Forms and Information Supporting Participation in the Covered Electronic Waste Recycling Program

CalRecycle has a variety of resources available to assist participants in the Covered Electronic Waste (CEW) Recycling Program. Participants may use the appropriate form below or supply the required information in an alternate acceptable format.
The only exception is the Payee Data Record (STD. 204 Form), which is required.

  • Prospective collectors and recyclers must be approved prior to participation.
  • The information provided below does not substitute for a thorough understanding of all CEW Recycling Program requirements. Prospective participants are urged to familiarize themselves with applicable statutes and regulations.

The information on this page does not apply to battery-embedded products. To learn more visit the SB 1215 page.

Listserv

CalRecycle sends out regular e-mail messages through a listserv to interested parties about developments in CalRecycle’s work to implement the Electronic Waste Recycling Act of 2003 (SB 20 [Chapter 526, Statutes of 2003]; as amended by SB 50 [Chapter 863, Statutes of 2004]).

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CEW Recycling Program Application Forms to Participate

There are three unique application forms provided below, as well as an authorized staff update form. The three Application for Approval forms are intended to be submitted by either:

  • A collector (CalRecycle 186C)
  • A dual entity (CalRecycle 186D), or
  • A recycler (CalRecycle 186R)

The definitions and requirements for collectors, dual entities and recyclers are outlined in regulations. All interested parties should thoroughly review the regulatory requirements and comply with the applicable Department of Toxic Substances Control’s (DTSC) requirements regarding notification and inspections prior to applying.

Application Instructions

Prospective participants can complete the application either electronically by using the fillable PDF feature, or in hard copy form, printing legibly in permanent ink.

Form/DateDownload FormatFor Use ByDescription
Application for Approval: Collector (CalRecycle 186C)

Last revised: November 2022

CalRecycle 186C (PDF)

Prospective Collectors or Collectors for Renewal

Use this form to apply to participate as only an approved collector.

Application for Approval: Dual Entity (CalRecycle 186D)

Last revised: November 2022

CalRecycle 186D (PDF)

Prospective Dual Entities or Dual Entities for Renewal

Use this form to apply to participate as both an approved collector and approved recycler.

Application for Approval: Recycler (CalRecycle 186R)

Last revised: November 2022

CalRecycle 186R (PDF)

Prospective Recyclers or Recyclers for Renewal

Use this form to apply to participate as only an approved recycler.
Authorized Signatory Update (CalRecycle 186S)

Last revised: September 2022

CalRecycle 186S (PDF)

Collectors, Dual Entities or Recyclers updating signatories

Use this form to notify CalRecycle of changes to authorized signatories within the two-year application approval term. If a change is made to the Primary Signatory, a complete CalRecycle 186C, 186R, or 186D application form will be required to encompass the acknowledgment of the certification statements noted on the application.
Payee Data Record (STD 204)

Last revised: March 2021

Form 204 (PDF)

Prospective Dual Entities and Recyclers or Dual Entities and Recyclers for Renewal

Use this form to provide CalRecycle the information necessary to prepare the Internal Revenue Service Form 1099 Miscellaneous Income documentation. This form should accompany only dual entity (186D) or recycler (186R) applications.
  • The signed application can be submitted electronically via email to ewasteapplications@calrecycle.ca.gov, or mailed to the mailing address noted on the form.
  • Digital signatures are acceptable and electronic submissions are preferred, as hardcopies are not required but should be maintained in the applicant’s records.

Approved Applications

Approved applications remain valid for two years following the date of approval as long as the approved participants in the CEW Recycling Program:

  • Continue to meet and fulfill the requirements of the Electronic Waste Recycling Act and implementing regulations;
  • Comply with all applicable laws and regulations, including but not limited to DTSC’s laws and regulations; and
  • Keep CalRecycle informed of any changes to information contained in the approved application, including but not limited to:
    • Facility and operational status,
    • Change of location; and
    • Change of authorized personnel.

Updates to records can be made using the appropriate form below or by notifying CalRecycle. Failure to do so may result in revocation of approval.

Renewal Process

Participants must reapply 90 days prior to the expiration date of their approved application. Participants may use the appropriate form below or supply the required information in an alternate acceptable format.

