Cde B1 1 Form PDF Details

Understanding the complexities of legally employing minors in California is crucial for businesses, and the "Statement of Intent to Employ a Minor and Request for Work Permit– Certificate of Age" form (CDE B1-1) plays a pivotal role in this process. This form, which must be completed in line with the California Education Code sections 49162 and 49163, serves not only as a notification of an employer's intent to hire a minor but also acts as a Certificate of Age as per section 49114 of the Education Code. It encompasses essential information including minor's personal details, school data, and employment specifics, requiring endorsements from both the employer and the minor's parent or legal guardian. Moreover, it underscores the employer’s commitment to adhere to labor laws, including non-discrimination and worker’s compensation insurance provisions. The form also provides a detailed summary on the back regarding minors' work regulations, derived from federal and state laws as well as district policies, which guide the permissible work hours and conditions to ensure the protection of minors in the workforce. Hence, the CDE B1-1 form is not just a procedural requirement but a critical document ensuring the lawful employment of minors while safeguarding their rights and well-being in California.

QuestionAnswer
Form NameCde B1 1 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameshow to complete a b11 form, california work permit, work form b1 pdf, cde b1 1

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STATE OF CALIFORNIA

DEPARTMENT OF EDUCATION

STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR WORK PERMIT– CERTIFICATE OF AGE

CDE B1-1 (Rev. 07-10)

A “STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR WORK PERMIT–CERTIFICATE OF AGE” form (CDE B1-1) shall be completed in accordance with California Education Code 49162 and 49163 as notification of intent to employ a minor. This form is also a Certificate of Age pursuant to California Education Code 49114.

(Print Information)

Minor’s Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Minor’s Name (First and Last)

 

 

Home Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Birth Date

Social Security Number

Grade

 

Age

 

 

 

 

 

 

 

 

 

Home Address

 

 

City

 

 

 

 

Zip Code

School Information

School Name

 

School Phone

 

 

 

 

 

 

 

School Address

 

City

 

Zip Code

To be filled in and signed by employer. (Please review the General Summary of Minors’ Work Regulations on reverse.)

Business Name or Agency of Placement

 

Business Phone

Supervisor’s Name

 

 

 

 

 

 

Business Address

 

City

 

Zip Code

Describe nature of work to be performed:

 

 

 

 

 

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.

Employer’s Name (Print First and Last)

Employer’s Signature

Date

To be filled in and signed by parent or legal guardian

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 and belief, the information herein is correct and true. I request that a work permit be issued.

Parent or Legal Guardian’s Name (Print First and Last)

Parent or Legal Guardian’s Signature

Date

For authorized work permit issuer use ONLY

Maximum number of hours of employment when school is in session:

 

Mon

Tue

Wed

Thu

 

Fri

Sat

Sun

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check Permit Type:

 

 

 

 

 

 

 

 

*Full-time

 

***Work Experience

 

Proof of Minor’s Age (Evidence Type)

 

 

 

 

 

 

 

Education, Vocational

 

 

 

 

 

 

**Workability

 

 

 

 

 

 

 

 

 

Education, or Personal

 

 

 

 

 

 

Restricted

 

Attendant

 

 

Verifying Authority’s Name and Title (Print)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

General

 

 

 

 

 

 

 

 

 

 

 

 

 

Verifying Authority’s Signature

 

 

 

 

 

 

 

 

 

 

 

 

*EC 49130 | **Permit Type defined by local school |***Special Education Grant

 

 

 

Copy–District or County Superintendent; Employer; Parent or Legal Guardian

 

 

(Over)

STATE OF CALIFORNIA

DEPARTMENT OF EDUCATION

STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR WORK PERMIT— CERTIFICATE OF AGE

CDE B1-1 (Rev. 07-10)

General Summary of Minors’ Work Regulations

FLSA-Federal Labor Standards Act, CDE-California Department of Education, EC-California Education Code, LC-California Labor Code, CFR-California Federal Regulations

If federal laws, state laws, and school district policies conflict, the more restrictive law (the one most protective of the minor) prevails. (FLSA)

Employers of minors required to attend school must complete a “Statement of Intent to Employ a Minor and Request for Work Permit” (CDE B1-1) for the school attendance for each such minor. (EC 49162)

Employers must retain a “Permit to Employ and Work” (CDE B1-4) for each such minor. (EC 49161)

Work permits (CDE B1-4) must be retained for three years and be available for inspection by sanctioned authorities at all times. (EC 49164)

A work permit (CDE B1-4) must be revoked whenever the issuing authority determines the employment is illegal or is impairing the health or education of the minor. (EC 49164)

A day of rest from work is required in every seven days, and shall not exceed six days in seven.

(LC 551, 552)

Minors under the age of 18 may not work in environments declared hazardous or dangerous for young workers, examples listed below: (LC 1294.1 and 1294.5, 29 CFR 570 Subpart E)

1.Explosive exposure

2.Motor vehicle driving/outside helper

3.Roofing

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.Power saws and shears

10.Power-driving meat slicing/processing machines

HOURS OF WORK

16 & 17 Year Olds

14 & 15 Year Olds

Must have completed 7th grade to work

Must have completed 7th grade to work

while school is in session.

while school is in session

(EC 49112)

(EC 49112)

 

 

School In Session

12 & 13 Year Olds

Labor laws generally prohibit non-farm employment of children younger than 14. Special rules apply to agricultural work, domestic work, and the entertainment industry. (LC 1285–1312)

4 hours per day on any schoolday

3 hours per schoolday outside of school

2 hours per schoolday and a maximum of

(EC 49112; 49116; LC 1391)

hours (EC 49112, 49116; LC 1391)

4 hours per week.

8 hours on any non-schoolday or on any

8 hours on any non-schoolday

(EC 49112)

 

day preceding a non-schoolday.

No more than 18 hours per week

 

(EC 49112; LC 1391)

 

(EC 49116; LC 1391)

 

 

 

48 hours per week (LC 1391)

WEE students may work during school

 

 

 

WEE students & personal attendants

hours & up to 23 hours per week.

 

may work more than 4 hours on a

(EC 49116; LC 1391)

 

schoolday, but never more than 8.

 

 

(EC 49116; LC 1391, 1392)

 

 

 

 

 

 

School Not In Session

 

 

 

 

8 hours per day (LC 1391, 1392)

8 hours per day (LC 1391, 1392)

8 hours per day (LC 1391, 1392)

48 hours per week (LC 1391)

40 hours per week (LC 1391)

40 hours per week (LC 1391)

 

 

 

 

Spread of Hours

 

 

 

 

5 a.m.–10 p.m. However, until 12:30

7 a.m.–7 p.m., except that from June 1

7 a.m.–7 p.m., except that from

a.m. on any evening preceding a non-

through Labor Day, until 9 p.m.

June 1 through Labor Day, until 9 p.m.

schoolday (LC 1391)

(LC 1391)

(LC 1391)

WEE students, with permission, until

 

 

12:30 a.m. on any day (LC 1391.1)

 

 

Messengers: 6 a.m.–9 p.m.

 

 

 

 

 

For more information about child labor laws, contact the U.S. Department of Labor at http://www.dol.gov/, and the State of California Department of Industrial Relations, Division of Labor Standards Enforcement at http://www.dir.ca.gov/DLSE/dlse.html.

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