The age and schooling certificate shall not be approved until the parent or guardian of such child shall present a school attendance certificate as hereinafter prescribed. A duplicate of such age and schooling certificate shall be filled out and sent by the school officer, before whom the same is made, to the Commissioner of Labor. The blank forms for school attendance certificate and for the age and schooling certificate shall be supplied to the principal, headmaster, or equivalent administrative officer of the school or to one of the child's parents if the child is being schooled at home by the State Superintendent of Public Instruction as hereinafter indicated.

This certifies that ................ (name of child) can read and write and that according to the records of this school and in my belief is now ............. (number of years and months) old, and has attended school during the full school term of the preceding year.

This certifies that I am .............. (father, mother or guardian) of ........... (name of child) s.s. # ..............., and that he (or she) was born at ............. (town or city), .......... (county), .............. (state or country), on the ........ (day, month and year of birth), and is now ............... (number of years and months old).

.................... (City or town or county).

Personally appeared before me the above-mentioned............ (name of person signing), and made oath that the foregoing certificate is true to the best of his (or her) knowledge and belief.

I hereby approve the foregoing certificate of............. (name of child), height............. (feet and inches), weight........... (pounds), complexion........... (fair or dark), hair............. (color), eyes.......... (color), having no sufficient reason to doubt that he (or she) is of the age therein certified.

This certificate belongs to............. (name of child), and is to be surrendered to him (or her) whenever he (or she) leaves the service of the employer holding the same, but if not claimed by said child within thirty days after leaving said service, shall be sent to the Commissioner of Labor.