Florida Regulations 69A-37.039: Prescribed Forms for Training and Certification
Current as of: 2024 | Check for updates
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(1) Information required by the Bureau in this chapter shall be furnished on-line at www.floridastatefirecollege.org. The information required at www.floridastatefirecollege.org is based on prescribed forms set forth below and incorporated herein. The forms can also be obtained:
(a) From fire departments or training centers;
(b) By writing to the Bureau, 11655 North West Gainesville Road, Ocala, Florida 34482-1486; or
(c) By downloading them from the website at www.myfloridacfo.com/Division/SFM/BFST.
(2) The following forms are hereby adopted and incorporated by reference in this rule:
(a) DFS-K4-1016, http://www.flrules.org/Gateway/reference.asp?No=Ref-12659, eff. 12/20, “”Application for Firefighter Certification Examination.””
(b) DFS-K4-1019, rev. 3/09, “”Fee Information/Application and Fingerprint Card Instructions.””
(c) DFS-K4-1022, http://www.flrules.org/Gateway/reference.asp?No=Ref-10097, rev. 01/18, “”Medical Examination to Determine Fitness for Firefighter Training.””
(d) DFS-K4-1023, https://www.flrules.org/Gateway/reference.asp?No=Ref-01465, rev. 06/12, “”Application for Firesafety Inspector Certification Examination.””
(e) DFS-K4-1026, rev. 03/09, “”Roster of Students.””
(f) DFS-K4-1028, http://www.flrules.org/Gateway/reference.asp?No=Ref-12660, eff. 12/20, “”Verification of Training Hours/Firefighter I and II.””
(g) DFS-K4-1033, rev. 03/09, “”Notice of Termination of Employment as a Firefighter.””
(h) DFS-K4-1038, rev. 07/14, http://www.flrules.org/Gateway/reference.asp?No=Ref-04760, “”Release and Waiver of Liability.””
(i) DFS-K4-1308, http://www.flrules.org/Gateway/reference.asp?No=Ref-12661, eff. 12/20, “”Application for Practical Examination for Retention of Firefighter Certification.””
(j) DFS-K4-1309, http://www.flrules.org/Gateway/reference.asp?No=Ref-12662, eff. 12/20, “”Preliminary Equivalency Application Firefighter Minimum Curriculum Requirements.””
(k) DFS-K4-1390, rev. 03/09, “”Application for Special Certificate of Compliance for Administrative & Command Head of a Fire/Rescue/EmergencyServices Organization.””
(l) DFS-K4-1438, http://www.flrules.org/Gateway/reference.asp?No=Ref-08170, rev. 3/17, “”Application for Fire Investigator Certification.””
(m) DFS-K4-1442, rev. 03/09, “”Firefighters Supplemental Compensation Program Request for Upgrade from Associate Level to Bachelor Level.””
(n) DFS-K4-1446, rev. 03/09, “”Application for Firesafety Inspector II Certification.””
(o) DFS-K4-1447, http://www.flrules.org/Gateway/reference.asp?No=Ref-03360, rev. 07/13, “”Application for Fire Officer I Certification.””
(p) DFS-K4-1448, http://www.flrules.org/Gateway/reference.asp?No=Ref-03362, rev. 07/13, “”Application for Fire Officer II Certification.””
(q) DFS-K4-1451, rev. 03/09, “”Application for Instructor I Certification.””
(r) DFS-K4-1452, rev. 03/09, “”Application for Instructor II Certification.””
(s) DFS-K4-1453, rev. 03/09, “”Application for Instructor III Certification.””
(t) DFS-K4-1455, rev. 03/09, “”Application for Single Course Exemption Instructor Certification.””
(u) DFS-K4-1456, rev. 03/09, “”Application for Fire and Lifesafety Educator Certification Examination.””
(v) DFS-K4-1457, rev. 03/09, “”Application for Fire Apparatus Pump Operator Certification Examination.””
(w) DFS-K4-1463, https://www.flrules.org/Gateway/reference.asp?No=Ref-01466, rev. 06/12, “”Certification Renewal Application Inspector/Instructor.””
(x) DFS-K4-2085, eff. 04/13, http://www.flrules.org/Gateway/reference.asp?No=Ref-03076, “”Application for Fire Code Administrator Certification.””
(y) DFS-K4-2104, http://www.flrules.org/Gateway/reference.asp?No=Ref-03363, eff. 07/13, “”Application for Fire Officer III Certification.””
