North Carolina Department Of Labor Youth Employment Certificate (Page 3 of 3) in pdf

NORTH CAROLINA DEPARTMENT OF LABOR

YOUTH EMPLOYMENT CERTIFICATE

Please Type or Print Clearly

Name of Youth:

Date of Birth: (mo/da/yr)

Age:

Sex:

Area Code

Phone

(

)

Complete Mailing Address:

City

State

Zip Code

Job Description: (Please be as complete as possible)

Company Name:

Type of Business:

*ABC ON-PREMISES PERMIT?

Yes

Complete Mailing Address:

City:

State:

Zip Code

Area Code

Phone

(

)

SIGNATURES & IMPORTANT INFORMATION BELOW

Minimum Age for Employment: Fourteen (14) for non-farm work with limited exceptions. Proof of age includes birth certificate, driver’s license or

DMV issued identification card, school records, insurance records, or other documentary evidence approved by the Department of Labor.

*ABC On-premises Permit Restrictions: Youth under age 18 may not prepare, dispense, serve, or sell alcoholic beverages for any reason even

if employed by their parents. Youth 16-17 may be employed in the premises to perform other duties including waitperson and cashier as long as

youth is not serving, taking orders or ringing up on-premises alcoholic beverages. Youth under age 16 may not work in the premises for any

reason. A limited exception exists for youth under age 16 who are employed by their parents to work in the premises to perform other duties. Youth

14-15 may work on the outside grounds to perform other duties with parent/guardian written permission (permit signature is acceptable).

Rest Breaks: No youth under age 16 may be employed for more than 5 consecutive hours without an interval of at least 30 minutes for rest

(applies to employers who are subject to state labor law only).

Hours Restrictions (14-15 year olds): Only between 7 am and 7 pm (except until 9 pm during the summer when school is not in session); only

outside school hours; no more than 3 hours per day or 18 hours per week when school is in session; and, no more than 8 hours per day or 40

hours per week when school is not in session.

Hours Restrictions (16-17 year olds): If regularly enrolled in grades 12 or lower, cannot be employed between 11pm and 5 am when there is

school the next day for the youth unless the employer receives written permission from the parent/guardian and the principal or principal’s

designee. This restriction does not apply to youth enrolled in GED programs or who have dropped out of school.

Permitted Occupations (14-15 year olds): Can only work in office or clerical occupations, in retail sales or service occupations including food

service and gasoline service stations. Cannot work in manufacturing, construction, or occupations involving the use of power-driven machinery

including lawn mowers.

Hazardous/Detrimental Occupations (Not Permitted For Youth Under Age 18) [*Limited apprenticeship/student learner exemptions]:

 Manufacturing or storing explosives

 Motor vehicle driving (limited exemption) and outside

 Welding, brazing and torch cutting*

 Any process where quartz or any other form of silicon dioxide or

helper

 Logging and sawmilling

asbestos silicate are present in powdered form*

 Power-driven woodworking machines*

 Any work involving exposure to lead or any of its compounds in any

 Power-driven metal forming, punching, shearing*

form*

 Any work involving exposure to benzene or any benzene compound

 Mining

 Slaughtering, meat packing, processing or rendering*

which is volatile or can penetrate the skin*

 Occupations in canneries, seafood and poultry processing which

 Power-driven bakery machines

 Power-driven paper products machines*

involve cutting or slicing machines, or freezing or packaging

 Manufacturing brick or tile

activities*

 Any work which involves the risk of falling a distance of 10 feet or

 Power-driven circular saws, band saws, or guillotine

more, including ladders and scaffolds*

shears*

 Any work as an electrician or electrician’s helper*

 Wrecking, demolition and shipbreaking operations

 Any work in confined spaces*

 Roofing operations*

 Occupations requiring the use of respirators*

 Excavation operations*

**NOTE: For more details on child labor/youth employment, go to:

The undersigned individuals certify that the above information is correct; the youth will not be employed in a hazardous, prohibited, or

detrimental occupation; will only be employed during legal hours; and, will be employed only in a permitted occupation.

Employer’s Signature:

Parent/Guardian/Custodian’s Signature:

Youth’s Signature:

(Youth must present proof of age and must sign in the presence of the issuing officer)

DSS/Designee’s Signature:

County

Designee ID Number

06/11/2014

North Carolina Department Of Labor Youth Employment Certificate Page 3

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