Affidavits/Attestation | Amusement Rides | Boiler Division | Conveyance Safety | Fire Alarm Inspector
Fire Department/NEFIRS | Fire Prevention | Fireworks | Fuels Safety Division | Investigations
Opioid Wellness/Resiliency Development | Plans | Public Records Request | Structure Burn
Training Division | Water-Based Contractors
NOTE: For ALL PDF Forms
Affidavits/Attestation
Documents with an original notary stamp and original signature should be mailed to the State Fire Marshal's Office at 246 S 14th St, Suite 1, Lincoln, NE 68508-1804. Photocopies cannot be accepted. Please refer to the specific category for the application forms.
- Ownership Affidavit (Structure Burn Permit)
- Requires both an original notary stamp and an original signature
Employee Affidavit (Water-Based Contractor)
- Requires both an original notary stamp and an original signature
- Employer Affidavit (Water-Based Contractor)
- Requires both an original notary stamp and an original signature
- United States Citizenship Attestation (Amusement Ride Inspector, Boiler Inspector, Elevator Inspector, Fire Alarm Inspector, Firework Display Operator, Water-Based Contractor)
- Requires an original signature
Boiler Division
See Division Page linked above for forms under Boiler Inspection section of Mechanical Safety Page.
Amusement Rides
Amusement Ride Inspector Checklist
Amusement Ride Permit Application
Amusement Ride Qualified Inspector Application
Amusement Ride Route Listing Form
Conveyance Safety
Dumbwaiter & Material Lift Safety Test Report
Escalator Moving Walk Safety Test Report
Hydraulic Elevator Safety Test Report
Roped Hydraulic Elevator Safety Test Report
Traction Elevator Safety Test Report
Fire Alarm Inspector
In accordance with Title 153, Chapter 6, individuals must be licensed to inspect fire alarm systems in the State of Nebraska. The license is valid for four years and costs $100. A license may be obtained by either passing a test or, if NICET certified Level II or above, sending us a copy of your NICET certificate along with the pro-rated fee of $25 per year of the certification. Example: If your NICET certification expires April 1, 2013 and you are applying for the license in March 2010, the fee would be $75.
Fire Alarm Inspector Application
United States Citizenship Attestation Form
The application must be completed to obtain a license to inspect fire alarms. The completed application and form must be mailed in along with the appropriate fee and a copy of your NICET certificate if applicable.
Tests are given on the third Tuesday of each month. The tests are conducted in Lincoln, Grand Island, Omaha, and North Platte. A Fire Alarm Test Schedule and list of study materials is available. For more information regarding the test, contact Noelle Crew.
For more information on NICET go to their website, http://www.nicet.org/, or call (888) 476-4238.
This agency does not license Fire Alarm Installers. For information on becoming a licensed installer, contact the State Electrical Division at (402) 471-3550.
Fire Departments/NEFIRS
Fire departments should complete this online form to report changes in chief, mailing address, etc. If necessary, a PDF form may be obtained from Deb Hostetler; however, our agency strongly encourages the online form.
NEFIRS Field Collection Form
This form is designed to be used at the scene to collect pertinent information necessary to complete the NEFIRS report. This form does not replace the regular NFIRS forms and should not be submitted to the State Fire Marshal’s office.
NEFIRS 5.0 Master Forms
Master forms to be used to report incidents using NFIRS 5.0. Departments must make the necessary copies from these masters as needed, if they are not using software to report. These reports must be completed by hand and mailed to the Lincoln office.
Structure Burn Permit
The State Fire Marshal’s office has two types of burn permits – an Open Burn Permit and a Structure Burn Permit. These permits are issued by the state’s fire departments in accordance with state law. Anyone obtaining either type of burn permit should also contact the Department of Environment and Energy regarding their requirements affecting open burns and any forms they may require.
Fire Prevention
Fire and Life Safety Education Training/Event Request
Fireworks
Fireworks License Application Retail Stand
As of 2013, the only method to submit applications is through our online portal.
Firework Display Operator License Application
The process to receive a Fireworks Display Operator License includes the completion of an Application and United States Citizenship Attestation Form. An original (not a copy) Citizen Attestation form must be mailed (not faxed or emailed) to the Lincoln address on the application.
A Fireworks Display Operators Test Schedule and list of study materials is available. For more information regarding the test, contact Noelle Crew.
Fuels Safety Division
Download and save PDFs to utilize the "Submit" function - "Submit" cannot be used if form is filled out in the web browser.
Aboveground Storage Tanks - NFPA 30 Equivalency Form (Updated: 12/28/21)
Underground Storage Tanks - Application to Install Tanks and/or Piping (Updated: 10/10/24)
This application needs to be completed whenever an underground storage tank that will hold either petroleum or hazardous substances is to be installed. The application, with original signature, may be mailed to the Lincoln office with a check or money order covering the fee. Or you may email the form and pay the fee online.
