Free 48409.pdf - Indiana


File Size: 21.1 kB
Pages: 1
Date: October 29, 2003
File Format: PDF
State: Indiana
Category: Government
Author: N. B. Carroll/B Plus C Communications
Word Count: 444 Words, 2,502 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.state.in.us/icpr/webfile/formsdiv/48409.pdf

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State Form 48409 (R3/3-00)

Written Parental Permission for Additional Work Hours for 16 & 17 Year Olds
I am the parent or legal guardian of: Name of Child As parent or guardian, I give the above named child permission to: if 16 years of age, work until midnight on nights not followed by a school day.
(Initial)

if 17 years of age, work until 11:30 p.m. on nights followed by a school day.
(Initial)

if 17 years of age, work until 1:00 a.m. on two non-consecutive school nights per week.
(Initial)

if 16 or 17 years of age, work up to 9 hours on a day not followed by a school day.
(Initial)

if 16 or 17 years of age, work up to 40 hours during a school week.
(Initial)

if 16 or 17 years of age, work up to 48 hours during a non-school week.
(Initial)

Printed Name of Parent or Guardian Signature of Parent or Guardian Date

State Form 48409 (R3 / 12-99)

Written Parental Permission for Additional Work Hours for 16 & 17 Year Olds
I am the parent or legal guardian of: Name of Child As parent or guardian, I give the above named child permission to: if 16 years of age, work until midnight on nights not followed by a school day.
(Initial)

if 17 years of age, work until 11:30 p.m. on nights followed by a school day.
(Initial)

if 17 years of age, work until 1:00 a.m. on two non-consecutive school nights per week.
(Initial)

if 16 or 17 years of age, work up to 9 hours on a day not followed by a school day.
(Initial)

if 16 or 17 years of age, work up to 40 hours during a school week.
(Initial)

if 16 or 17 years of age, work up to 48 hours during a non-school week.
(Initial)

Printed Name of Parent or Guardian Signature of Parent or Guardian Date

State Form 48409 (R3 / 12-99)

Written Parental Permission for Additional Work Hours for 16 & 17 Year Olds
I am the parent or legal guardian of: Name of Child As parent or guardian, I give the above named child permission to: if 16 years of age, work until midnight on nights not followed by a school day.
(Initial)

if 17 years of age, work until 11:30 p.m. on nights followed by a school day.
(Initial)

if 17 years of age, work until 1:00 a.m. on two non-consecutive school nights per week.
(Initial)

if 16 or 17 years of age, work up to 9 hours on a day not followed by a school day.
(Initial)

if 16 or 17 years of age, work up to 40 hours during a school week.
(Initial)

if 16 or 17 years of age, work up to 48 hours during a non-school week.
(Initial)

Printed Name of Parent or Guardian Signature of Parent or Guardian Date