Michigan Form Permit PDF Details

The Michigan Form Permit is a tool used to help communities identify and address the needs of their local businesses. The form can be filled out by business owners or their representatives, and it asks for information about the company's products and services, as well as its goals and objectives. This form serves as a foundation for future communication between the business owner and the municipality. By completing this form, business owners can ensure that they are getting the most out of their relationship with their local government. Additionally, it provides municipal officials with a better understanding of how businesses operate in their community, which can lead to more efficient development planning. Overall, the Michigan Form Permit is an important tool for both businesses and municipalities alike.

We've compiled some quick facts about the michigan form permit. It's really worth finding the time to learn this before starting filling in your form.

QuestionAnswer
Form NameMichigan Form Permit
Form Length2 pages
Fillable?Yes
Fillable fields54
Avg. time to fill out11 min 22 sec
Other namesmichigan work permit, michigan form permit, michigan work permit form, mi form offer employment

Form Preview Example

State of Michigan

Combined Offer of Employment and Work Permit/Age Certificate CA-7 for minors 16 and 17 years of age

Permit Number for School Use (optional)

Employer Information:

The employer must have a completed work permit form on file before a minor begins work.

The employer must always provide competent adult supervision.

The employer of the minor must comply with federal, state, and local laws and regulations including nondiscrimination against any applicant

or employee because of race, color, religion, national origin or ancestry, age, gender, height, weight, marital status, or disability.

The employer must return the work permit to the issuing officer upon termination of the minor’s employment.

Directions: Please type or print using an ink pen. See back of this form for summary of requirements.

Section I: To be Completed by Minor Applicant

Name of Minor:

 

 

Address:

 

 

 

 

 

 

 

 

 

City:

 

 

ZIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Age:

Date of Birth

 

Last Four Digits of

 

Contact Telephone Number for

 

Application Submitted Electronically: [ ] Yes [ ] No

 

Month/Day/Year:

 

Social Security Number:

 

Minor:

 

 

 

If yes, provide email address to return approved form:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of School (present or last attended):

Address:

 

 

 

 

 

 

 

 

 

City:

 

 

ZIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Grade Completed:

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of Business (e.g., fast food,

retail sales):

School Status (check one): [ ] in school [ ] home schooled [

] online/cyber/virtual

[

] Not Attending

 

 

 

 

 

Name of Parent/Guardian (circle one):

Parent/Guardian Telephone:

 

 

 

 

 

Parent/Guardian Email Address (optional):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section II: To be Completed by the Employer - Offer of Employment

 

 

 

 

 

 

 

 

 

Name of Business:

 

 

Address:

 

 

 

 

 

 

 

 

 

City:

 

 

ZIP:

 

 

 

 

 

 

 

 

 

 

Earliest Starting Time a.m./p.m.:

Latest Ending Time

a.m./p.m.:

 

 

Hours per Day:

Number of Days per

Week:

Total Hours of Employment per

 

 

 

 

 

 

 

 

 

 

Not more than 6 per week

Week:

 

 

 

 

 

 

 

 

 

 

 

 

No more than 24 hours when school is

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

in session and 48 hours when school is

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

not in session

Applicant’s Job Title:

Hourly Wage:

Job Duties/Tasks to be Performed by Minor:

 

Equipment/Tools to be Used by Minor:

 

 

 

 

 

 

 

 

 

Will the minor be working under an existing hours deviation granted by the Michigan Wage and Hour Division? [

] No

[ ] Yes

 

 

If yes, attach a copy of the approved Michigan hours deviation and retain parent/guardian consent at the worksite.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Employer:

 

 

Title:

 

 

 

 

 

 

 

 

 

Telephone:

 

Date:

(x)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section III: To be Completed by School’s Issuing Officer – Must be Signed by the Issuing Officer to be Valid

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of Work Hours

This is to certify that:

 

 

 

 

 

 

 

Evidence of Age Confirmed by (issuing officer checks one):

Per Week When School

(1) this form was properly completed,

 

 

 

 

 

 

 

 

 

 

 

 

 

is in Session:

(2) listed job duties are compliant with state and federal laws and

[

] Birth Certificate

[

] Certificate of Arrival in the U.S.

No more than

regulations,

 

 

 

 

24 hours per week

(3) listed hours are compliant with state and federal laws and

[

] Driver’s License

[

] Hospital Record of Birth

Number of Work Hours

regulations,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

While School Not in

(4) this form was signed by employer,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[

] School Record

[

] Baptismal Certificate

Session:

(5) I authorize the issuance of this work permit.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[

] Other (describe)

 

 

 

 

 

 

No more than

 

 

 

 

 

 

 

 

 

 

 

 

48 hours per week

Name of School District:

 

 

 

 

 

 

Printed Name of Issuing Officer:

 

 

Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, State, ZIP:

 

 

 

 

 

 

Signature of Issuing Officer:

 

 

Issue Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone Number:

 

 

 

 

 

 

(x)

 

 

 

 

 

 

 

 

 

Form CA-7 (revised 4/2021) Combined Offer of Employment & Work Permit and Age Certificate

Instructions for completing CA-7 must be printed on back of form for form to be valid.

