Cde B1 4 Form PDF Details

The Cde B1 4 Form is a form created by the Canadian Centre for Occupational Health and Safety. It contains all of the information needed to complete an incident report in accordance with provincial regulations. The purpose of this blog post is to provide you with more information about what's in the form, how it can be used, and why it should be completed after an injury or accident has occurred.

In the table, there's some information in regards to the cde b1 4 form. There, you will obtain the details about the PDF you intend to fill out, like the estimated time to fill it out along with other details.

Form NameCde B1 4 Form
Form Length1 pages
Fillable fields32
Avg. time to fill out6 min 43 sec
Other namesform b1 4, you cde b1 form, cde form b1 4, work permit form b1 4

Form Preview Example



A work permit shall not be issued to a minor until the “STATEMENT OF INTENT TO EMPLOY A MINOR AND REQUEST FOR A WORK PERMIT–CERTIFICATE OF AGE” (CDE From B1-1) form has been signed by the parent or guardian, foster parent, caregiver, or residential shelter service provider and filed with the issuing authority. California Education Code (EC) 49110(c)

(Print Information)


Permit Expiration Date






Check Permit Type:







Work permits shall expire five days after the opening of the next


Work Experience Education,



succeeding school year. Full-time exempt work permits issued to 14





Vocational Cooperative



& 15 year olds shall expire no later than the end of the current school




year. EC 49118 and 49130






Education, or Personal Attendant





































































Minor’s Information




























Minor’s Name (Print First and Last)



Social Security Number





















Home Phone



Age at Time of Issuance

Birth Date


















Home Address









Zip Code

















School Information





























School Name






School Phone





















School Address









Zip Code
































Maximum Work Hours Permitted

1.Maximum number of work hours on a school day

2.Maximum number of work hours on a non-school day

3.Maximum weekly work hours while school is in session

4.Maximum weekly work hours while school is not in session

Remarks or Work Limitations:

This permit is valid only at the business listed below:

Business Name

Business Address

To be signed by minor

Minor’s Signature



I hereby certify that, to the best of my knowledge, the information herein is correct and true. I hereby certify that I have a working knowledge of child labor laws and all laws pertaining to the issuance of work permits in California. EC 49110

Issuing Authority’s Name and Title (Print)

Issuing Authority’s Signature


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

How to Edit Cde B1 4 Form Online for Free

The PDF editor was developed to be as straightforward as possible. Since you stick to the next actions, the procedure for filling in the permit to employ and work cde b1 4 document is going to be stress-free.

Step 1: On the website page, press the orange "Get form now" button.

Step 2: So you will be on your file edit page. You'll be able to add, adjust, highlight, check, cross, insert or delete areas or text.

The PDF template you decide to prepare will contain the following segments:

filling in cde form b1 4 work permit part 1

You should submit the Remarks or Work Limitations:, This permit is valid only at the, Business Name, To be signed by minor, Minor’s Signature, Date, Certification, and Business Address area with the necessary information.

Completing cde form b1 4 work permit part 2

You may be requested to enter the particulars to help the application fill out the field Issuing Authority’s Name and Title, Issuing Authority’s Signature, Date, and Copy–District or County.

cde form b1 4 work permit Issuing Authority’s Name and Title, Issuing Authority’s Signature, Date, and Copy–District or County fields to fill

Step 3: Hit the button "Done". The PDF document is available to be transferred. You will be able upload it to your device or email it.

Step 4: You should create as many duplicates of the form as you can to avoid possible misunderstandings.

Watch Cde B1 4 Form Video Instruction

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