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It includes designated sections for recording comprehensive personal identification data such as name, Social Security Number, date of birth, contact details, and emergency notification information. Furthermore, the form serves as a structured checklist for administrative compliance, covering essential employment eligibility, tax withholding, financial documentation, driving certifications, and physical fitness requirements necessary for dispatch center operations. The document ensures that all critical personnel and training records are systematically tracked and reported. This standardized collection process facilitates the efficient management of administrative and logistical tasks, ensuring that all necessary paperwork, including W-4, I-9, and specific fire-related certifications, are accurately completed and submitted to the appropriate departments. It acts as a primary record for individuals managing temporary deployments and professional qualifications within the dispatch framework.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":57,"@type":76,"position":81},"https://docshare.wps.com/document/general/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/casual-personal-information-form-coidc-2021/434618/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/casual-personal-information-form-coidc-2021/434618.png","ImageObject",300,407,{"name":92,"@type":93},"WPS_1786070896","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-19","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What information is required for the emergency contact section?","Question",{"text":112,"@type":113},"The form requests the name and phone number of an individual to be notified in the event of an emergency.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What administrative documents must be faxed to the ASC Pay department?",{"text":117,"@type":113},"Employees must fax their Employment Eligibility I-9, Direct Deposit Salary SF-1199a, and Federal Withholding W-4 forms.",{"name":119,"@type":110,"acceptedAnswer":120},"Which driving-related documents are listed for completion?",{"text":121,"@type":113},"Required driving documents include the Physical Fitness Inquiry OF-345, R6 Application to Drive FS-6500-231, R6 Driver Responsibilities, Defensive Driving Certification, and the DMV Driving Record.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},434618,1791308353,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":56,"category_name":57,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":14},549768072016,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Central Oregon Interagency Dispatch Center (COIDC)  \n2021 AD Personal Information  \nName (as it appears on your ID):    \nFirst: Middle: Last:  \nSocial Security Number:   Date of Birth (DOB):    \nECI \\#: Phone Numbers  \nAddress:  \nCity, State, Zip  \nEmail :  \nTeam Member? Y N What Team(s)?    \nHome:  \nCell:  \nOther:  \nFAX:  \n\n|  |\n| --- |\n|  |\n|  |\n\nList of Quals:  \nWho do you want us to notify if there is an emergency?  \nName: Phone:  \n\n| Empl Eligibility I‐9 (Exp 4 years): Dir Dep Salary SF‐1199a:\u003Cbr>Federal Withholding W‐4:\u003Cbr>THREE ITEMS ABOVE\u003Cbr>FAXED TO ASC Pay: |  |  | Fin Info Security FS‐6500‐214: Dir Dep Travel FS‐6500‐231:\u003Cbr>TWO ITEMS ABOVE FAXED TO \\# ON 214: |  |  |\n| --- | --- | --- | --- | --- | --- |\n|  |  |  |  |  |  |\n|  |  |  |  |  |  |\n|  |  |  | DRIVING Phys Fitness Inquiry OF‐345:\u003Cbr>DRIVING R6 App to Drive FS‐6500‐231: DRIVING R6 Driver Responsibilities: Defensive DRIVING Cert (Exp 4 years): DMV DRIVING RECORD: |  |  |\n| HSQ for Pack Test:\u003Cbr>Pack Test Date:\u003Cbr>Fire Refresher Date:\u003Cbr>Red Card Sent to AD: |  |  |  |  |  |\n|  |  |  |  |  |  |\n|  |  |  |  |  |  |\n|  |  |  |  |  |  |\n\nStart Remaining  \nTraining Hours:  \n\n| 80 |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n\nAll AD forms and information available at: [http://gacc.nifc.gov/nwcc/districts/COIDC/ADcasual.html](http://gacc.nifc.gov/nwcc/districts/COIDC/ADcasual.html)  \nE:\\Logistics\\AD_Info\\AD‐Personal_information‐Form.xls","cbCaiam0tVbQ8NZF","https://ap.wps.com/l/cbCaiam0tVbQ8NZF","pdf",215323,"English","# Personal Information\n## Contact and Identification Details\n## Emergency Notification\n## Administrative Compliance Checklist\n## Training and Qualifications","[{\"question\":\"What information is required for the emergency contact section?\",\"answer\":\"The form requests the name and phone number of an individual to be notified in the event of an emergency.\"},{\"question\":\"What administrative documents must be faxed to the ASC Pay department?\",\"answer\":\"Employees must fax their Employment Eligibility I-9, Direct Deposit Salary SF-1199a, and Federal Withholding W-4 forms.\"},{\"question\":\"Which driving-related documents are listed for completion?\",\"answer\":\"Required driving documents include the Physical Fitness Inquiry OF-345, R6 Application to Drive FS-6500-231, R6 Driver Responsibilities, Defensive Driving Certification, and the DMV Driving Record.\"}]","Casual Personal Information Form - COIDC 2021 | PDF",1790670009]