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Expires xx-xx-xxxx 29 C. F.R. Part 570. See instructions on reverse side. Note Persons are not required to respond to this collection of information unless it displays a currently valid OMB control number. Signature of minor submitting INTENTION TO EMPLOY PORTION TO BE COMPLETED BY EMPLOYER IF Applicant is under 18 years of age and to be employed in industry or under 16 years of age and to be employed In Agriculture. Name of employer Company 15. Business address of employer Number Street City...

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