review by school officials or the designated issuing authority. The review process is designed to ensure that all information is correct and that the employment does not interfere with the minor's education or welfare. If everything checks out, the work permit is issued, marking the final administrative step before the minor can start their job. Remember, this permit is not just a formality but a safeguard for the young worker’s rights, well-being, and education. Hence, ensuring the accuracy and completeness of the Statement of Intent to Employ Minor and Request for Work Permit form is more than just bureaucratic compliance—it's a step toward responsible and legally sound employment practices for minors.

Frequently Asked Questions

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 legal document required for individuals under the age of 18 who are seeking to enter the workforce. This form needs to be completed by both the potential employer and the minor. It ensures that the employment is suitable for the minor’s age and does not interfere with their education.

Who needs to fill out this form?

This form must be filled out by:

  • The minor seeking employment.
  • The employer offering the position.
  • A parent or guardian of the minor.
  • The minor's school, which will issue the work permit upon approving the request.

Where can one obtain this form?

The form is usually available from the minor’s school, specifically through the school's main office or career center. Alternatively, it can also be found on the state department of labor's website or the local state education department's website.

What information is needed to complete the form?

To successfully fill out the form, the following information is needed:

  1. The minor's personal information, including full name and date of birth.
  2. The employer's business information, including company name and address.
  3. Details of the job offer, such as position, duties, hours of work, and salary.
  4. Parent or guardian’s consent.
  5. School official’s approval and signature.

Is there a filing fee?

No, typically there is no filing fee required for submitting a Statement of Intent to Employ Minor and Request for Work Permit.

How long does it take to process this form?

The processing time can vary, but it often takes anywhere from a few days up to a week. This timeframe can depend on the school’s policies and the time of year. For example, during the busy start of the school year, it may take longer.

What happens after the form is submitted?

Once the form is submitted and all parties have provided their necessary information and consents, the school will review the application. If approved, the school will issue a work permit to the minor. This permit is what legally allows the minor to start their employment under the terms specified in the form.

Can a minor start working before receiving the work permit?

No, it is important for the minor to wait until they have received the work permit before commencing any work. Working without a valid work permit can lead to legal consequences for both the employer and the minor.

Is the work permit valid for any job the minor wants to undertake in the future?

No, the work permit is specific to the employer and position listed on the approved form. If the minor wants to change jobs or work for a different employer, a new Statement of Intent to Employ Minor and Request for Work Permit form must be completed and a new permit obtained.

What are the responsibilities of the employer regarding this form?

Employers are responsible for:

  • Ensuring the form is accurately completed and submitted.
  • Verifying the minor’s age and ensuring they are legally allowed to work.
  • Complying with all child labor laws, including work hours and conditions specific to minors.
  • Maintaining a copy of the work permit on file as long as the minor is employed.

Common mistakes

Filling out the Statement of Intent to Employ Minor and Request for Work Permit form can sometimes trip people up. One common mistake is neglecting to check the accuracy of all the details. It's crucial that every piece of information is double-checked for correctness. Simple errors, like a misspelled name or the wrong date of birth, can derail the whole process. Small oversights can lead to unnecessary delays in obtaining the work permit.

Forgetting to obtain all the necessary signatures is another error that often occurs. This form requires signatures from the minor, the parent or guardian, and the employer. Each signature serves as a vital endorsement, confirming the agreement and understanding among all parties involved. Missing any of these signatures means the application is incomplete, which can stall or even void the request for a work permit.

A third mistake involves not fully understanding the restrictions and conditions associated with the minor's employment. The form outlines specific rules regarding work hours, conditions, and types of employment permitted for minors. Failing to acknowledge or comply with these rules can not only put the minor at risk but can also result in penalties for the employer. It's essential for everyone involved to be aware of and adhere to these guidelines to ensure a safe and legal work environment.

Last but not least, some people submit the form without keeping a copy for their records. Having a copy on hand is important for future reference, especially if questions arise about the minor's employment conditions or if there is a need to verify employment authorization. Without a copy, it becomes more challenging to address any issues or disputes that may surface later on. Always keep a copy of the completed form before submitting it, to safeguard against potential complications.

Documents used along the form

When a minor seeks employment, the process involves various forms and documents beyond the Statement of Intent to Employ Minor and Request for Work Permit. These forms help ensure the minor's safety, legal compliance, and rights protection. The assortment of documents spans parental consents to government-issued identifications, each playing a unique role in the employment process. Understanding these documents can streamline the employment process for minors, employers, and parents or guardians.

