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Forms
Employment and Age Certificate
Form 4598


Wage Claim
Form 17081


Complaint Inquiry
Form 52114


Employment Discrimination Questionnaire/Affidavit
Form 14543


Employment Retaliation (Whistleblower) Questionnaire/Affidavit
Form 54049


Housing Discrimination Intake Questionnaire
Form 52229


Human Rights Discrimination Intake Questionnaire
Form 52974



Instructions for Employment and Age Certificate

Form 4598 (75kb pdf)

The Employment and Age Certificate ("work permit") is required to be completed at the start of each employment relationship entered into by teens ages 14 and 15. Information for the form is gathered from the teen, his or her parent or legal guardian, and the employer. Once completed, the original form and copies are to be distributed according to the schedule indicated at the bottom of the form.

Limited exemptions exist that relieve teens of the requirement to complete an Employment and Age Certificate. Teens meeting one or more of the following exemptions are not be required to complete and file a work permit:

  • The teen is exempt from compulsory school attendance requirements under N.D.C.C. 15.1-20-02(1)(b), (c), or (d)

  • The teen works for and under the direct supervision of his or her parent, grandparent, or legal guardian (provided that the parent, grandparent, or legal guardian has 100% ownership of the business)

  • The teen works in domestic service (domestic service means services of a household nature performed in or about the employer's private home)

  • The teen works on a farm doing agricultural work

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