Report Manual Flashcards
Declaration of Municipality
Form 003
Must be submitted by new employees.
New form must be submitted with any/all change of address (F-31 Status Change)
Certificate of Military Training Pay
Form CS-8
Request for Military Leave With Pay Differential.
Submitted when military orders are received:
2 copies of the CS-8.
1 copy of F-25S listing the working days member will be absent.
1 copy of Military Training Orders signed by Commanding Officer.
Probationary Employees Progress Report
Form CS-11
Made out by immediate supervisor.
New employees: near the end of 6th month of probation
Newly promoted members below rank of Fire Chief: near the end of the 3rd month of probationary period.
Resignation
Form F-13
Rarely used.
If members turns in F-13 they should be counseled by their DC.
Application for Permit
Form F-15
References: CFPC Section Numbers spreadsheet in file folder
Interdepartment Correspondence Sheet
Form 17
Performance Appraisal Evaluation
Performance Appraisal Evaluation
F-21A (Non-Supervisory)
F-21B (Supervisory)
F-21C (Administrative)
Annual ratings due to Personnel Office by 4/1
References: Ratings Form Flow Chart, Performance Evaluation Appraisal Manual
Transfer Exchange Request/Notification Form
Form F-23
Application for Transfer
F-24
Application for Leave of Absence
F-25S
Requisition for Supplies
F-27
Due the first of each month (D1/D2 odd mos, D3/D4 even mos)
Outside Work Notice
F-28S
Prepare two copies. Submit 1 copy through normal channels to FC. Employee retains 2nd copy.
To withdraw, submit 2nd copy with “Cancel this Notification”, the date, and employee signature in the lower right hand corner of the form.
Change of Status Report
F-31
Change of address also requires a new Form 003 (Declaration of
Municipality)
Change of marital status requires a Medical Insurance Change Form
Change of withholding status requires new W-4
Equipment Repair Report
F-40
Accessible via shortcut on desktop, or CFDWEB
>Apparatus and Equipment Maintenance
>Central Stores
>Facility Maintenance
>Other Form F-40
*F-47 required with F-40 for lost or damaged equipment
Company Multiple Alarm Report
F-46C
Made out for: 3-Alarm or greater fires, serious injury or death to civilians or FF occurs, or at anytime requested by IC
Email to the suppression DC that had responsibility for the fire, Ops Administrative DC (Car 301), and AC of Ops.
Chiefs Report
F-47
Submit one copy.
Retain copy for company files.
Record in company diary.
*Anything unusual must be reported
Motor Vehicle Accident Response Form
F-54 MVA
Hydrant Report
F-57
Submit two copies.
Any defect requiring repairs by Water Works including hydrants or hydrant valves.
Notice of Official Reprimand
Form 66S
Filled out by LT and above
Prepare 4 Copies: White - employee Pink - civil service Canary - division head Goldenrod - supervisor
Trade Request
F-76
Submitted 3 calendar days in advance for 1-2 tour trades, 6 calendar days for 3+ tour trades.
Application and Approval for Tuition Reimbursement
F-80
Submit signed original for to AC of HR
Supervisor’s Investigation of Vehicle Accident
F-90S
F-90S, F-90S WS, and F-92S (Driver’s Report of a Vehicle Accident) must be completed any time a FD vehicle is involved in an accident.
Submit one signed copy to DC of Health & Safety
References in folder: F-90S WS Vehicle Accident Worksheet
BMV 3303 (PDF Format) Dept of Public Safety and BMV Crash
Report
Supervisor’s Investigation of Employee Injury
F-91S/F
F-91S/F WS Employee Injury Work Sheet
Competed by assigned ALS Supervisor. Emailed, faxed, or personally delivered to DC where member was assigned at the time of the injury.
Driver’s Report of a Vehicle Accident
F-92S
Must be completed any time FD vehicle is involved in an accident.
Filled out by member driving apparatus at time of the accident.
