Form Ccc 58 PDF Details

If you are starting a new business, you will need to file Form Ccc 58. This form is used to apply for an Employer Identification Number (EIN). An EIN is required for all businesses, regardless of size or type. The process is simple, and can be completed online in minutes. Once your application is approved, you will receive your EIN immediately. Having an EIN allows you to open a business bank account and hire employees. It is important to file Form Ccc 58 as soon as possible, as it can take several weeks for the application to be processed. For more information on Form Ccc 58, visit the IRS website today.

QuestionAnswer
Form NameForm Ccc 58
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other names2medium, CDF, CCC-96A, vistor

Form Preview Example

STATE OF CALIFORNIA

PROJECT EVALUATION FORM

CCC-58 (REV. 08/97)

[A]PROJECT DATA

Project/Work Code: Contract:

Project Title: Project Description:

Center Code:

Hourly/Performance:

CALIFORNIA CONSERVATION CORPS

Page 1 of 3

Center:

Resource Category:

SAMPLE COPY ONLY

Project Evaluator:

Date:

[B] SPONSOR INFORMATION

Agency Code:

Sponsor Organization:

 

 

Address:

 

 

 

 

 

 

 

 

 

City:

 

 

 

State:

ZIP:

Sponsor Representative:

Title:

 

 

 

Phone:

 

 

 

 

 

Technical Supervisor:

Title:

 

 

Phone:

 

 

 

 

 

 

 

[C] EMERGENCY RESPONSE INFORMATION

CDF Incident #:

CCC Index #:

 

CDF Req #:

 

OES #:

HQ Ref #:

 

 

Corpsmember Overtime Pay Serial #:

 

 

 

 

 

 

[D]ESTIMATE INFORMATION

Hours: Start Date:

[E]WORKSITE INFORMATION

Directions to Worksite Location:

ZIP:

[F] FOR HQ USE ONLY (initial and date)

County Code:

County:

Received:

Logged:

Verified:

Analyst:

Entered:

Checked:

STATE OF CALIFORNIA

CALIFORNIA CONSERVATION CORPS

PROJECT EVALUATION FORM

 

Page 2 of 3

CCC-58 (REV. 01/95)

 

 

 

[G] EDUCATIONAL ACTIVITIES scheduled during the work day.

 

 

 

SPONSOR: Educational presentation to increase Corpsmember understanding of the natural environment

Length of time scheduled:

CCC: The CCC will be doing the following work/learn activities.

Length of time scheduled:

[H] EQUIPMENT & MATERIALS

To be supplied by SPONSOR:

To be supplied by CCC:

 

Qty

Description

Qty

Description

Special SPIKE equipment needed by crew:

SPIKE Information (description and location of housing):

STATE OF CALIFORNIA

CALIFORNIA CONSERVATION CORPS

PROJECT EVALUATION FORM

Page 3 of 3

CCC-58 (REV. 01/95)

 

[I]NARRATIVE ON HOW PROJECT WILL MEET ALL LEGISLATIVELY MANDATED OBJECTIVES (Assign a numerical rating: 1=low, 2=medium, 3=high)

Conserving, improving, developing natural resources, maintaining environmentally important lands or waters:

RATING:

Providing public benefit or access (Estimated vistor use, increased safety, reduced maintenance costs, etc.):

RATING:

Providing Corpsmembers with opportunities for training in employable skills (e.g. specific tools and use, fire control, carpentry):

RATING:

[J] PROJECT CHECKLIST & SIGNATURE BLOCKS

IN SIGNING THIS DOCUMENT, THE PROJECT COORDINATOR AND CONSERVATION SUPERVISOR VERIFY THAT:

G A CCC-96 (Sponsor Agreement) has been submitted to HQ.

G If a reimbursable project, a CCC-96A and/or STD-13 (contracts) have been submitted to HQ. G If the sponsor is a non-profit entity, a statement of non-profit status is on file.

G The project conforms to CCC Health & Safety Program guidelines (Section 6-3).

GA CCC-175 (Job Hazard Analysis) has been completed and is attached.

 

Print

Sign

 

 

Project Coordinator:

 

Date:

 

 

 

 

 

 

 

Conservationist Supervisor:

 

Date:

 

 

 

 

 

 

 

 

 

 

 

IN SIGNING THIS DOCUMENT THE SPONSOR VERIFIES THAT (check one box):

1.G They have provided the location, identity, and amounts of any hazardous substances at the worksite on an attached sheet and have provided all appropriate Material Safety Data Sheets for hazardous materials that are present at the worksite.

 

OR

G that to the best of their knowledge the worksite is free of any known hazardous materials (such as residues from

 

 

pesticide applications, storage of solvents, and spills of hazardous substances.)

 

 

2.

AND that all applicable local, state, and federal permits approvals, and clearances have

been obtained.

 

Sponsor Representative:

 

 

 

Print:

 

Sign:

Date: