Fla. Admin. Code 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:
1. (a) From fire departments or training centers;
2. (b) By writing to the Bureau, 11655 North West Gainesville Road, Ocala, Florida 34482-1486; or
3. (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:
1. (a) DFS-K4-1016, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12659" http://www.flrules.org/Gateway/reference.asp?No=Ref-12659, eff. 12/20, “Application for Firefighter Certification Examination.”
2. (b) DFS-K4-1019, rev. 3/09, “Fee Information/Application and Fingerprint Card Instructions.”
3. (c) DFS-K4-1022, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-10097" http://www.flrules.org/Gateway/reference.asp?No=Ref-10097, rev. 01/18, “Medical Examination to Determine Fitness for Firefighter Training.”
4. (d) DFS-K4-1023, HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-01465" https://www.flrules.org/Gateway/reference.asp?No=Ref-01465, rev. 06/12, “Application for Firesafety Inspector Certification Examination.”
5. (e) DFS-K4-1026, rev. 03/09, “Roster of Students.”
6. (f) DFS-K4-1028, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12660" http://www.flrules.org/Gateway/reference.asp?No=Ref-12660, eff. 12/20, “Verification of Training Hours/Firefighter I and II.”
7. (g) DFS-K4-1033, rev. 03/09, “Notice of Termination of Employment as a Firefighter.”
8. (h) DFS-K4-1038, rev. 07/14, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-04760" http://www.flrules.org/Gateway/reference.asp?No=Ref-04760, “Release and Waiver of Liability.”
9. (i) DFS-K4-1308, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12661" http://www.flrules.org/Gateway/reference.asp?No=Ref-12661, eff. 12/20, “Application for Practical Examination for Retention of Firefighter Certification.”
10. (j) DFS-K4-1309, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12662" http://www.flrules.org/Gateway/reference.asp?No=Ref-12662, eff. 12/20, “Preliminary Equivalency Application Firefighter Minimum Curriculum Requirements.”
11. (k) DFS-K4-1390, rev. 03/09, “Application for Special Certificate of Compliance for Administrative & Command Head of a Fire/Rescue/EmergencyServices Organization.”
12. (l) DFS-K4-1438, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-08170" http://www.flrules.org/Gateway/reference.asp?No=Ref-08170, rev. 3/17, “Application for Fire Investigator Certification.”
13. (m) DFS-K4-1442, rev. 03/09, “Firefighters Supplemental Compensation Program Request for Upgrade from Associate Level to Bachelor Level.”
14. (n) DFS-K4-1446, rev. 03/09, “Application for Firesafety Inspector II Certification.”
15. (o) DFS-K4-1447, HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-03360" http://www.flrules.org/Gateway/reference.asp?No=Ref-03360, rev. 07/13, “Application for Fire Officer I Certification.”
16. (p) DFS-K4-1448, HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-03362" http://www.flrules.org/Gateway/reference.asp?No=Ref-03362, rev. 07/13, “Application for Fire Officer II Certification.”
17. (q) DFS-K4-1451, rev. 03/09, “Application for Instructor I Certification.”
18. (r) DFS-K4-1452, rev. 03/09, “Application for Instructor II Certification.”
19. (s) DFS-K4-1453, rev. 03/09, “Application for Instructor III Certification.”
20. (t) DFS-K4-1455, rev. 03/09, “Application for Single Course Exemption Instructor Certification.”
21. (u) DFS-K4-1456, rev. 03/09, “Application for Fire and Lifesafety Educator Certification Examination.”
22. (v) DFS-K4-1457, rev. 03/09, “Application for Fire Apparatus Pump Operator Certification Examination.”
23. (w) DFS-K4-1463, HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-01466%20" https://www.flrules.org/Gateway/reference.asp?No=Ref-01466, rev. 06/12, “Certification Renewal Application Inspector/Instructor.”
24. (x) DFS-K4-2085, eff. 04/13, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03076" http://www.flrules.org/Gateway/reference.asp?No=Ref-03076, “Application for Fire Code Administrator Certification.”
25. (y) DFS-K4-2104, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03363" http://www.flrules.org/Gateway/reference.asp?No=Ref-03363, eff. 07/13, “Application for Fire Officer III Certification.”
26. (z) DFS-K4-2105, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03364" http://www.flrules.org/Gateway/reference.asp?No=Ref-03364, eff. 07/13, “Application for Fire Officer IV Certification.”
27. (aa) DFS-K4-2106, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03365" http://www.flrules.org/Gateway/reference.asp?No=Ref-03365, eff. 07/13, “Fire Officer I Task Book.”
28. (bb) DFS-K4-2107, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03366" http://www.flrules.org/Gateway/reference.asp?No=Ref-03366, eff. 07/13, “Fire Officer II Task Book.”
29. (cc) DFS-K4-2108, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03367" http://www.flrules.org/Gateway/reference.asp?No=Ref-03367, eff. 07/13, “Fire Officer III Portfolio Workbook.”
30. (dd) DFS-K4-2109, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03368" http://www.flrules.org/Gateway/reference.asp?No=Ref-03368, eff. 07/13, “Fire Officer IV Portfolio Workbook.”
31. (ee) DFS-K4-2105, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-03364" http://www.flrules.org/Gateway/reference.asp?No=Ref-03364, eff. 07/13, “Application for Fire Officer IV Certification.”
32. (ff) DFS-K4-2138, “Health and Safety Officer Task Book,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-05016" http://www.flrules.org/Gateway/reference.asp?No=Ref-05016, eff. 08/14.
33. (gg) DFS-K4-2139, “Incident Safety Officer Task Book,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-05015" http://www.flrules.org/Gateway/reference.asp?No=Ref-05015, eff. 08/14.
