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Employment Certificate

Sample Employment Certificate

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The following is a sample employment certificate. It contains the information that will need to be submitted in order for a minor to obtain working papers. Working papers can be obtained from either your local high school or the Department of Labor, depending on where you live.

 

Sample Employment Certificate (Working Papers) For Minors

_____ Employment During School Year

_____ Employment During School Vacations

This certificate authorizes the employment of

__________________________________________________ (Name of Minor)

____________________________________ (Address of Minor)

 

Minor’s Age _____ Date of Birth _________________

Date of Issue _____________

Date of expiration _____________

Proof of age accepted ______________________________________ (specify proof of age)

Certificate of physical fitness accepted____________________

Grade Completed_____________ (Specify)

Place of Birth _____________________________________________

 

Color of Hair _______________ Color of Eyes ________________

Height _____ feet _____inches

Weight ______ pounds

Name of Parent(s) ___________________________________

Telephone Number ____________________________________

Signature of Minor ______________________________________

 

Issuing Office

Issuing Officer's Signature______________________

Title________________________

Telephone Number__________________

Name of School__________________________________________________

Address of School_______________________________________________

City/State/Zip__________________________________________________

 

Certificate is valid for one year.

Note: Federal Hour Restrictions

 
  • Not more than 3 Hours on a School Day
  • Not more than 18 Hours in a School Week
  • Not More than 8 Hours on a Nonschool Day
  • Not more than 40 Hours in a Nonschool Week
  • Not Before 7 a.m. nor After 7 p.m. (9 p.m. from June 1st through Labor Day)

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