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The Work Permit form is a crucial document for minors seeking employment, ensuring that their employment conforms to local regulations regarding age, hours, and job types. Before a minor can begin working, this form requires essential information including the minor's name, age, grade level, and date of birth, as well as the address of both the student and their parent or guardian. The document necessitates a physician's certificate to affirm that the minor is fit for the designated work. With this application, parents or guardians must provide their consent through a signature, confirming their approval for the minor to work and attesting to the accuracy of the submitted information. Additionally, employers are required to complete sections indicating their commitment to comply with employment laws governing minors, including hours of work, job responsibilities, and educational attendance. The form also includes specific details about the workplace, such as the employer's contact information and job site address. The overall process is designed to safeguard minors by ensuring they can work legally while also maintaining their schooling commitments.

Work Permit Example

APPLICATION FOR MINOR WORK PERMIT

STUDENT / APPLICANT INFORMATION

3331 02 ORC

4109 02 ORC

Name of Student / Applicant in full:

 

Sex:

 

 

Grade Level:

 

 

 

 

 

 

 

 

 

Male

 

Female

 

 

 

 

 

 

 

 

 

 

 

 

 

Proof of Age (Type of document):

 

Age:

Date of Birth:

 

Physician's certificate:

 

 

 

 

 

 

 

Submitted with

 

 

 

 

 

 

 

 

 

 

 

 

 

 

this application

 

 

 

 

 

 

 

 

Address of Student /Applicant:

 

 

 

 

 

 

 

Valid physician's certificate on file

School District:

 

Building:

 

 

 

 

 

 

 

 

Parent or Guardian:

Parent or Guardian Telephone Number:

Address of Parent or Guardian:

I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE ABOVE STATEMENTS ARE TRUE AND THAT THE MINOR

NAMED ABOVE WILL WORK WITH MY APPROVAL.

X

Signature of Parent or Guardian

Date Signed

THE NUMBER OF HOURS OR DAYS AND THE TIMES DISPLAYED BELOW OR ON THE FINAL PERMIT ARE FOR REGULATORY PURPOSES ONLY AND ARE NOT TO BE CONSTRUED IN

ANY WAY OR MANNER TO BE INDICATIVE OF A CONTRACT BETWEEN AN EMPLOYER AND THE EMPLOYEE.

I HEREBY CERTIFY THAT I HAVE EXAMINED AND APPROVED THE ABOVE NOTED DOCUMENTARY PROOF OF AGE.

X

Superintendent / Chief Adminstrative Officer / Designated Issuing Officer

Name of Office

Address of Office

PLEDGE OF EMPLOYER

-

Name of Firm:

Telephone Number at Minor's Work Location:

 

 

 

 

 

 

Address of Student /Applicant's Place of Employment, Job Site, or Work Location:

 

 

 

 

 

 

Specific Nature of Employment:

 

 

 

 

 

 

 

Employer's Tax ID Number (9 digits). THIS FIELD IS MANDATORY )~'

I

 

 

IF MINOR WORKS A VARIED OR

 

 

 

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IRREGULAR SCHEDULE ENTER

 

 

 

 

 

 

 

 

 

 

 

 

''REPRESENTATIVE" TIM~S IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No. of Days Per Week: Hours Per Day: Starting Time:

Quitting Time:

ITEMS 1 THRU 4. ARE HOURS

 

 

 

 

TO BE WORKED WITHIN THE

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ILIMITS OF THE LAW?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE UNDERSIGNED HEREBY AGREES TO EMPLOY THE ABOVE NAMED CHILD IN ACCORDANCE WITH LAWS REGULATING THE EMPLOYMENT OF MINORS. THE EMPLOYER FURTHER AGREES TO GIVE MINOR A COPY OF THE WAGE AGREEMENT IN ACCORDANCE WITH SEC. 4109.42 ORC. THE EMPLOYMENT WILL BECOME EFFECTIVE AS SOON AS THE NECESSARY AGE AND SCHOOLING CERTIFICATE

IS VERIFIED BY THE EMPLOYER. THE EMPLOYER AGREES TO PERMIT THE CHILD TO ATTEND PART TIME SCHOOL WHEN SUCH IS AVAILABLE AND TO NOTIFY THE SCHOOL WITHIN FIVE DAYS AFTER THE EMPLOYMENT OF THE CHILD TERMINATES

