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Notification of Fatality Report


  • The following form is used in conjunction with your Internet Browser. Some browsers may not support it. A reply email will be sent to the sender after we review the information to ensure you that the form was received and contained the necessary information. You may also print the form, complete it, and fax it to our Division at 317-233-8494.
  • Submit the form by clicking the Submit button below. A message will pop up advising that a program is trying to access your email account. This is a normal security measure implemented to protect everyone against viruses. Click "OK" to proceed to send the form.
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  • We appreciate your assistance in notifying us if your agency has experienced a fire fatality. It helps us accurately assess the fire fatality situation in Indiana.