(z) DFS-K4-2105, http://www.flrules.org/Gateway/reference.asp?No=Ref-03364, eff. 07/13, “”Application for Fire Officer IV Certification.””
(aa) DFS-K4-2106, http://www.flrules.org/Gateway/reference.asp?No=Ref-03365, eff. 07/13, “”Fire Officer I Task Book.””
(bb) DFS-K4-2107, http://www.flrules.org/Gateway/reference.asp?No=Ref-03366, eff. 07/13, “”Fire Officer II Task Book.””
(cc) DFS-K4-2108, http://www.flrules.org/Gateway/reference.asp?No=Ref-03367, eff. 07/13, “”Fire Officer III Portfolio Workbook.””
(dd) DFS-K4-2109, http://www.flrules.org/Gateway/reference.asp?No=Ref-03368, eff. 07/13, “”Fire Officer IV Portfolio Workbook.””
(ee) DFS-K4-2105, http://www.flrules.org/Gateway/reference.asp?No=Ref-03364, eff. 07/13, “”Application for Fire Officer IV Certification.””
(ff) DFS-K4-2138, “”Health and Safety Officer Task Book,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05016, eff. 08/14.
(gg) DFS-K4-2139, “”Incident Safety Officer Task Book,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05015, eff. 08/14.
(hh) DFS-K4-2140, “”Application for Health and Safety Officer Certificate of Completion,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05014, eff. 08/14.
(ii) DFS-K4-2141, “”Application for Incident Safety Officer Certificate of Completion,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05013, eff. 08/14.
(jj) DFS-K4-2142, “”Application for Safety Officer Certificate of Competency,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05012, eff. 08/14
(kk) DFS-K4-2148, http://www.flrules.org/Gateway/reference.asp?No=Ref-07044, “”Confined Space Rescue Operations Task Book,”” eff. 04/16.
(ll) DFS-K4-2149, http://www.flrules.org/Gateway/reference.asp?No=Ref-07045, “”Confined Space Rescue Technician Task Book,”” eff. 04/16.
(mm) DFS-K4-2150, http://www.flrules.org/Gateway/reference.asp?No=Ref-07046, “”Rope Rescue Operations Task Book,”” eff. 04/16.
(nn) DFS-K4-2151, http://www.flrules.org/Gateway/reference.asp?No=Ref-07047, “”Rope Rescue Technician Task Book,”” eff. 04/16.
(oo) DFS-K4-2152, http://www.flrules.org/Gateway/reference.asp?No=Ref-07048, “”Structural Collapse Rescue Operations Task Book,”” eff. 04/16.
(pp) DFS-K4-2153, http://www.flrules.org/Gateway/reference.asp?No=Ref-07049, “”Structural Collapse Rescue Technician Task Book,”” eff. 04/16.
(qq) DFS-K4-2154, http://www.flrules.org/Gateway/reference.asp?No=Ref-07050, “”Trench Rescue Operations Task Book,”” eff. 04/16.
(rr) DFS-K4-2155, http://www.flrules.org/Gateway/reference.asp?No=Ref-07051, “”Trench Rescue Technician Task Book,”” eff. 04/16.
(ss) DFS-K4-2156, http://www.flrules.org/Gateway/reference.asp?No=Ref-07052, “”Vehicle/Machinery Rescue Operations Task Book,”” eff. 04/16.
(tt) DFS-K4-2157, http://www.flrules.org/Gateway/reference.asp?No=Ref-07053, “”Vehicle/Machinery Rescue Technician Task Book,”” eff. 04/16.
(uu) DFS-K4-2160, http://www.flrules.org/Gateway/reference.asp?No=Ref-07054, “”Application for Hazardous Materials Technician Certificate of Competency,”” eff. 04/16.
(vv) DFS-K4-2161, http://www.flrules.org/Gateway/reference.asp?No=Ref-07055, “”Application for FLUSAR Rescue Specialist Certificate of Completion,”” eff. 04/16.
(ww) DFS-K4-2167, http://www.flrules.org/Gateway/reference.asp?No=Ref-07056, “”Class Offering Request,”” eff. 04/16.
(xx) DFS-K4-2168, http://www.flrules.org/Gateway/reference.asp?No=Ref-07057, “”Instructor Approval Request,”” eff. 04/16.
(yy) DFS-K4-2171, http://www.flrules.org/Gateway/reference.asp?No=Ref-08171, “”Fire Investigator Task Book,”” eff. 1/17.