PK

Signature of person authorized to sign for employer

Date signed

Telephone number

 

 

 

 

 

 

 

 

Address of employer if different from minor's place of employment

E-Mail address

 

LAWS COM 0000 (Repl.- Oho F.- 11 & 111)

(Optional- if employer wants notification in case of revocation)

PHYSICIAN'S CERTIFICATE FOR MINOR WORK PERMIT

3331 02 ORC

• 109.02ORC

APPLICANT INFORMATION

Name of Student I Applicant in full:

 

 

 

 

 

 

 

 

 

 

 

 

Sex:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Male

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

Height:

 

 

Weight:

 

 

 

Color of Hair:

Color of Eyes:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ft.

in.

 

 

 

lbs.

 

 

 

 

 

 

 

 

Distinguishing Characteristics, if any:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Female

School District:

Building:

 

 

 

 

 

 

Parent or Guardian:

Parent or Guardian Telephone Number:

PHYSICIAN'S APPROVAL

 

 

 

 

 

 

 

 

 

 

I

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE UNDERSIGNED HEREBY CERTIFIES THAT THEY HAVE

NOTE: IF WORK SHOULD BE LIMITED TO A CERTAIN TYPE OF

 

THROUGHLY EXAMINED THE ABOVE NAMED APPLICANT WHO

EMPLOYMENT, THE PHYSICIAN MUST MARK THIS FORM

 

WAS BORN ON THE DATE STATED ABOVE AND WHO MEETS THE

ACCORDINGLY IN THE AREA BELOW.

 

 

 

DESCRIPTION GIVEN HEREON, AND THAY SAID PERSON;

 

 

 

 

 

 

 

 

IS

 

IS NOT

Limited Certificate:

 

YES

 

NO

 

 

 

 

 

 

 

IN THEIR OPINION PHYSICALLY FIT TO PERFORM THE WORK OF

 

 

 

 

 

 

ANY EMPLOYMENT NOT FORBIDDEN BY LAW TO A PERSON OF

If Marked YES;

 

 

 

 

 

THIS AGE AND SEX.

 

 

 

 

 

 

 

 

 

Employment should be Limited to Work Specified Below:

 

 

 

 

 

 

X

Physician's Signature

Date Signed

LAWS COM 0000 (Replaces OHIO FORM V)

Form Characteristics

Fact Name Description
Purpose The Work Permit form is designed for minors seeking employment and ensures compliance with labor laws regarding the employment of minors.
Governing Law This form is governed by Ohio Revised Code (ORC) sections 4109.02 and 4109.42, which outline the regulations for employing minors.
Applicant Information The form requires detailed information about the minor, including their name, age, date of birth, and proof of age documentation.
Physician's Certificate A valid physician's certificate must be submitted, indicating that the minor is physically fit to work and meets health requirements.
Parent or Guardian Consent The signature of a parent or guardian is necessary, ensuring they approve the minor's employment.
Employment Details Employers must provide specific details about the job, including hours, starting times, and the nature of the employment.
Wage Agreement The employer is required to give the minor a copy of the wage agreement, as stipulated in section 4109.42 of the ORC.
Limitations on Employment If the minor's employment is limited to certain types of work, this must be explicitly marked on the form by the physician.

Guidelines on Utilizing Work Permit

After gathering all necessary information, you're ready to fill out the Work Permit form for a minor. This form requires details about the applicant, as well as the parent or guardian and employer. Completing this form accurately is essential for ensuring compliance with local regulations.

  1. Personal Information: Start with the name of the student or applicant. Ensure you fill in the sex and grade level.
  2. Age and Proof of Age: Provide the minor’s age and date of birth. Indicate the type of document used to prove age.
  3. Parent or Guardian Details: Fill in the name, address, and telephone number of the parent or guardian.
  4. Certification by Parent or Guardian: Sign and date the section which certifies the statements about the minor's employment are true and that they approve of the job.
  5. Employer Information: Enter the name, address, and telephone number of the employer. Include the nature of the employment and the employer’s tax ID number.
  6. Working Hours: Specify the number of days per week and hours per day the minor will be working. Include starting and quitting times.
  7. Superintendent's Approval: An authorized person from the school must sign, certifying that they have examined the necessary documents.
  8. Physician's Certificate: Have the physician complete the section confirming the minor is physically fit for the job and sign it.

