Certification Of Participation In The California Conservation Camp Or Institutional Firehouse Program {L-0541}

L-541 - CERTIFICATION OF PARTICIPATION IN THE CALIFORNIA CONSERVATION CAMP OR INSTITUTIONAL FIREHOUSE PROGRAM. The form is addressed to the California Department of Corrections and Rehabilitation (CDCR) and is meant for the Classification and Parole Representative. The petitioner's name, CDCR number, the name of the conservation camp or institutional firehouse program, and the petitioner's approximate dates of participation in the program are all required. The purpose of this form is to certify the petitioner's participation in the California Conservation Camp or Institutional Firehouse Program for potential relief under Penal Code section 1203.4b. There is a section designated for CDCR use only where the representative can indicate whether the petitioner has been released from custody, successfully participated in the program as an incarcerated individual hand crew member, or if they have not been released or did not successfully participate. The form concludes with spaces for the date, the printed name of the CDCR Classification & Parole Representative, and their signature. www.FormsWorkflow.com