OFFICE RECORD CARD
State Form 2718R Child's Name
Child's Address
Place of Birth
Birthdate
Age
Sex
Female Male DOCUMENTS ACCEPTED AS PROOF OF AGE ARE LISTED BELOW IN PREFERENTIAL ORDER (Check method used) 1. Birth Certificate Transcript of Birth Certificate School Records verified by Birth Certificate
FRONT
2. 3.
Baptismal Certificate Family Bible Record
Transcript of Baptismal Certificate showing child's date of birth and place of baptism Passport or Immigration Papers Life Insurance Policy in existence minimum one year
ALL THREE ARE REQUIRED 4. (a.) Sworn statement by public health/public school physician or superintendent attesting to child's physical age (b.) Parent's statement (c.) Available school records Other (specify) Child's Signature Written request for transcript of birth mailed on (date) Issuing Officer's Signature
Fold here
Remark
BACK
Date Of Issue
Certif. No.
Prospective Employer
Address
Work Schedule Days Hrs. Per Per Week Day
Date Terminated Revoked