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Application for Registration as a Certified Firm Under the Provisions of Article 10 Office of the State Fire Marshal's Regulations

  1. (If partnership, include name of each partner under Responsible Persons Information below)

  2. Application is made for registration as a certified firm.

    Application will not be processed until all documents have been received.

  3. All correspondence will be delivered through email, please make sure to include this.

  4. Certification type

  5. Responsible Persons Information

    List information required for each individual, owner, partner, and other responsible persons in applicant business

  6. Certification

    Under the penalties imposed by K.S.A. 21-3805, I declare that I have examined this application and documents submitted in support thereof, and to the best of my knowledge and belief, they are true, correct and complete. I also certify that I am familiar with Article 10 State Fire Marshal’s Regulations, KAR 22-10-1 through KAR 22-10-17.

  7. By typing your name and date below, you attest that the information contained herein is true and accurate.

  8. Leave This Blank:

  9. This field is not part of the form submission.