Once all sections are filled out and all necessary signatures are in place, the completed form can be submitted to the appropriate authority, typically the school or district office. Make sure to keep a copy for your records.

What You Should Know About This Form

What is the purpose of the Work Permit form?

The Work Permit form is designed to obtain legal authorization for minors to work. It ensures that the minor's age, health, and educational status meet the requirements for employment under local laws. The form must be completed and signed by both the minor's parent or guardian and an authorized school official before the minor can start working.

Who needs to fill out the Work Permit form?

The Work Permit form must be filled out by the minor seeking employment, their parent or guardian, and a designated issuing officer from the school. All parties play a vital role in ensuring that the necessary information and signatures are provided, confirming the minor's eligibility to work.

What documentation is required to complete the Work Permit form?

To complete the Work Permit form, several documents are necessary. Applicants need to provide proof of age, which can be a birth certificate or other legal identification. A physician’s certificate confirming the minor's fitness for work is also required. This certificate must indicate whether the minor is physically capable of performing the specific work tasks required.

How long is the Work Permit valid?

The Work Permit remains valid until the minor turns 18 years old or until a change in the minor's employment status occurs, such as termination or a change in job duties. Employers are also advised to keep the permit on file for reference and compliance with labor laws.

What happens if there is a problem with the Work Permit application?

If there is an issue with the Work Permit application, it may be sent back for corrections. Common problems include missing signatures or incomplete information. Both the employer and the minor should ensure that all required fields are filled out correctly before submitting the form to prevent delays in the approval process.

Common mistakes

Filling out a Work Permit form can be straightforward, but many applicants often encounter specific mistakes that may delay the process or even lead to disqualification. Understanding these common pitfalls can help ensure a smoother application experience.

Neglecting to Provide Complete Personal Information is one of the most frequent errors. Each section of the personal information must be filled out thoroughly. Omitting details such as the full name, date of birth, or grade level can result in immediate rejection of the application. It’s essential to double-check that all required fields are populated.

This leads to another common mistake: Submitting Incorrect Proof of Age. The application clearly asks for verification of age. If the documentation provided is not valid or is outdated, the application may be rejected. It is important to ensure that the proof of age is a current, legally acceptable document.

Failure to Obtain Parental or Guardian Approval can also invalidate the application. The signature of a parent or guardian is required to certify that the minor will work with their consent. Without this signature, the application is incomplete. Timely communication with parents or guardians to obtain this approval is crucial.

The form requires a physician’s certificate, and not having an up-to-date certificate can cause significant delays. It is necessary to have a valid physician's certification on file for the application to be processed. Applicants should schedule a physical examination well ahead of submitting the application.

Another frequent oversight is not specifying the nature of employment. The employer must provide clear details about the job responsibilities. Vague descriptions can lead to confusion or disqualification, as the authorities need to understand the scope of work the minor will be engaged in.

Ignoring the Required Signature from the Employer is a crucial mistake. The application needs the employer's signature to confirm their commitment to follow the laws regulating the employment of minors. Without this signature, the application will be considered incomplete.

Applicants sometimes misunderstand the requirements regarding working hours. Filling out the hours section incorrectly can lead to regulatory issues. Ensure that the hours worked are within legal limits. If the minor works irregular hours, carefully enter "representative times" as specified in the instructions.

Finally, overlooking the need for an employer’s Tax ID Number can impede the permit approval process. This nine-digit number is mandatory. Applicants must verify that this information is accurate and complete before submission to avoid delays.

In summary, carefully reviewing and completing each section of the Work Permit form can help prevent these common mistakes. Attention to detail and timely communication with all parties involved are keys to a successful application process.

Documents used along the form

When applying for a Work Permit, various documents may be required alongside the application form. Each document serves a specific purpose to ensure compliance with laws regarding the employment of minors. Understanding these materials can help streamline the application process and meet legal requirement.

  • Physician's Certificate: This document attests to the minor’s physical fitness for employment. A physician must complete this certificate, confirming that the applicant meets the health criteria needed for the specific job. It also indicates if any restrictions should be placed on the type of work the minor can perform.
  • Proof of Age: Proof of age documentation is crucial in verifying the applicant's eligibility for employment. Acceptable forms may include a birth certificate, a school record, or other official identification that clearly states the applicant’s date of birth.
  • Employer’s Pledge: The pledge is a declaration by the employer agreeing to abide by all laws regulating the employment of minors. It ensures that the minor will be treated fairly, paid appropriately, and allowed to attend school as needed. The employer also commits to providing a wage agreement.
  • Parental or Guardian Consent: A signature from a parent or guardian is required to authorize the minor's employment. This consent ensures that the parent is aware of the minor's work schedule and nature of the job, which is crucial for safeguarding the minor's best interests.
  • School District Approval: The school district may require an approval letter confirming that the minor is in good standing academically. This approval helps ensure that work does not interfere with the minor's education.

