0410) A Statement of Intent to Employ Minor and Request for Work Permit form must be completed before a Permit to Employ and Work form (CDE B14) can be issued to a minor
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Click ‘Get Form’ to open it in the editor.
Begin by entering the minor's information, including their full name, birth date, home phone number, social security number, home address, grade, age, and city.
Next, provide the school information. Fill in the school name, school phone number, and school address along with the corresponding city and zip code.
In the employer section, input your business name or agency of placement along with your business phone number and address. Describe the nature of work to be performed.
Ensure that both the employer and parent or legal guardian sign and date the form to certify that all information is correct.
Finally, review all entries for accuracy before submitting the completed form through our platform.
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STATEMENT of INTENT to EMPLOY a minor and REQUEST FOR work permitCDE Form B1-1CDE Form B1-4California work permit for minors PDFSTATEMENT of INTENT to EMPLOY MINOR and REQUEST FOR work permit Form B1-1B1 4 work permitB1-1 formCde form b1 1 instructions
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