
A 50 fee applies to each additional LIMITED FIRE SPRINKLER SYSTEM LSS FIXED FIRE EXTINGUISHING SYSTEM PRE-ENGINEERED KITCHEN FFK PORTABLE FIRE EXTINGUISHERS PFE See special documentation requirements for this endorsement IS THIS APPLICATION FORM FOR YOUR HEADQUARTERS LOCATION YES NO IF NO PLEASE PROVIDE NAME LOCATION OF HEADQUARTERS OFFICE NAMES OF OFFICERS OF THE BUSINESS SIGNED DATE By signing this form I attest that all of the information above is true to the best of my knowledge and is presented under the penalties of perjury. FOR DEPARTMENT OF SAFETY USE ONLY COPY OF R.M. E. CERTIFICATE YES NO PAYMENT CHECK CHECK COPY OF CERTIFICATE OF INSURANCE YES NO CREDIT CARD AMOUNT IF CORP COPY OF CERTIFICATE OF GOOD STANDING BY SECRETARY OF STATE IF PFE COPY OF SITE INSPECTION REPORT BY NHFMO OF THE FACILITY YES DSFM 97 06/11 NO. STATE OF NEW HAMPSHIRE DEPARTMENT OF SAFETY DIVISION OF FIRE SAFETY OFFICE OF THE STATE FIRE MARSHAL 33 HAZEN DRIVE CONCORD NH 03305 603-223-4289 VOLUNTARY CERTIFI....
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How to fill out the Dsfm Form online
Filling out the Dsfm Form is an essential step for individuals and businesses seeking voluntary certification of fire protection equipment technicians. This guide provides clear and instructive steps to assist users in successfully completing the form online.
Follow the steps to fill out your Dsfm Form with ease.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by selecting the application type from the options provided. Indicate if this is an original application or a renewal by placing a checkmark in the appropriate box.
- If you are renewing your application, provide your previous certificate number in the designated space.
- Enter the firm name in the designated field, followed by the firm's mailing address. Ensure you include the city, state, and ZIP code.
- Provide the physical address of the firm, noting that a P.O. Box is not acceptable, and fill in the city, state, and ZIP code.
- Include the firm telephone number and the federal employer ID number. Also, provide the firm's email address for correspondence.
- Fill in the name of the responsible managing employee (R.M.E.) and their certification number in the appropriate fields.
- Input the R.M.E. address, along with the city, state, and ZIP code for this person.
- Select any endorsements being applied for by checking the appropriate boxes. Note that an additional fee applies for each endorsement.
- Indicate if this application is for your headquarters location by selecting 'Yes' or 'No.' If 'No,' provide the name and location of your headquarters office.
- List the names of the business officers in the designated space.
- Sign the form, affirming that all information is accurate to the best of your knowledge, and include the date of signing.
- Review the form for accuracy before submitting. Once complete, you can save changes, download, print, or share the form.
Complete your Dsfm Form online today and take an important step toward certification.
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