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CEW Recycling Program Collection and Recycling Forms and Documents

CalRecycle provides the following forms and documents to support approved recyclers’ and approved collectors’ participation in the CEW Recycling Program.

  • These materials are provided as guidance and do not relieve participants of any other data, information or record maintenance requirements contained in regulation or statute.
  • While use of the forms is not mandatory, participants must provide equivalent information in supporting documentation and submit as part of a complete payment claim package.
  • The forms below are listed in the order they should be organized in a claim.
Form/DateDownload FormatFor Use ByDescription
Covered Electronic Waste Recycling Payment Claim
(CalRecycle 196)
Last revised: May 2022

CalRecycle 196 (PDF)

CalRecycle 196 Instructions (PDF)

 

Approved RecyclersUse this form for each Reporting Month within which payment is claimed. Information on this form includes calculation of payment claim, indication of supporting documents attached to the claim, and declarations and signatures of authorized agents. All applicable forms included below (or equivalent documentation) must accompany this form to make a complete payment claim package.
Worksheet A: Covered Electronic Waste Recycling Payment Claim (Cancellation of CRT CEWs)
(CalRecycle 196A) 
Last revised: May 2022

CalRecycle 196A (PDF)

CalRecycle 196A Instructions (PDF)

Approved RecyclersUse this form if the approved recycler cancels CRT CEWs. Information documented will include the type of cancellation method used, calculation of payment, post-cancellation disposition of glass cullet or bare CRTs, and weights of treatment residuals.

Worksheet B: Covered Electronic Waste Recycling Payment Claim (Cancellation of Non-CRT CEWs)
(CalRecycle 196B)

Last revised: June 2022

CalRecycle 196B (PDF)

CalRecycle 196B Instructions (PDF)

Approved RecyclersUse this form if the approved recycler cancels Non-CRT CEWs. Information documented will include calculation of payment, post-cancellation disposition of Bare Plasma Panels and LCD Lamps and weights of treatment residuals.
Covered Electronic Waste Transfer Summary
(CalRecycle 197S)
Last revised: May 2022

CalRecycle 197S (PDF)

CalRecycle 197S Instructions (PDF)

Approved RecyclersUse this form to summarize CEW transactions between approved collectors and an approved recycler as documented on all Covered Electronic Waste Transfer Receipts (CalRecycle 197s). The form summarizes unit and weight transfers by approved collectors.
Covered Electronic Waste Transfer Receipt
(CalRecycle 197)
Last revised: May 2022

CalRecycle 197 (PDF)

CalRecycle 197 Instructions (PDF)

Approved Collectors and/or Approved RecyclersUse this form to document the transfer of CEWs between an approved collector and an approved recycler. The form allows for required declarations and weight verifications.
Covered Electronic Waste Collection Log
(CalRecycle 198)
Last revised: January 2020

CalRecycle 198 (PDF)

CalRecycle 198 Instructions (PDF)

Approved CollectorsUse this form to document required information on all CEWs accepted by the Collector from California sources.
Covered Electronic Waste Source-Anonymous Collection Log
(CalRecycle 198 SA)
Last revised: January 2020

CalRecycle 198SA (PDF)

CalRecycle 198SA Instructions (PDF)

Approved CollectorsUse this form to document the handling of source-anonymous (SA) CEW. SA CEWs must be logged separately from other CEWs. Depending on the circumstances, limitations may apply regarding who may collect SA CEWs.
Proof of Designation
(CalRecycle 184)
Last revised: August 2020
New regulations are effective on October 1, 2020

CalRecycle 184 (PDF)

CalRecycle 184 Instructions (PDF)

Local Government

Use this form as a Proof of Designation (POD) under Title 14 CCR § 18660.49, when initiated by a California Local Government and duly executed by a representative authorized to take action on behalf of that Local Government. A copy of this POD must be transmitted to CalRecycle at least 30 days prior to CEW collection activities conducted under the Designation.

Evidence of this POD must accompany the CEW collection logs associated with CEWs transferred from a Designated Approved Collector to an approved recycler, and must also accompany any recycling payment claim that includes CEWs recovered under this Designation. Interested parties should review the applicable regulations and guidance.