Each of these documents plays an integral role in the overall application process for a Work Permit. Having them prepared ahead of time can often lead to a smoother and faster approval, allowing minors to embark on their work experience while adhering to legal standards.

Similar forms

The Work Permit form shares similarities with several other documents used in employment and education contexts. Below are four documents that bear resemblance to the Work Permit form:

  • Employment Agreement: Like the Work Permit form, an employment agreement outlines the specifics of a working relationship, including job responsibilities, hours of work, and wage agreements. Both documents require the signatures of relevant parties to validate the terms of employment.
  • Parental Consent Form: This form is similar in that it requires a parent or guardian's approval for a minor to engage in activities, such as employment or participation in events. Both documents necessitate signatures to confirm that the parent or guardian agrees with the minor's involvement.
  • Medical Clearance Form: This document confirms the physical fitness of an individual, similar to the section in the Work Permit that requires a physician's certificate. Both forms rely on professional evaluations to ensure that the individual meets specific health standards for employment.
  • School Attendance Authorization: This document allows for coordination between a minor's work schedule and their school attendance. Just like the Work Permit, it emphasizes compliance with regulations governing minors' work and education, ensuring that the minor can attend school while also fulfilling work obligations.

Dos and Don'ts

Do's and Don'ts for Filling Out the Work Permit Form

  • Do: Fill in all required information completely and accurately.
  • Do: Ensure the physician's certificate is valid and submitted with your application.
  • Do: Have a parent or guardian sign the form, certifying the information is true.
  • Do: Include the employer's Tax ID number, as this field is mandatory.
  • Don't: Leave any mandatory fields blank; doing so can delay your application.
  • Don't: Provide incorrect or misleading information about age or work conditions.
  • Don't: Forget to specify the exact nature of the employment.
  • Don't: Assume that the hours listed on the form are final; confirm with your employer.

Misconceptions

Here are some common misconceptions about the Work Permit form:

  • Only certain jobs require a Work Permit. Many believe that only specific types of work need a permit, but any employment for minors usually requires one.
  • The Work Permit forms are only for summer jobs. This isn't true. The Work Permit is necessary for any job throughout the year, not just during summer breaks.
  • A parent’s signature is not needed. Some think a parent or guardian can skip signing, but their approval is essential for the application to be valid.
  • Work Permits are issued automatically. People often think that if they fill out a form, they will automatically get a permit. However, it requires approval from a designated issuing officer.
  • The doctor’s note isn't important. Many underestimate the requirement for a physician's certificate. This document is crucial to confirm the minor's eligibility for work.
  • There are no restrictions on work hours. Some believe that minors can work any hours they want. In reality, there are laws restricting the number of hours and days they can work.
  • Applying for a Work Permit is a lengthy process. While some assume it takes too long, the application process can be quick if all documents are correctly submitted.
  • Work Permits are only necessary for full-time jobs. This is misleading; even part-time work for minors requires a Work Permit.
  • Work Permits last indefinitely. A common notion is that once issued, permits do not expire. In truth, they often need renewal depending on changes in employment status, age, or other factors.

Key takeaways

When filling out and using the Work Permit form, certain key aspects should be kept in mind to ensure compliance and clarity.

  • All required fields must be accurately completed, including the student’s full name, date of birth, and address.
  • The form must include proof of age, such as a birth certificate or other legal documentation.
  • A valid physician's certificate must be submitted with the application, confirming the applicant's physical fitness for the job.
  • Both a parent or guardian’s signature and the superintendent's signature are necessary for the application to be valid.
  • Details of the job such as the nature of employment and employer’s tax ID number are mandatory.
  • Specific work hours and days must adhere to regulations concerning minor employment.
  • Employers must agree to provide a copy of the wage agreement to the minor employee.
  • Notification to the school is required if the employment terminates.
  • Physicians may dictate limitations on the type of employment, if necessary, by marking the relevant sections on the form.