All of the Forms are in PDF Format.  Some of the documents are not perfectly clear, if you need better copies check with the secretary.


Government Entity Letter  (This is the equivalent of a Tax-Exempt Form)

Ambulance Accident Report
VAW Form

VFIS Accident Form - after you have notified the Chief of an injury, please print and fill out this form and get to the Secretary to fill in and mail.
VFIS Physician Form - after you have notified the Chief of an injury, please print and give this to your doctor to fill out and mail in.

VF1 or VF2 or VF3 -- filled out by Chief and Secretary when injury has occurred.  This is the equivalent to Workmen's Comp.  Insurance information is Fire Districts of New York Mutual Insurance Company, 501 South Main Street, Spring Valley, NY 10977.  888-314-3004 or 845-352-8855

Physical Notification Letter (New Member) - phone numbers are same for current members
Application Form for District after accepted by Fire Company, return to Secretary
Declination for Hepatitis Vaccine

Under 18 Permission Slip

Call/Activity Sheet (updated 7/01/08)

Voucher

These forms must be filled out to receive your LOSAP credit and payment.  The first two forms are to be filled out by everyone.  The Payment Commencement Form is not filled out until you are 61 years old.

LOSAP Beneficiary Form
LOSAP Participation Form
LOSAP Payment Commencement Form
LOSAP Waiver Form - only fill out if don't want to participate in LOSAP