CEW Recycling Program Net Cost Forms and Guidance

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Net Cost Forms

The CEW Recycling Program subsidizes the average net cost of CEW collection and recycling CEW in California by making payments to approved collectors and recyclers. To properly set the recovery and recycling payment rates, CalRecycle must evaluate the costs incurred and revenues received by approved participants when conducting collection and recycling activities. An essential tool in this evaluation is the Net Cost Report currently required of all participant

  • Approved collectors and recyclers must maintain records documenting costs and revenues and annually submit a report to CalRecycle on the net costs of recovering and recycling covered electronic wastes (CEWs).
  • CalRecycle allows the electronic submission of these reports through a secure server: Covered Electronic Waste Information System (CEWIS)
  • If you are filing on paper, use the forms in the table below. CalRecycle 220 is a summary report and must be accompanied by completed copies of the appropriate Net Cost Worksheets (CalRecycle 220C/CalRecycle 220R).
  • Participants may use the appropriate form below or supply the required information in an alternate acceptable format.

Form/Date

Download Format

For Use By

Description

Covered Electronic Waste Net Cost Report
(CalRecycle 220)

Last revised: December 2023

CalRecycle 220 (PDF)

Approved Collectors and Recyclers

This form is a summary report and must be accompanied by completed copies of the appropriate Net Cost Worksheets. Much of the detailed information needed to complete Form 220 and the Annual CEW Net Cost Report is captured and calculated in the 220C and 220R worksheets.

Collector Net Cost Worksheets
(CalRecycle 220C)

Last revised December 2023

CalRecycle 220C (PDF)

Approved Collectors

This form is to be completed by collectors and recyclers for their CEW recovery activities.

Recycler Net Cost Worksheets (CalRecycle 220R)

Last revised December 2023

CalRecycle 220R (PDF)

Approved Recyclers

This form is for use by recyclers only, so a dual entity must complete both 220C and 220R worksheets.

 

Report Validity

Submitting a fraudulent or inaccurate Net Cost Report is considered a prohibited activity and may result in revocation of approval in the payment system or in further enforcement action (Public Resources Code Sections 42474 (d) and (e)). All reporting entities are expected to use generally accepted accounting methods when calculating revenues and costs. Since CalRecycle uses this data in its consideration of payment rate changes when authorized by statute, it is imperative reports are accurate.

Net Cost Guidance

Additional guidance is available on CalRecycle’s Publications site. This guide describes the reporting and documentation requirements for CEW recovery and recycling activities conducted during the previous calendar year. This guide provides detailed, line-by-line instructions for completing all three of these forms or online reporting.

Net Cost FAQ

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Who is required to submit a Net Cost Report and what is the deadline?

All approved collectors and approved recyclers active at any time during the reporting year (covering the previous calendar year ending December 31) must submit an annual Net Cost Report to CalRecycle. The report is due by March 1.

Where can I obtain guidance on completing the Net Cost Report?

CalRecycle allows collectors and recyclers to submit their reports via CalRecycle’s secure Internet portal known as the Covered Electronic Waste Information System (CEWIS). Details of that process will be emailed to approved participants. A guide with specific instructions can be downloaded from CalRecycle’s Publications web.

What must the Net Cost Report include?

Per Title 14, California Code of Regulations (CCR), Section 18660.10(d), the annual Net Cost Report must include (among other requirements):

  • An annualized summary of the revenues, costs and net costs (costs minus revenues) for the recovery of all CEW for collectors and for recyclers, the recycling of CRT and non-CRT CEW (reported separately as of 2018 due to regulatory changes);
  • Total annualized revenues excluding recovery and recycling payments received from CalRecycle (or, for Collectors, received from the recycler), plus a description of the types of revenues included;
  • Total annualized costs, plus a description of the types of costs included; and
  • The net cost per pound of CEW recovery for collectors and the separate net cost per pound of CEW recycling for recyclers.
  • It is very important to also understand what must not be included in the report, which is revenues, costs, or weight of material not included in the CalRecycle program. This would be computer towers, printers, other computer peripherals, and miscellaneous electronics not defined as covered electronic wastes.