Summary of Requirements

CA-7 MICHIGAN WORK PERMIT AND AGE CERTIFICATE

Who Needs a CA-7 Work Permit? A minor who is 16 or 17 years of age and not specifically exempted from the Youth Employment Standards Act (P.A. 90 of 1978). This completed form permits a minor to be employed only by the employer and at the location listed in Section II. Employers must complete a CA-7 for minors who start employment at 16 years of age. CA-7 Work Permits are valid until a minor turns 18 years of age or graduates as long as the minor works for the same employer. Home schooled students must be issued a work permit from an authorized issuing officer. Additionally, 16- or 17-year-old minors currently not attending school who have not met the requirements of graduation, or have not obtained a GED, or have not been emancipated by court order must secure a work permit from an authorized issuing officer.

Who Issues the Work Permit? The issuing officer is the chief administrator of a school district, intermediate school district, public school academy, or nonpublic school, or a person authorized by that chief administrator, in writing, to act on his/her behalf. A work permit may be issued by the school the minor attends, the school district where the minor resides, or the district where the minor will be employed.

Employment of Minors: A person under 18 years of age shall not be employed in, about, or in connection with an occupation which is hazardous or injurious to the minor’s health or personal well-being or which is contrary to standards established by state and federal acts, e.g., construction, slicers, motor vehicle operation, power-driven machinery. The minimum age for employment is 14 years except that a minor 11 years of age or older may be employed as a golf or bridge caddy or youth athletic program referee and a minor 13 years of age or older may be employed in some farming occupations or as a trap-setter. Adult supervision is required.

Instructions for Completing and Issuing:

1.The Minor completes Section I of the CA-7 form.

2.The prospective Employer completes Section II.

3.The Issuing Officer verifies the age of Minor using the best available evidence and ensures compliance with state and federal laws and regulations.

4.The Work Permit is issued by the Issuing Officer signing and dating the form in Section III.

5.The Issuing Officer maintains a copy for the school file.

6.The Minor returns the completed form to the Employer before beginning work.

The failure or refusal to issue a work permit by the school may be appealed by the minor in accordance with Public Act 306 of 1969.

Employer’s Responsibilities: The issuance of a work permit does not authorize employment of minors contrary to state or federal laws and regulations.

Must have a completed work permit form maintained at the minor’s worksite before a minor begins work.

Shall keep any approved deviation with parental consent on file at the minor’s worksite.

Must always provide competent adult supervision.

Must comply with federal, state, and local laws and regulations including nondiscrimination against any applicant or employee because of race, color, religion, national origin or ancestry, age, gender, height, weight, marital status, or disability.

Records required by Public Act 90 of 1978, as amended, must be maintained, and made available for inspection by an authorized department representative.

Must return the work permit to the issuing officer upon termination of the minor’s employment.

Must post required workplace posters at worksite; Michigan Wage and Hour posters may be downloaded at www.michigan.gov/wagehour.

Issuing Officer’s Responsibilities: A copy of the CA-7 and any Michigan Department of Labor and Economic Opportunity deviation forms shall be filed in the minor’s permanent school file. Work permits shall not be issued if the work is hazardous, information is incomplete, or if the minor’s employment is in violation of state or federal laws and regulations.

Hours of Work: Minors 16 years of age and older may work:

1.6 days in 1 week.

2.A weekly average of 8 hours per day.

3.10 hours in one day.

4.24 hours in 1 week when school is in session and 48 hours in 1 week when school is not in session.

5.Not more than 5 hours continuously without a documented 30-minute uninterrupted meal or rest period.

6.Between 6:00 a.m. and 10:30 p.m., but not during school hours

7.Until 11:30 p.m. Friday and Saturday and when not regularly attending school, e.g., summer vacation.

Hours Deviations: At any time, an employer may apply through the Michigan Wage and Hour Division for a General Hours or an Individual Hours Deviation allowing the minor to start work before and end work after the times allowed by the act. The number of hours a minor may work during a day or week remains the same.

Michigan Youth Employment Standards Act (P.A. 90 of 1978): For information about the law, rules, and regulations contact the Michigan Department of Labor and Economic Opportunity, Wage and Hour Division; PO Box 30476, Lansing, MI, 48909, phone 517-284-7800, www.michigan.gov/wagehour .

Federal Fair Labor Standards Act: For information about federal child labor provisions contact the U.S. Department of Labor, Wage and Hour Division, at 1-866-4USWAGE or www.youthrules.dol.gov.

Revocation of Permit: A permit may be revoked by the school issuing officer if: (1) poor school attendance results in a level of schoolwork lower than that prior to beginning employment or (2) the Michigan Department of Labor and Economic Opportunity/U.S. Department of Labor informs the school of an employer’s violations of state or federal laws or regulations. Any minor who has a permit revoked shall be informed of the appeal process by the school.

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