Underground Storage Tanks - Application to Close Tanks and/or Piping (Updated: 6/6/24)
This application must be completed and approved by this office before an underground storage tank and/or piping is closed. You may email the form or mail the hard copy to the Lincoln office. There is no fee for this permit
Daily Inventory Instructions
Instructions on how to use the Daily Inventory Record for Underground Storage Tanks.
Daily Inventory Record
Daily Inventory Record for Underground Storage Tanks. Daily Inventory should be performed at approximately the same time every day.
UST Operator Checklist - 30 Day Walkthrough
The 30 Day Walkthrough Inspection checklist for UST operators.
Notification for Underground Storage Tanks
This form must be completed when notifying the State Fire Marshal of regulated underground storage tanks that have not previously been registered. This form will normally be used for a new installation and will be signed by both the owner and the installation contractor. You may email the form or mail the hard copy to the Lincoln office.
Underground Storage Tanks - 2 Page Notification of Change
This form must be completed when notifying this office of a change in ownership, tank status, product stored or other facility information regarding regulated underground storage tanks. You may email the form or mail the hard copy to the Lincoln office.
Underground Storage Tanks - One Time Notification
This form must be completed for: (1) Farm or Residential Motor Fuel Tanks (1,100 gallons or less), (2) Small Heating Oil Tanks (1,100 gallons or less), or (3) Tanks Permanently Abandoned as of January 1, 1974. . The application, with original signature, may be mailed to the Lincoln office with a check or money order covering the fee. Or you may email the form and pay the fee online.
Underground Storage Tanks - Registration for Heating Oil Tanks Over 1,100 Gallons
This form must be completed for all underground heating oil tanks over 1,100 gallons which are exempt under the requirement of the Federal Notification Program. You may email the form or mail the hard copy to the Lincoln office.
Underground Storage Tanks - Application for Contractor License
Any company that wants to install and/or close underground storage tanks must complete this form. You may email the form or mail the hard copy to the Lincoln office.
Underground Storage Tanks - Application for Individual Certification
Any individual seeking certification to install and/or close underground storage tanks should complete this application. You may email the form or mail the hard copy to the Lincoln office.
Underground Storage Tanks - Cathodic Protection Tester Certificate
Any individual seeking certification to test cathodic protection of underground storage tanks should complete this application. You may email the form or mail the hard copy to the Lincoln office.
Investigations Division
Download and save PDFs to utilize the "Submit" function - "Submit" cannot be used if form is filled out in the web browser.
Fire Report Request
To request a Fire Report, please use the Public Records Request form.
Opioid Wellness/Resiliency Development
The Nebraska State Fire Marshal Agency is offering a funding opportunity to benefit First Responders in the State of Nebraska. These funds are available as part of the Opioid Prevention and Treatment Act. Please read the Sub-Award document which lists purpose/description, timeframes for applications, terms, and conditions. If an entity wishes to apply for consideration, please complete the application.
Plans Division
Download and save PDFs to utilize the "Submit" function - "Submit" cannot be used if form is filled out in the web browser.
Equivalency Concepts
The Equivalency Concepts form is used to allow the use of equivalent measures to those listed in a Code Review. If you feel that you have a solution to a Code issue, use the Equivalency Concepts form. It will be reviewed by State Fire Marshal administration and the State Fire Marshal will decide whether to accept or deny the equivalency. This form requires a signature and, therefore, must be mailed to the Lincoln office.
Fire Suppression System – Plan Review Information
This form must be completed by anyone submitting plans for a water-based fire protection system in addition to the Plan Submittal Form.
Fire Protection of Cooking Operations
Check off list of requirements to run cooking equipment without an exhaust hood or fire suppression system.
Contractor’s Material and Test Certificate for Aboveground Piping
This form must be completed before final approval is given for the aboveground piping installed for water-based fire protection systems.
Contractor’s Material and Test Certificate for Underground Piping
This form must be completed before final approval is given for the underground piping installed for water-based fire protection systems.
Public Records Request
Public Records Request Form
This form can be used to request records from a specific division or all agency records for an address.
Structure Burn Permits
Training Division
Download and save PDFs to utilize the "Submit" function - "Submit" cannot be used if form is filled out in the web browser.
Water-Based Contractors
Download and save PDFs to utilize the "Submit" function - "Submit" cannot be used if form is filled out in the web browser.
Fire Sprinkler Inspection
This form must be completed and submitted to the State Fire Marshal’s Office for inspections conducted on water-based fire protection systems. The completed report must be mailed to the Lincoln office. Due to signature requirements this form cannot be emailed.
Water-Based Fire Protection Contractor’s Certificate Application
An Employee Affidavit, Employer Affidavit and a United States Citizenship Attestation should be mailed to the State Fire Marshal's Office at 246 S 14th St, Suite 1, Lincoln, NE 68508-1804. These documents must contain original notary marks and original signatures. Photocopies and scans of the affidavits and attestations may delay your application. For more information, please see Water-Based Based Contractors.