34. (hh) DFS-K4-2140, “Application for Health and Safety Officer Certificate of Completion,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-05014" http://www.flrules.org/Gateway/reference.asp?No=Ref-05014, eff. 08/14.
35. (ii) DFS-K4-2141, “Application for Incident Safety Officer Certificate of Completion,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-05013" http://www.flrules.org/Gateway/reference.asp?No=Ref-05013, eff. 08/14.
36. (jj) DFS-K4-2142, “Application for Safety Officer Certificate of Competency,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-05012" http://www.flrules.org/Gateway/reference.asp?No=Ref-05012, eff. 08/14
37. (kk) DFS-K4-2148, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07044" http://www.flrules.org/Gateway/reference.asp?No=Ref-07044, “Confined Space Rescue Operations Task Book,” eff. 04/16.
38. (ll) DFS-K4-2149, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07045" http://www.flrules.org/Gateway/reference.asp?No=Ref-07045, “Confined Space Rescue Technician Task Book,” eff. 04/16.
39. (mm) DFS-K4-2150, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07046" http://www.flrules.org/Gateway/reference.asp?No=Ref-07046, “Rope Rescue Operations Task Book,” eff. 04/16.
40. (nn) DFS-K4-2151, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07047" http://www.flrules.org/Gateway/reference.asp?No=Ref-07047, “Rope Rescue Technician Task Book,” eff. 04/16.
41. (oo) DFS-K4-2152, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07048" http://www.flrules.org/Gateway/reference.asp?No=Ref-07048, “Structural Collapse Rescue Operations Task Book,” eff. 04/16.
42. (pp) DFS-K4-2153, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07049" http://www.flrules.org/Gateway/reference.asp?No=Ref-07049, “Structural Collapse Rescue Technician Task Book,” eff. 04/16.
43. (qq) DFS-K4-2154, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07050" http://www.flrules.org/Gateway/reference.asp?No=Ref-07050, “Trench Rescue Operations Task Book,” eff. 04/16.
44. (rr) DFS-K4-2155, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07051" http://www.flrules.org/Gateway/reference.asp?No=Ref-07051, “Trench Rescue Technician Task Book,” eff. 04/16.
45. (ss) DFS-K4-2156, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07052" http://www.flrules.org/Gateway/reference.asp?No=Ref-07052, “Vehicle/Machinery Rescue Operations Task Book,” eff. 04/16.
46. (tt) DFS-K4-2157, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07053" http://www.flrules.org/Gateway/reference.asp?No=Ref-07053, “Vehicle/Machinery Rescue Technician Task Book,” eff. 04/16.
47. (uu) DFS-K4-2160, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07054" http://www.flrules.org/Gateway/reference.asp?No=Ref-07054, “Application for Hazardous Materials Technician Certificate of Competency,” eff. 04/16.
48. (vv) DFS-K4-2161, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07055" http://www.flrules.org/Gateway/reference.asp?No=Ref-07055, “Application for FLUSAR Rescue Specialist Certificate of Completion,” eff. 04/16.
49. (ww) DFS-K4-2167, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07056" http://www.flrules.org/Gateway/reference.asp?No=Ref-07056, “Class Offering Request,” eff. 04/16.
50. (xx) DFS-K4-2168, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07057" http://www.flrules.org/Gateway/reference.asp?No=Ref-07057, “Instructor Approval Request,” eff. 04/16.
51. (yy) DFS-K4-2171, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-08171" http://www.flrules.org/Gateway/reference.asp?No=Ref-08171, “Fire Investigator Task Book,” eff. 1/17.
52. (zz) DFS-K4-2175, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-08172" http://www.flrules.org/Gateway/reference.asp?No=Ref-08172, “Fire Investigator Portfolio,” eff. 1/17.
53. (aaa) DFS-K4-2174, “Application for Firefighter Assistance Grant Program,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-08003" http://www.flrules.org/Gateway/reference.asp?No=Ref-08003, eff. 7/16.
54. (bbb) Form DFS-K4-2191, “Florida Fire Service Needs Assessment,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-08002" http://www.flrules.org/Gateway/reference.asp?No=Ref-08002, eff. 1/17.
55. (ccc) DFS-K4-2202, “Application for Lifetime Firefighter Designation,” HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-09073" http://www.flrules.org/Gateway/reference.asp?No=Ref-09073, eff. 01/18.
56. (ddd) Form DFS-K4-2206, “Aircraft Rescue and Fire Fighting (ARFF) Driver Task Book,” eff. 01/19, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12462" http://www.flrules.org/Gateway/reference.asp?No=Ref-12462.
57. (eee) Form DFS-K4-2207, “Aircraft Rescue and Fire Fighting (ARFF) Officer Portfolio Workbook,” eff. 01/19, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12463" http://www.flrules.org/Gateway/reference.asp?No=Ref-12463.
58. (fff) Form DFS-K4-2208, “Aircraft Rescue and Fire Fighting (ARFF) Firefighter Task Book,” eff. 01/19, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12464" http://www.flrules.org/Gateway/reference.asp?No=Ref-12464.
59. (ggg) DFS-K4-2300, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12663" http://www.flrules.org/Gateway/reference.asp?No=Ref-12663, eff. 12/20, “Application for Firefighter Cancer Decontamination Equipment Grant Program.”
60. (hhh) Form DFS-K4-2204, “Firesafety Inspector II Task Book,” eff. 02/21, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12901" http://www.flrules.org/Gateway/reference.asp?No=Ref-12901.
61. (iii) Form DFS-K4-2205, “Application for Firesafety Inspector III Certification,” eff. 02/21, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-12902" http://www.flrules.org/Gateway/reference.asp?No=Ref-12902.

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. History–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.