New Jersey > Statewide > Division Of Alcoholic Beverage Control
Application For Special Permit Authorizing Employment Of Persons Under 18 Years Of Age - New Jersey
| Application For Special Permit Authorizing Employment Of Persons Under 18 Years Of Age Form. This is a New Jersey form and can be used in Division Of Alcoholic Beverage Control Statewide . |
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STATE OF NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY DIVISION OF ALCOHOLIC BEVERAGE CONTROL P.O. BOX 087, 140 EAST FRONT STREET TRENTON, NJ 08625-0087 APPLICATION FOR SPECIAL PERMIT AUTHORIZING EMPLOYMENT OF PERSONS UNDER 18 YEARS OF AGE BY AN ALCOHOLIC BEVERAGE LICENSEE [EMP] This application must be accompanied by a fee of $15.00 in the form of check or money order payable to the Division of A.B.C. New applicants must also submit: I. II. One passport-size photograph (full face)taken within the last 30 days. A photocopy of applicant's Employment Certificate (working papers)issued by his/her District Board of Education. CHECK ONE: NEW APPLICANT ( 1. 2. ) RENEWAL APPLICANT ( ) Full Name of Applicant:_____________________________________ PLEASE PRINT CLEARLY OR TYPE Home Address of Applicant:__________________________________ STREET ADDRESS ________________________________________________________________________ CITY/TOWN STATE ZIP CODE 3. 4. Social Security Number__________-_______-__________ Description of Applicant: Age______________________ Date of Birth______/______/______ Eye Color________________ Weight___________________ Male/Female_________ Hair Color__________ Height______________ NOTE: 5. Are you presently, or have you ever been under the supervision of any parole or probation authority? If yes, you must attach a copy of your court disposition or a letter from your parole officer. YES ( ) NO ( ) American LegalNet, Inc. www.FormsWorkflow.com NOTE: BOTH SIDES OF THIS APPLICATION MUST BE FILLED OUT IN IT=S ENTIRETY BEFORE A PERMIT IS ISSUED. THIS AREA TO BE COMPLETED BY ALCOHOLIC BEVERAGE LICENSEE. (EMPLOYER): 6. 7. Name of Licensee:___________________________________________ PLEASE PRINT CLEARLY OR TYPE Address of Licensed Premises:_______________________________ STREET ADDRESS ____________________________________________________________ CITY/TOWN STATE ZIP CODE 8. 9. 10. 11. 12-Digit License Number________-______-________-________ MUST BE FILLED IN CORRECTLY Contact Name________________________________________________ Contact Telephone Number____________________________________ Description of Applicant's Job Duties:______________________ ____________________________________________________________ ___________________________________ SIGNATURE OF LICENSEE __________________________ DATED THIS AREA TO BE COMPLETED BY PARENT OR GUARDIAN OF APPLICANT: I, ____________________________________, parent/guardian of _______________________________________, hereby consent to his/her employment by the New Jersey Alcoholic Beverage Licensee named herein. ___________________________________ SIGNATURE OF PARENT/GUARDIAN __________________________ DATED 11/07 American LegalNet, Inc. www.FormsWorkflow.com
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