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HAWAII DEPARTMENT OF LABOR AND …

hawaii department of labor and industrial relations wage standards division - child labor office certificate of employment (to be used only for minors under 16)

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HAWAII DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONSWAGE STANDARDS DIVISION - CHILD LABOR OFFICECERTIFICATE OF EMPLOYMENT(To be Used Only for Minors Under 16)Minors 16 and 17 years of age should apply for a Certificate of Age, by presenting an *acceptable proof of age document to the Child LaborOffice. You may also apply through the department's website at : This application should be signed by the employer only if the minor is promised a job. Before the minor starts working,a completed application (form CL-1) and an *acceptable proof of age document must be submitted to this office. A minor is NOTpermitted to work until the employer receives a Temporary Authorization minor is not required to appear in person - anyone may return this application and the proof of age document either in person or bymail. You may fax the application, but the original CL-1 is required to be returned to this office before a certificate can be issued. If theemployment is allowable under the Child Labor Law, a Certificate of Employment will be mailed to the employer. Certificates are issuedonly for employment with the employer named on this ON HOURSMinors 14 and 15 years of age may work: Not more than 3 hours per day on a school dayNot more than 8 hours per day on a non-school day During a school week, not more than 18 hours per week During a non-school week, not more than 40 hours per week On school days and the day before a school day: Between 7:00 and 7:00 On non-school days and the day before a non-school day: Between 6:00 and 9:00 limitations:Not more than 6 consecutive days of work; Not more than 5 consecutive hours without at least a 30-minute rest ormeal the job the minor will be performing if this application is approved;some jobs are considered hazardous for 14 and 15 year employment may also be subject to the federal child labor provisions under the Fair Labor Standards Act. For information, contactthe Department of Labor (USDOL), Wage and Hour - or print legibly and clearly the information on the to complete:Job and Title Minor Hired to Begin OnDate the minor will start of Work (a to e)Employer must fill in the hours the minor will be informationEmployer/Representative NameEmployer/representative must print name, sign and date the applicationFill in requested employer or guardian to or guardian name,signature, address, phoneMinor's parent or guardian must print name, sign, and provideinformation.*ACCEPTABLE PROOF OF AGE DOCUMENTS:Birth certificateCourt recordNOTE: A social security card is NOT anDriver's licenseBaptismal certificate acceptable proof of age recordState of Hawaii IDHospital recordSchool record (NOT school ID)Immigration record (alien card, passport, visa)Military ID (front and back of card)INSTRUCTIONS FOR FORM CL-1, APPLICATION FOR MINOR'S For further information, forms, and publications: Contact the Child Labor Office in your county at the locations listed belowor on the internet at Office hours are from 7:45 to 4:30 , Monday through Friday,except State our Website at for ALL interactive and downloadable forms. (Rev. 12/12)State Building, Rm. 108, Hilo, HI 96720HiloKauaiMauiOahuWest Hawaii830 Punchbowl Street, Rm. 340, Honolulu, HI 968133060 Eiwa Street, Rm. 202, Lihue, HI 967662264 Aupuni Street, Wailuku, HI 96793Phone: (808) 586-8777Phone: (808) 974-6464Post Office Building, Box 49, Kealakekua, HI 96750Phone: (808) 322-4808Phone: (808) 274-3351Phone: (808) 984-207511 - - - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Visit our Website at for ALL interactive and downloadable forms. (Rev. 12/12)HAWAII DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONSWAGE STANDARDS DIVISION - CHILD LABOR OFFICECL-1 APPLICATION FOR MINOR'S CERTIFICATE OF EMPLOYMENT (To be Used for Minors Under 16 Only)WARNING: A minor is NOT permitted to work until the employer receives a Temporary Authorization original signed application must be completed and returned to the Child Labor Office and when approved, the employer will beissued a temporary authorization slip and the minor's Certificate of Employment. See additional information on the OR TYPE - MUST BE LEGIBLE: (Use black ink)Minor'sInformation1. Last Name of Minor, First Name, Middle Male Phone ( )6. Mailing Address of MinorAptCityZip Code7. Name of School AttendingYear-round:Yes NoEmployerto Complete8. Job Minor Hired to Begin On10. Hours of Work (See instruction for restrictions):a. Start Timeb. End Timec. # Minutes Breakd. # Hours/Daye. # Days/WeekMonday - FridaySaturdaySundayEmployerInformation1 1. Name of Business12. Business Address (Mailing Address if not same)CityZip Code13. Employer DOL Number___ ___ ___ ___ ___ ___ ___ ___ ___ ___14a. Business Phone14b. Business Fax ( ) ( )15. Type of Business16. Signature of Employer/RepresentativeTitlePrint or Type Name of Employer/Representative17. Date of ApplicationParent orguardianto complete ( ) Phone Address Signature18. Print Name of Parent or GuardianThis request for an employment certificate is made with my knowledge and consent:FOR CHILDLABOROFFICEUSE ONLYProof of Age:BCHDLIMIDSRDate of BirthOtherDLIR OfficialDate TA IssuedCL-1 Ref Last four digits of minor's Social Security No. xxx - xx - _________SIDJob Title8a.

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