  • Parent or Guardian Consent Form: This document indicates a parent or guardian's approval of the minor's intent to work. It's crucial for verifying that the minor has parental support in their employment.
  • Proof of Age: Often necessitated by law, this could be a birth certificate, passport, or state-issued ID card, confirming the minor's age to ensure they are of legal working age for the specified job.
  • Employer's Agreement: An agreement or confirmation letter from the employer specifying the job description, hours of work, and other employment terms.
  • School Attendance Verification: A document from the minor's school confirming attendance. This is necessary to ensure the minor’s employment doesn't interfere with their education.
  • Health Assessment or Medical Clearance: Sometimes required for jobs that may pose health risks, to confirm that the minor is fit for the specific type of work.
  • Emergency Contact Information: A form listing contact information for immediate reach in case of an emergency during work.
  • Training Certificates or Licenses: For jobs that require specific skills or training, minors may need to provide evidence of having completed relevant courses or obtained necessary licenses.
  • Social Security Card: Employers usually require a minor’s Social Security number for tax purposes and to verify work eligibility in the United States.
  • Workplace Safety and Minors’ Rights Information: Documentation that educates the minor on their rights as an employee and information on workplace safety.
  • Job Offer Letter: A formal letter from the employer offering the position to the minor. It typically outlines the job duties, compensation, and terms of employment.

Navigating the employment process as a minor or as the guardian or employer of a minor requires careful attention to legal and safety considerations. Properly completing and submitting the necessary documents ensures a smooth process for all parties involved, setting the stage for a fruitful and lawful employment relationship. In addition to satisfying legal requirements, these documents collectively support the well-being and rights of working minors.

Similar forms

The Employment Eligibility Verification Form I-9 is closely related to the Statement of Intent to Employ Minor and Request for Work Permit in that both are crucial for verifying an individual's eligibility to work within the United States. While the Statement of Intent focuses on minors seeking employment, the Form I-9 is a broader requirement for all employees to confirm their identity and eligibility to work, underscoring the legal backbone of employment practices.

Similarly, the Application for Employment Authorization (Form I-765) shares a common purpose with the Statement of Intent, as it serves individuals seeking permission to work legally in the U.S. Where the Statement of Intent caters specifically to minors, Form I-765 is typically utilized by those not holding U.S. citizenship or permanent residency, highlighting the diverse requirements across different demographics seeking employment.

Another document that echoes the Statement of Intent is the Child Labor Work Permit, which is a critical document for minors in many states. Like the Statement of Intent, the Child Labor Work Permit is designed to ensure that the employment of minors complies with legal standards and regulations, focusing specifically on the protection of the minor’s rights and safety in the workplace.

The Occupational Safety and Health Administration (OSHA) Form 300, which logs work-related injuries and illnesses, parallels the protective nature of the Statement of Intent. Although serving different functions, both forms are instrumental in safeguarding the workplace environment, with the Statement of Intent helping to regulate the conditions under which minors are employed.

The Federal and State Tax Withholding Forms bear a resemblance to the Statement of Intent as they are foundational documents for correctly processing payroll and ensuring compliance with tax laws. These forms, much like the Statement of Intent, help regulate the administrative side of employment, ensuring both employer and employee adhere to legal obligations from the onset of employment.

The Worker’s Compensation Insurance Form is another document that aligns with the Statement of Intent's purpose of safeguarding the welfare of employees, in this case, minors. It ensures that in the event of a work-related injury or illness, the necessary medical benefits and wage replacements are provided, highlighting a shared emphasis on the protection and well-being of workers.

The New Hire Reporting Form, required by state agencies to track newly hired or rehired employees, complements the Statement of Intent by facilitating the enforcement of child support orders among other things. Both documents contribute to a framework that supports legal and social responsibilities within the employment process, aiming to promote fairness and legal adherence.

Lastly, the Minor’s Release Form, often used in conjunction with the Statement of Intent in industries like entertainment, explicitly obtains consent from a minor’s parent or guardian for their child to work. It closely mirrors the Statement of Intent’s objective of ensuring that a minor’s employment is sanctioned by those legally responsible for them, reinforcing the protective measures afforded to minors entering the workforce.