Inspection Request (Copy of Form)
Form F-107 ✏️
Complaint Slip (Copy of Form)
Form F-108 ✏️
Inspection Form (Copy of Form)
Form F-109 ✏️
Inspection Card (Copy of Form)
Form F-110✏️
Monthly Company Summary
Form F-112 🖥
Due on the 4th of every month
New Construction Inspections Form
Form F-119 🖥
Places of Assembly Posting Record (Copy of Form)
Form F-120 ✏️
Fire Fighting Equipment Inventory
Form F-141B (Eng) and F-141C (Lad) 🖥
Due Annually on the 2nd of January
Annual Fire Hydrant Inventory Report
Form F-201 🖥
Due annually on the 15th of November
Quarterly Certification Status Report
Form F-207C🖥
Due on the 1st of the Month in Jan, April, July, October
Roster for Fire College
Form F-211 🖥
Pay Request for Overtime Work-Above-Grade
Form F-212 🖥
Request for Retirement and Election of Lump Sum
Form F-214 🖥
Progress Sheet Utility Operator
Form F-215A, F-215B, F-215C ✏️
Permission to Flow Test Private Hydrant
Form F-222 🖥
Vacation and Holiday Grants
Form F-234 🖥
Quarterly Qualification Status Report
Form F-207Q 🖥
Due on the 1st of the Month Jan, April, July, October
Fire Company Annual Report
Form F-236 🖥
Due on the 3rd of January each year.
Record of Hydrant Spanner Loaned
Temporary Use of Fire Hydrants (Information Sheet)
Form F-238 🖥
Form F-238A 📄
Water Usage Report
Form F-241 🖥
Due on the 3rd of each month.
Accident Information to Vehicle Operator
Form F-251 ✏️
Premise History Entry
Form F-272 🖥
Citizen Complaint Report
Form 273B ✏️
Juvenile Firesetter Program Authorization for Release of Information (Copy of Form)
Form F-289 ✏️
Juvenile Firesetter Program (Copy of Form)
Form F-289✏️
Certification of Healthcare Provider
Form WH-380 ✏️
Employee Request for Family Medical Leave Form
Conditional Notification to Employee
Response to FMLA 48 Hour
Response to FMLA 40 Hour
Form F-406🖥
Form F-406A 📄
Form F-406B 📄
Form F-406C 📄
FMLA Clarification
Your FMLA Rights
FMLA FAQsFire Dept Minor Injury Report
Form F-500🖥 (✏️)
Firefighter Exposure to Infectious Disease Report
Form F-501 🖥 (✏️)
Narcotic Usage Report
Form F-502 🖥 (✏️)
Basic Incident Report
Form 902 🖥
Quarterly Reports
Community Relations Report (F-47 on the 1st)
Hydrant Report (F-47 on the 1st)
Place of Assembly Report (F-47 on the 1st)
Company Cerification Report (F-207C on the 1st)
Company Qualification Report (F-207Q on the 1st)
Monthly Reports
Requisition for Supplies (F-27 on the 1st)
Water Usage Report (F-241 on the 3rd)
Company Summary (F-112 on the 4th)
Annual Reports
Engine Inventory (F-141B due on January 2nd) Truck Inventory (F-141C due on January 2nd)
Annual Hydrant Inventory Report (F-201 due on November 15th)
Forcible Entry Form
Form F-05
F-05 is to be left behind at premises when forcible entry is required due to emergency and no key holder response within reasonable amount of time.
To be carried on all apparatus and hand written at the scene.
Date, Time, Company, Run #.
F-47 submitted anytime forcible entry is required.
Probationary period for Fire Chief and Fire Fighter is _____________.
For all other classes,______________.
1 year
6 months
Recommendation for Commendation Report
F-22
Prepare two copies, submit one copy. Retain on copy for company file.
Submitted through normal channels to Ops AC.
Reference Procedures Section 507
Three instances that require a F-21 to be made out:
- Annual Rating - made out yearly and due 4/1
- Probationary Rating - completed approx 1 mo before end of probationary period
- Special Ratings - consult PAEM as to when these ratings are to be made out nothing found in PAEM