(zz) DFS-K4-2175, http://www.flrules.org/Gateway/reference.asp?No=Ref-08172, “”Fire Investigator Portfolio,”” eff. 1/17.
(aaa)
(b) By writing to the Bureau, 11655 North West Gainesville Road, Ocala, Florida 34482-1486; or
(c) By downloading them from the website at www.myfloridacfo.com/Division/SFM/BFST.
(2) The following forms are hereby adopted and incorporated by reference in this rule:
(a) DFS-K4-1016, http://www.flrules.org/Gateway/reference.asp?No=Ref-12659, eff. 12/20, “”Application for Firefighter Certification Examination.””
(b) DFS-K4-1019, rev. 3/09, “”Fee Information/Application and Fingerprint Card Instructions.””
(c) DFS-K4-1022, http://www.flrules.org/Gateway/reference.asp?No=Ref-10097, rev. 01/18, “”Medical Examination to Determine Fitness for Firefighter Training.””
(d) DFS-K4-1023, https://www.flrules.org/Gateway/reference.asp?No=Ref-01465, rev. 06/12, “”Application for Firesafety Inspector Certification Examination.””
(e) DFS-K4-1026, rev. 03/09, “”Roster of Students.””
(f) DFS-K4-1028, http://www.flrules.org/Gateway/reference.asp?No=Ref-12660, eff. 12/20, “”Verification of Training Hours/Firefighter I and II.””
(g) DFS-K4-1033, rev. 03/09, “”Notice of Termination of Employment as a Firefighter.””
(h) DFS-K4-1038, rev. 07/14, http://www.flrules.org/Gateway/reference.asp?No=Ref-04760, “”Release and Waiver of Liability.””
(i) DFS-K4-1308, http://www.flrules.org/Gateway/reference.asp?No=Ref-12661, eff. 12/20, “”Application for Practical Examination for Retention of Firefighter Certification.””
(j) DFS-K4-1309, http://www.flrules.org/Gateway/reference.asp?No=Ref-12662, eff. 12/20, “”Preliminary Equivalency Application Firefighter Minimum Curriculum Requirements.””
(k) DFS-K4-1390, rev. 03/09, “”Application for Special Certificate of Compliance for Administrative & Command Head of a Fire/Rescue/EmergencyServices Organization.””
(l) DFS-K4-1438, http://www.flrules.org/Gateway/reference.asp?No=Ref-08170, rev. 3/17, “”Application for Fire Investigator Certification.””
(m) DFS-K4-1442, rev. 03/09, “”Firefighters Supplemental Compensation Program Request for Upgrade from Associate Level to Bachelor Level.””
(n) DFS-K4-1446, rev. 03/09, “”Application for Firesafety Inspector II Certification.””
(o) DFS-K4-1447, http://www.flrules.org/Gateway/reference.asp?No=Ref-03360, rev. 07/13, “”Application for Fire Officer I Certification.””
(p) DFS-K4-1448, http://www.flrules.org/Gateway/reference.asp?No=Ref-03362, rev. 07/13, “”Application for Fire Officer II Certification.””
(q) DFS-K4-1451, rev. 03/09, “”Application for Instructor I Certification.””
(r) DFS-K4-1452, rev. 03/09, “”Application for Instructor II Certification.””
(s) DFS-K4-1453, rev. 03/09, “”Application for Instructor III Certification.””
(t) DFS-K4-1455, rev. 03/09, “”Application for Single Course Exemption Instructor Certification.””
(u) DFS-K4-1456, rev. 03/09, “”Application for Fire and Lifesafety Educator Certification Examination.””
(v) DFS-K4-1457, rev. 03/09, “”Application for Fire Apparatus Pump Operator Certification Examination.””
(w) DFS-K4-1463, https://www.flrules.org/Gateway/reference.asp?No=Ref-01466, rev. 06/12, “”Certification Renewal Application Inspector/Instructor.””
(x) DFS-K4-2085, eff. 04/13, http://www.flrules.org/Gateway/reference.asp?No=Ref-03076, “”Application for Fire Code Administrator Certification.””
(y) DFS-K4-2104, http://www.flrules.org/Gateway/reference.asp?No=Ref-03363, eff. 07/13, “”Application for Fire Officer III Certification.””
(z) DFS-K4-2105, http://www.flrules.org/Gateway/reference.asp?No=Ref-03364, eff. 07/13, “”Application for Fire Officer IV Certification.””
