An application for a waiver pursuant to section 13(c)(4) of the Act shall contain the following information:
(a) The name, address, and zip code of the employer, or each employer of a group of employers, and the authorized representative, if any, of an employer or group.
(b) The telephone number and area code for any employer or authorized representative from whom additional information concerning the application may be obtained.
(c) The address, location, and/or area (State, county, and/or other geographic designation), clearly identifying each employer's farm(s) or field(s) where 10 and 11 year old hand-harvest laborers are to be employed.
(d) The specific crop or crops to be hand-harvested at each designated farm or field.
(e) Substantiation of the claim that such agricultural operation ``is customarily and generally recognized as being paid on a piece rate basis in the region in which such individuals would be employed.'' The Administrator will accept signed statements to that effect from agricultural employers and employees and others, such as agricultural extension agents, in the region of employment who are familiar with farming operations and practices in the region and with the method of compensation used in such operations and practices.
(f) Designated dates of not more than 8 weeks an any calendar year, between June 1 and October 15, during which it is anticipated that 10 and 11 year old minors will be employed in the hand-harvesting of the specified short season crop or crops.
(g) A statement that the 10- and 11-year old hand harvesters will be employed outside school hours.