Fla. Admin. Code Ann. R. 69A-37.039 - Prescribed Forms for Training and Certification
(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) DFS-K4-2174, "Application for
Firefighter Assistance Grant Program,"
http://www.flrules.org/Gateway/reference.asp?No=Ref-08003,
eff. 7/16.
(bbb) Form DFS-K4-2191,
"Florida Fire Service Needs Assessment,"
http://www.flrules.org/Gateway/reference.asp?No=Ref-08002,
eff. 1/17.
(ccc) DFS-K4-2202,
"Application for Lifetime Firefighter Designation,"
http://www.flrules.org/Gateway/reference.asp?No=Ref-09073,
eff. 01/18.
(ddd) Form DFS-K4-2206,
"Aircraft Rescue and Fire Fighting (ARFF) Driver Task Book," eff. 01/19,
http://www.flrules.org/Gateway/reference.asp?No=Ref-12462.
(eee) Form DFS-K4-2207, "Aircraft Rescue and
Fire Fighting (ARFF) Officer Portfolio Workbook," eff. 01/19,
http://www.flrules.org/Gateway/reference.asp?No=Ref-12463.
(fff) Form DFS-K4-2208, "Aircraft Rescue and
Fire Fighting (ARFF) Firefighter Task Book," eff. 01/19,
http://www.flrules.org/Gateway/reference.asp?No=Ref-12464.
(ggg) DFS-K4-2300,
http://www.flrules.org/Gateway/reference.asp?No=Ref-12663,
eff. 12/20, "Application for Firefighter Cancer Decontamination Equipment Grant
Program."
(hhh) Form DFS-K4-2204,
"Firesafety Inspector II Task Book," eff. 02/21,
http://www.flrules.org/Gateway/reference.asp?No=Ref-12901.
(iii) Form DFS-K4-2205, "Application for
Firesafety Inspector III Certification," eff. 02/21,
http://www.flrules.org/Gateway/reference.asp?No=Ref-12902.
Notes
Rulemaking Authority 633.104, 633.128(1), 633.135(3), 633.137(3), 633.216(9), 633.406(2), 633.408, 633.418(1), 633.508(2) FS. Law Implemented 633.112(1), 633.128, 633.135, 633.137, 633.138, 633.216, 633.406, 633.408, 633.412, 633.415, 633.418, 633.508(2) FS.
New 9-7-81, Formerly 4A-37.20, 4A-37.39, Amended 11-26-85, 1-3-90, 6-30-91, 3-20-95, 9-13-98, 12-10-01, Formerly 4A-37.039, Amended 3-19-09, 8-27-12, 8-20-13, 11-18-13, 2-15-15 (f), 2-15-15 (ee)-(ii), 7-13-16, 3-7-17, 5-18-17, 2-19-18, 1-1-19, 1-11-21, 2-8-21, 4-29-21.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(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) DFS-K4-2174, "Application for Firefighter Assistance Grant Program," http://www.flrules.org/Gateway/reference.asp?No=Ref-08003, eff. 7/16.
(bbb) Form DFS-K4-2191, "Florida Fire Service Needs Assessment," http://www.flrules.org/Gateway/reference.asp?No=Ref-08002, eff. 1/17.
(ccc) DFS-K4-2202, "Application for Lifetime Firefighter Designation," http://www.flrules.org/Gateway/reference.asp?No=Ref-09073, eff. 01/18.
(ddd) Form DFS-K4-2206, "Aircraft Rescue and Fire Fighting (ARFF) Driver Task Book," eff. 01/19, http://www.flrules.org/Gateway/reference.asp?No=Ref-12462.
(eee) Form DFS-K4-2207, "Aircraft Rescue and Fire Fighting (ARFF) Officer Portfolio Workbook," eff. 01/19, http://www.flrules.org/Gateway/reference.asp?No=Ref-12463.
(fff) Form DFS-K4-2208, "Aircraft Rescue and Fire Fighting (ARFF) Firefighter Task Book," eff. 01/19, http://www.flrules.org/Gateway/reference.asp?No=Ref-12464.
(ggg) DFS-K4-2300, http://www.flrules.org/Gateway/reference.asp?No=Ref-12663, eff. 12/20, "Application for Firefighter Cancer Decontamination Equipment Grant Program."
(hhh) Form DFS-K4-2204, "Firesafety Inspector II Task Book," eff. 02/21, http://www.flrules.org/Gateway/reference.asp?No=Ref-12901.
(iii) Form DFS-K4-2205, "Application for Firesafety Inspector III Certification," eff. 02/21, http://www.flrules.org/Gateway/reference.asp?No=Ref-12902.
Notes
Rulemaking Authority 633.104, 633.128(1), 633.135(3), 633.137(3), 633.216(9), 633.406(2), 633.408, 633.418(1), 633.508(2) FS. Law Implemented 633.112(1), 633.128, 633.135, 633.137, 633.138, 633.216, 633.406, 633.408, 633.412, 633.415, 633.418, 633.508(2) FS.
New 9-7-81, Formerly 4A-37.20, 4A-37.39, Amended 11-26-85, 1-3-90, 6-30-91, 3-20-95, 9-13-98, 12-10-01, Formerly 4A-37.039, Amended 3-19-09, 8-27-12, 8-20-13, 11-18-13, 2-15-15 (f), 2-15-15 (ee)-(ii), 7-13-16, 3-7-17, 5-18-17, 2-19-18, 1-1-19, 1-11-21, 2-8-21, 4-29-21.