California Covered Electronic Waste Recycling Payment Claim (Form 196A)

Form Template

The California Covered Electronic Waste Recycling Payment Claim (Form 196A) offers a straightforward waste management

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claim form but it can be modified to match your current requirements and records items such as date, reporting information, disposition of un-cancelled CRTS and/or CRT-containing devices, post-cancellation disposition of glass cullet or bare CRTs and estimated weight of treatment residuals. GoCanvas applications, like the California Covered Electronic Waste Recycling Payment Claim (Form 196A) mobile app create a PDF that is saved in your account for your recycling records and can easily be integrated into your paperless recordkeeping system. Complete this form and attach to Payment Claim (CalRecycle Form 196) along with all supporting documentation requested. This app must only contain information for the same reporting period for which payment claims are made. Using GoCanvas ensures that the form is completed legibly and easily edited if corrections need to be made.

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