Dos and Don'ts

When filling out the Statement of Intent to Employ Minor and Request for Work Permit form, individuals should approach the task with care and attention to detail to ensure the process is completed properly and accurately. Below are essential dos and don’ts to keep in mind:

  • Do gather all necessary information before beginning to fill out the form. This includes the minor's personal information, potential employer details, and the specifics of the job offer.
  • Do ensure the information is accurate and up-to-date. This aids in avoiding any delays in the processing of the work permit.
  • Do have the minor's parent or guardian review the form before submission. Their consent is crucial, and their review can help catch any mistakes or omissions.
  • Do use black or blue ink if the form is being filled out by hand. This is to ensure the form's legibility and maintain a professional appearance.
  • Do double-check the form for any errors or missing information before submitting it. This includes verifying dates, spelling of names, and accuracy of contact information.
  • Don’t leave any sections blank unless they are explicitly marked as optional. Incomplete forms can result in processing delays or outright denial of the work permit.
  • Don’t guess on details if unsure. It's better to seek clarification from the potential employer or consult with a school official or legal expert.
  • Don’t use correction fluid or tape; if a mistake is made, it's advisable to start over on a new form to keep the document clean and legible.
  • Don’t submit the form without the required signatures. The minor, the parent or guardian, and the employer must all sign the form where necessary.

Adhering to these guidelines can streamline the process, ensuring a smoother path to obtaining a work permit for a minor. It's also a way to demonstrate respect for the legal guidelines that protect young workers in the workforce.

Misconceptions

Understanding the Statement of Intent to Employ Minor and Request for Work Permit form is crucial for both employers and young workers. However, there are several misconceptions surrounding its use and requirements. Let's clarify these points:

  • The form is only for high school students: This is a common misconception. In reality, the form is applicable to all minors looking to engage in employment, regardless of whether they're in high school, middle school, or being homeschooled.

  • It's the minor's responsibility to obtain the form: While minors must be active participants in the process, employers often play a critical role in initiating the process by providing the necessary information and documentation to the minor.

  • The form guarantees employment: Submitting the Statement of Intent to Employ Minor and Request for Work Permit doesn't guarantee employment. It's merely a step in the process, subject to approval by the issuing authority based on various criteria.

  • Approval is automatic: Many assume that once the form is submitted, approval is automatic. However, the approval process involves a review of the minor's age, proposed work hours, and the nature of the work, among other factors.

  • There's no need to renew the work permit: Actually, work permits need to be renewed for each new job or if a minor continues working for the same employer after a certain period, typically at the start of a new school year.

  • Any job is permissible: The form doesn't grant permission for minors to work in any job. There are restrictions on the types of work minors can do, focusing on their safety and welfare.

  • The process is the same in all states: The process for obtaining a work permit can vary significantly from one state to another, including the forms used, the information required, and the approval process.

  • Employers don't need to keep a copy of the form: Employers must keep a copy of the approved work permit on file for as long as the minor is employed.

  • A work permit covers multiple jobs at the same time: If a minor wants to work more than one job, they generally need a separate work permit for each employer, ensuring that overall work hours still comply with legal restrictions for minors.

Clearing up these misconceptions is key to ensuring that the employment of minors is handled responsibly and legally. Both employers and young workers must understand their obligations and rights throughout this process.

Key takeaways

The Statement of Intent to Employ Minor and Request for Work Permit form is a crucial document for minors seeking employment. Understanding how to properly fill out and use this form is important for both employers and young workers. Here are key takeaways that can help ensure the process goes smoothly.

  • Understand the Purpose: The form is designed to ensure that the employment of a minor is legal and does not interfere with their education or well-being.
  • Gather Necessary Information: Before filling out the form, both the employer and the minor should gather all necessary information, including the minor’s personal details, proposed job description, and work hours.
  • Complete Accurately: Accuracy is vital. Both the minor and the employer must ensure all information provided on the form is correct to avoid delays.
  • Parental or Guardian Approval: A parent or guardian must usually sign the form, indicating their approval of the minor's employment and the conditions under which it will occur.
  • School Certification: The minor’s school may need to certify the form, confirming that the employment will not interfere with the minor’s education.
  • Follow Age Restrictions: Be aware of and abide by the age restrictions for work as specified by law, which the form helps to enforce.
  • Understand Work Hour Limitations: The form will specify the number of hours a minor is allowed to work, which is essential for compliance with labor laws designed to protect young workers.
  • Keep the Form Accessible: Once completed, the minor should keep the work permit (issued upon approval of the form) at the workplace as it may be required for verification by authorities.
  • Renewal and Changes: If there are any changes in the employment condition or if the minor seeks a new job, it is important to understand that a new form must be filled out and a new permit obtained.

By following these guidelines, minors and their employers can ensure that they comply with relevant labor laws and regulations, protecting the rights and safety of young workers.

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