Inspection Division Forms

Boilers & Elevators | Safety and Training | School-to-Work | Wage and Hour | Youth Employment

Boilers and Elevators

• Boiler Inspector's License Application
• Application for License for Inspector, Mechanic, Accessibility Lift Mechanic
• Elevator Accident Report Form
• Elevator Violation Checklist for Cable
• Elevator Violation Checklist for Hydraulic
• Elevators, Dumbwaiters, Escalators and Accessibility Lifts Placed Out of Service or Decommissioned

Safety and Training

• Safety Summary Form
• Safety Summary Form
• Safety Summary Form Supplemental Instructions
• A Guide for Developing a Written Safety Program
• Self Inspection Checklist

School-to-Work

• Pre-Screening Form
• Pre-Screening Form (apply for school-to-work approval online)
• Approval Form for Non-Paid Work-Based Activities
• Co-op Agreement
• Application for Approval of Out-of-School Building Construction Projects
• Guidelines for Approval of Building Trades Activities

Wage and Hour

• A Guide to the Whistleblowers' and Wage Claim Process
• A Guide to the Wage Adjustment and Civil Penalty Hearing Processes
• Wage Claim Form
• Wage Claim Form

• Whistleblowers Complaint Form
• Whistleblowers Complaint Form
• Request for Payment of Wages Other Than Weekly (RSA 275:43II and LAB 803.01)
• Request for Payment of Wages Other Than Weekly (RSA 275:43II and LAB 803.01)
• Voluntary Waiver to the Day of Rest (RSA 275:33 and RSA 275:33-b)
• Voluntary Waiver to the Lunch or Eating Period (RSA 275:30-a)
• Voluntary Waiver to the prohibition against mandatory overtime for nurses and assistance under RSA 326-B (RSA 275:67 and RSA 275:68)
• Authorization for Accidental Overpayment Deduction
• Sample Authorization for Voluntary Payroll Deduction Form (RSA 275:48)
• Sample Form for New Hire Checklist
• Sample Form for Rate of Pay Notification
• Employers' Request for Child Labor (RSA276-A:5 and LAB 1001.04)
• Parental Permission Form (RSA 276-A:VIII and LAB 1002.02)
• Application for Employment of Disabled Person (RSA 279:22-a)

Youth Employment

• Employer's Request for Child Labor Form (RSA 276-A:5 and LAB 1001.04)
• Parental Permission Form (RSA 276-A:VIII and LAB 1002.02)
• Approval Form for Non-Paid Work-Based Activities
• Pre-Screening Form
• State & Federal Child Labor Information Guide
• Application for Approval for Out-of-School Building Construction Projects
• Guideline for Approval of Building Trade Activities
• Verification of Adequate Health of Child