(aa) DFS-K4-2106, http://www.flrules.org/Gateway/reference.asp?No=Ref-03365, eff. 07/13, “”Fire Officer I Task Book.””
(bb) DFS-K4-2107, http://www.flrules.org/Gateway/reference.asp?No=Ref-03366, eff. 07/13, “”Fire Officer II Task Book.””
(cc) DFS-K4-2108, http://www.flrules.org/Gateway/reference.asp?No=Ref-03367, eff. 07/13, “”Fire Officer III Portfolio Workbook.””
(dd) DFS-K4-2109, http://www.flrules.org/Gateway/reference.asp?No=Ref-03368, eff. 07/13, “”Fire Officer IV Portfolio Workbook.””
(ee) DFS-K4-2105, http://www.flrules.org/Gateway/reference.asp?No=Ref-03364, eff. 07/13, “”Application for Fire Officer IV Certification.””
(ff) DFS-K4-2138, “”Health and Safety Officer Task Book,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05016, eff. 08/14.
(gg) DFS-K4-2139, “”Incident Safety Officer Task Book,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05015, eff. 08/14.
(hh) DFS-K4-2140, “”Application for Health and Safety Officer Certificate of Completion,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05014, eff. 08/14.
(ii) DFS-K4-2141, “”Application for Incident Safety Officer Certificate of Completion,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05013, eff. 08/14.
(jj) DFS-K4-2142, “”Application for Safety Officer Certificate of Competency,”” http://www.flrules.org/Gateway/reference.asp?No=Ref-05012, eff. 08/14
(kk) DFS-K4-2148, http://www.flrules.org/Gateway/reference.asp?No=Ref-07044, “”Confined Space Rescue Operations Task Book,”” eff. 04/16.
(ll) DFS-K4-2149, http://www.flrules.org/Gateway/reference.asp?No=Ref-07045, “”Confined Space Rescue Technician Task Book,”” eff. 04/16.
(mm) DFS-K4-2150, http://www.flrules.org/Gateway/reference.asp?No=Ref-07046, “”Rope Rescue Operations Task Book,”” eff. 04/16.
(nn) DFS-K4-2151, http://www.flrules.org/Gateway/reference.asp?No=Ref-07047, “”Rope Rescue Technician Task Book,”” eff. 04/16.
(oo) DFS-K4-2152, http://www.flrules.org/Gateway/reference.asp?No=Ref-07048, “”Structural Collapse Rescue Operations Task Book,”” eff. 04/16.
(pp) DFS-K4-2153, http://www.flrules.org/Gateway/reference.asp?No=Ref-07049, “”Structural Collapse Rescue Technician Task Book,”” eff. 04/16.
(qq) DFS-K4-2154, http://www.flrules.org/Gateway/reference.asp?No=Ref-07050, “”Trench Rescue Operations Task Book,”” eff. 04/16.
(rr) DFS-K4-2155, http://www.flrules.org/Gateway/reference.asp?No=Ref-07051, “”Trench Rescue Technician Task Book,”” eff. 04/16.
(ss) DFS-K4-2156, http://www.flrules.org/Gateway/reference.asp?No=Ref-07052, “”Vehicle/Machinery Rescue Operations Task Book,”” eff. 04/16.
(tt) DFS-K4-2157, http://www.flrules.org/Gateway/reference.asp?No=Ref-07053, “”Vehicle/Machinery Rescue Technician Task Book,”” eff. 04/16.
(uu) DFS-K4-2160, http://www.flrules.org/Gateway/reference.asp?No=Ref-07054, “”Application for Hazardous Materials Technician Certificate of Competency,”” eff. 04/16.
(vv) DFS-K4-2161, http://www.flrules.org/Gateway/reference.asp?No=Ref-07055, “”Application for FLUSAR Rescue Specialist Certificate of Completion,”” eff. 04/16.
(ww) DFS-K4-2167, http://www.flrules.org/Gateway/reference.asp?No=Ref-07056, “”Class Offering Request,”” eff. 04/16.
(xx) DFS-K4-2168, http://www.flrules.org/Gateway/reference.asp?No=Ref-07057, “”Instructor Approval Request,”” eff. 04/16.
(yy) DFS-K4-2171, http://www.flrules.org/Gateway/reference.asp?No=Ref-08171, “”Fire Investigator Task Book,”” eff. 1/17.
(zz) DFS-K4-2175, http://www.flrules.org/Gateway/reference.asp?No=Ref-08172, “”Fire Investigator Portfolio,”” eff. 1/17.
(aaa)