What documentation is required to be maintained?

The Net Cost Reports submitted to CalRecycle must be supported by detailed documentation maintained at the approved collector’s or recycler’s place of business.

Approved collectors must maintain records on the costs, revenues, and net costs associated with the collection, transportation, and disposition of all CEWs handled (14 CCR Section 18660.20(j)(3)).

Approved recyclers must maintain records on the net costs associated with the disposition of CRT and non-CRT CEWs handled, the net costs of accepting the transfer of CEWs, the net costs of each cancellation method used, and any additional administrative costs of providing recovery payments to approved collectors (14 CCR Section 18660.21(I)(5)). As noted previously, due to regulatory changes, recyclers must report CRT and non-CRT CEW values separately.

Do Net Cost Reports need to cover recovery and recycling separately?

Yes. Approved collectors must maintain records and report net costs associated with CEW recovery. Approved recyclers must maintain records and report net costs associated with CEW recycling by the CEW categories of CRT and non-CRT. Approved recyclers who are also approved collectors must maintain records and report net costs separately for CEW recovery and for CEW recycling activities.

What have been the most common problems with these reports in previous years?

  • Incomplete information (e.g., missing weight data and omitted costs or revenues) or incorrect information (weights and costs associated with electronic wastes other than CEW). Use of online reporting can help ensure complete reporting.
  • Late or non-submission of Net Cost Report. A report is required if a collector or recycler has been approved to participate in the system at any time in the reporting year, even if no CEW was handled. CalRecycle may revoke or suspend approval of a collector or recycler for failure to submit a Net Cost Report.
  • Information contained on the participating organization’s approved application doesn’t match information reported on the Net Cost Report. An Application for Approval (Form 186C, 186D, 186R, or 186S) should be submitted to CalRecycle to update records as necessary. CalRecycle may revoke or suspend approval of a collector or recycler for failure to notify CalRecycle of changes to information contained in the approval application. Examples are:
    • Wrong person signs the Form 220. The Net Cost Report must be signed by a person authorized in the collector’s or recycler’s approved application.
    • Organization changed address, authorized personnel, or contact information without sending required update to CalRecycle per 14 CCR Section 18660.18.
    • Change of ownership without sending required update to CalRecycle per 14 CCR Section 18660.18.

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Why is CalRecycle requiring this information, and how will it be used?

CalRecycle will analyze and compile information from the Net Cost Reports to evaluate the need to adjust payment rates for CEW recovery and recycling operations.

Does CalRecycle intend to review or audit net cost documentation?

Yes. As part of CalRecycle’s analysis of the Net Cost Report, CalRecycle staff will review the information submitted and follow up with participants when issues are noted. It is also important to note that CalRecycle Auditors or its agents will routinely visit a sample of collectors and recyclers each year to review or audit their operations and documentation as authorized in 14 CCR Section 18660.9, including net cost documentation.

How can the specific costs of recovering or recycling CEWs be separated from the costs of other, unrelated business activities?

CalRecycle recognizes allocating some business costs to CEW recovery or recycling may be challenging if your organization handles other types of waste materials in addition to CEWs or is engaged in additional business activities unrelated to recovering and recycling.

CalRecycle allows a range of cost allocation methods, as long as they reflect an adherence to generally accepted accounting principles and standard cost accounting methods, which are intended to accurately document the actual costs of recovering and recycling CEWs as specified in regulations. An explanation of any allocation methodologies should be provided in the worksheets (Form 220C and Form 220R).

How should a collector account for payments made by a recycler above the standard CEW recovery payment?

Any payments for CEW above the standard recovery payment rate should be reported as revenue. Payments for any other non-CEW materials should not be included anywhere in the report.

The approved collector is responsible for costs incurred for collecting, consolidating, and transporting CEW to the recycling facility (Public Resources Code Section 42477). If the approved recycler pays any of the costs of an approved collector such as boxes, stretch wrap, or transportation to the recycler’s facility, how should these be accounted?

According to statute, the recovery payment is intended to reimburse the collector for having incurred certain transportation costs. However, if the recycler provides these services to an approved collector, the value of those services will be reflected in lower transportation costs reported by the collector.

