Grant Forms

This page contains forms that may be used by the California Department of Resources Recycling and Recovery’s (CalRecycle) various grant programs. To find out what specific forms are required for your grant, please review the Procedures and Requirements for your specific grant program, or contact your CalRecycle grant manager if you have questions or need additional information.

General Grant Forms | Farm and Ranch Cleanup Grants | Food Waste Prevention and Rescue Grant Program | Household Hazardous Waste Grants | Local Government Waste Tire Amnesty Grants | Local Government Waste Tire Cleanup Grants | Local Government Waste Tire Enforcement Grants | Organics Grant Program | Recycled Fiber, Plastic, and Glass Grant Program | Reuse Grant Program  | Rubberized Pavement Grant Program | Tire-Derived Aggregate Grants | Tire-Derived Product Grants | Tire Incentive Program | Used Oil Recycling Grants

General Grant Forms

• General Checklist of Business Permits, Licenses, and Filings, CalRecycle 669 (Rev. 11/18)
• Grant Payment Request, CalRecycle 87 (Rev. 7/21)
• Payee Data Record, STD. 204
• Personnel Expenditure Summary, CalRecycle 165 (Rev. 2/10)
• Reliable Contractor Declaration*, CalRecycle 168 (Rev. 9/16)
• Travel Expense Log Form (Includes a sample completed form), CalRecycle 246 (Rev. 3/23)

*Unreliable Contractor List

Farm and Ranch Cleanup

• Budget Form CalRecycle 789 (Rev. 7/20)
• Site Characterization Form CalRecycle 790 (Rev. 7/20)
• Work Plan Form CalRecycle 791 (Rev. 7/20)
• Expenditure Itemization Summary, CalRecycle 224 (Rev. 8/19)
• Farm and Ranch Solid Waste Cleanup and Abatement Grant Program Final Payment Request Checklist and Final Report Form, CalRecycle 750 (Rev. 6/19)
• Farm and Ranch Solid Waste Cleanup and Abatement Grant Program Payment Request Checklist & Progress Report Form, CalRecycle 749 (Rev. 6/19)
• Grant Report, CalRecycle 248 (Rev. 9/19)
• Farm and Ranch Grant Program Property Access Authorization and Non-Responsibility Affidavit, CalRecycle 889 (Rev. 6/20)

Food Waste Prevention and Rescue Grant Program

• Expenditure Itemization Summary, CalRecycle 777-FW (Rev. 5/19)
• Expenditure Itemization Summary, CalRecycle 777-FW4 (New 6/21)

Household Hazardous Waste

• Expenditure Itemization Summary, CalRecycle 667 (Rev. 1/18)

Local Government Waste Tire Amnesty Grants

• Expenditure Itemization Summary (Tire Amnesty – TA), CalRecycle 755 (Rev. 9/21)
• Payment Request Checklist and Progress Report (Tire Amnesty – TA), CalRecycle 753 (Rev. 8/21)
• Payment Request Checklist and Final Progress Report (Tire Amnesty – TA), CalRecycle 754 (Rev. 8/21)

Local Government Waste Tire Cleanup Grants

• Expenditure Itemization Summary (Tire Cleanup – TCU), CalRecycle 745 (Rev. 2/21)
• Payment Request Checklist and Final Report (Tire Cleanup – TCU), CalRecycle 759 (Rev. 9/21)
• Property Access Authorization and Non-Responsibility Affidavit for Private Property (Tire Cleanup – TCU), CalRecycle 741 (2/21)

Local Government Waste Tire Enforcement Grants

• CalRecycle Waste Tire Surveillance/Field Patrolling , CalRecycle 229 (Rev. 2/20)
• TEA Personnel Expenditure Summary, CalRecycle 767 (Rev. 2/20)

Organics Grant Program

• Expenditure Itemization Summary, CalRecycle 777 (Revised 5/19)
• Feedstock Certification, CalRecycle 778-GHG (Revised 2/23)

Recycled Fiber, Plastic, and Glass Grant Program

• Expenditure Itemization Summary, CalRecycle 777 (Revised 5/19)
• Feedstock Certification, CalRecycle 778-FPG-1 (Revised 4/19)
  (Use this form for FPG1 and FPG2 grants)
• Feedstock Certification, CalRecycle 778-FPG (New 10/21)
  (Use this form for FPG3 and later grants)

Reuse Grant Program

• Expenditure Itemization Summary, CalRecycle 777-GRU (New 6/21)

Rubberized Pavement Grant Program

• Rubberized Pavement Certification, CalRecycle 739-TRP (Rev. 8/13)
• Rubberized Pavement Payment Calculation Summary–Tier 1, CalRecycle 748-1 (10/16)
  (Use this form for all TRP7 (and later) grants approved for Tier 1 rates)
• Rubberized Pavement Payment Calculation Summary–Tier 2, CalRecycle 748-2 (10/16)
  (Use this form for all TRP7 (and later) grants approved for Tier 2 rates)
• Rubberized Pavement Payment Calculation Summary–Full Differential Cost, CalRecycle 748-Full (10/16)
  (Use this form for all TRP7 (and later) grants approved for full differential cost)

Tire-Derived Aggregate Grants

• Tire Derived Aggregate (TDA) Certification, CalRecycle 740-TDA (Rev. 8/13)
• Expenditure Itemization Summary, CalRecycle 861-EIS-TDA (New 10/16)

Tire-Derived Product Grants

• Tire-Derived Product (TDP) Certification, CalRecycle 227 (Rev. 2/17)

Tire Incentive Program

• Tire Incentive Program Certification, CalRecycle 774 (Rev. 8/17)
  (Use this form for all TIP4 and later grants)

Used Oil Recycling

• Collection Center Basics to Customize Handout, (New 6/15)
• Certified Center Site Visit Checklist* (Manual), CalRecycle 664 (Rev. 5/15)
• Certified Center Auto-Fill Site Visit Checklist (System Generated)*
• Expenditure Itemization Summary, CalRecycle 667 (Rev. 2/15)

* Forms required for Used Oil Payment Program (OPP) reporting.

For more information contact: Financial Assistance, grants@calrecycle.ca.gov