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2. Frederick County Division of Fire and Rescue Services
4. Fire Report Request Form
8. Type of Report*

   1. Fire Incident Report

   1. Fire Investigation Summary
10. Date of Incident*
    Date of Incident
11. Incident Number (if known)
13. Responding Fire Company (if known)
    -- Select One --Independent Hose Company - Station 1Junior Fire Company - Station 2United Fire Company - Station 3Citizens Truck Company - Station 4Brunswick Volunteer Fire Company - Station 5Vigilant Hose Company - Station 6Middletown Volunteer Fire Company - Station 7Myersville Volunteer Fire Company - Station 8New Midway Volunteer Fire Company - Station 9Guardian Hose Company - Station 10Walkersville Volunteer Fire Company - Station 11Braddock Heights Fire Company - Station 12Rocky Ridge Fire Company - Station 13Carroll Manor Volunteer Fire Company - Station 14New Market District Volunteer Fire Company - Station 15Woodsboro Fire Company - Station 16Libertytown Volunteer Fire Company - Station 17Graceham Fire Company - Station 18Brunswick Ambulance Company - Station 19Jefferson Volunteer Fire Company - Station 20Wolfsville Volunteer Fire Company - Station 21Lewistown Volunteer Fire Company - Station 22Urbana Fire Company - Station 23Walkersville Rescue Squad - Station 24Green Valley - Station 25Emmitsburg Ambulance Company - Station 26Point of Rocks - Station 28Thurmont Ambulance Company - Station 30Westview - Station 31Spring Ridge - Station 33
15. Incident Location Information
17. Street Number
18. Street Name*
19. Street Type
20. Apt #
22. City*
23. State*
24. Zip
28. Requesting Party Information
30. First and Last Name*
31. Business
33. Address1*
35. Address2
37. City*
38. State*
39. Zip*
41. Email
42. Phone Number*
46. Relationship to Incident and Purpose of Request*
48. Method to receive report*

    1. Via email (PDF)
    2. Via US Mail
50. If there are any questions about your request, you may contact the Division of Fire and Rescue Services at 301-600-1479.
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit Submit and Print

* indicates a required field