How do I submit a report?

CalRecycle provides an online portal and PDF versions of standardized forms (220, 220C, and 220R) to assist approved collectors and recyclers in fulfilling net cost reporting requirements. CalRecycle encourages collectors and recyclers to submit their reports via CEWIS, the secure Internet portal. Details of that process will be emailed to approved participants. The PDF versions of the Net Cost Report forms can be useful in compiling the information necessary to complete the report online. Alternatively, the forms including a signed original of the CalRecycle 220 certification may be mailed to our office by March 1. To submit a hardcopy of your report to CalRecycle, please address it as follows:

Department of Resources Recycling and Recovery
Attention: Electronic Waste Recycling Program, MS-10B
1001 I Street
Sacramento, CA 95814
(916) 341-6269

If the report is submitted correctly online, there is no need to send a hardcopy.

How can a collector or recycler get more information or help?

  • General information on the California Electronics Waste Recycling Act of 2003 is available through CalRecycle’s website at: www.calrecycle.ca.gov/electronics
  • Regulations covering the net cost reporting requirement (14 CCR Section 18660.10) and CalRecycle’s authority to conduct audits (14 CCR 18660.9) are available online. 
  • For further information and assistance regarding the Net Cost Report, contact CalRecycle’s electronic waste recycling program staff by phone (866) 218-6103 or by e-mail (ewaste@calrecycle.ca.gov).

Collector Outreach

Collectors receiving material from the public as a part of CalRecycle’s Covered Electronic Waste Recycling Program must gather source documentation in order for the material to be eligible in a recycling claim. The flyers below help memorialize the transaction and explain why and how the personal information is used. Alternative languages are available upon request.

Below is a tool intended to assist Approved Collectors in the collection and submission of information required pursuant to the Covered Electronic Waste Recycling Program regulations. There are many ways to fill out collection logs. Some examples are included in this informational packet that may work for your situation, and help to meet all applicable statutory and regulatory requirements.

Weighmaster Enforcement Program

CalRecycle established an interagency agreement (IAA) with the Department of Food and Agriculture (CDFA), Division of Measurement Standards (DMS), Weighmaster Enforcement Program (WEP).

The intent of this IAA is to survey, audit, inspect, and, as necessary, investigate compliance with applicable Weighmaster laws governing material transactions within the state. The IAA allows the WEP to focus further on the electronic waste management industry as a whole and participants in the CEW Recycling Program in particular. With payments in the CEW Recycling Program based on weight and with other associated requirements requiring counts, it is vital that these measures are determined and recorded compliantly.

Weighmaster Complaint Form

Links to the CDFA Weighmaster Enforcement Program complaint form, to be used for instances of suspected noncompliance.

Complete the form with as much information as possible, including the name of the organization in the address section.
Attach the complaint form and any supporting documents to an email and send to: CDFA.CalRecycle.Complaint@cdfa.ca.gov

This page is for informational purposes only; it does not list all requirements in statute and regulations.

Other Related Resources

  • Designated Approved Collector Guidance
    The Designated Approved Collector provision, as described under Title 14 CCR Chapter 8.2, Article 7 Section 18660.47 – 18660.50, provides a means for Local Governments to authorize approved collectors to conduct CEW recovery activities under specific circumstances.
  • DTSC Requirements
    • Information on the Notice of Intent to Handle
      Any entity handling a minimum threshold of discarded CRTs or universal waste electronic devices (UWED) is required to notify DTSC, regardless of whether they are participating in the CEW Recycling Program. Please note that, depending on a handler’s activities, other DTSC requirements may apply.
    • Electronic Waste Annual Reports
      Collectors and recyclers must properly report their handling and recycling activities to the Department of Toxic Substance Control (DTSC) prior to their February 1 deadline as required 22 CCR Section 66273.32(d) and/or 66273.74(b).
  • Manufacturer Take-Back Program Information
    The CEW Recycling Program – Manufacturer Payments under Title 14, CCR Section 18660.35 et seq, provides a means for manufacturers to participate in the CEW Recycling Program.

For more information contact: Covered Electronic Waste Recycling Program, EWaste@calrecycle.ca.gov