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Fire Report Request

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Requestor Name*
Agency Name (if applicable)
Mailing Address*
Phone Number
Fax Number
Email
Preferred Method of Contact*
Location / Address of Fire*
City*
Date of Fire
Date of Fire
Estimated Date of Fire
If the actual date of the fire is unknown, please provide an approximate date.
Type of Report Requested*
1. Basic Incident Report
2. Investigation Report
3. Photo Disc