Introduction to NFIRS Distance Learning (Training)

NFIRS 5.0 Self-Study Program

Arson and Juvenile
Firesetter Module:
NFIRS-11

Objectives
After completing the Arson and Juvenile Firesetter Module you will
be able to:
1. Describe when the Arson and Juvenile Firesetter Module is to be
used.
2. Demonstrate how to complete the Arson and Juvenile Firesetter
Module and identify appropriate other modules, given the scenario of
a hypothetical incident.

11-1

Table of Contents
Arson and Juvenile Firesetter Module: NFIRS-11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1
Pretest #11 - Arson and Juvenile Firesetter Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3
Using the Arson and Juvenile Firesetter Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Section A: FDID, State, Incident Date, Station, Incident Number, Exposure. . . . . . . . . . . . . . 11-4
Section B: Agency Referred To. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Section C: Case Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Section D: Availability of Material First Ignited. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Section E: Suspected Motivation Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Section F: Apparent Group Involvement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Section G: Entry Method/Extent of Fire Involvement on Arrival. . . . . . . . . . . . . . . . . . . . . . 11-7
Section H: Incendiary Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Section I: Other Investigative Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Section J: Property Ownership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Section K: Initial Observations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Section L: Laboratory Used. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Juvenile Firesetter Module: NFIRS-11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-10
Section A: FDID, State, Incident Date, Station, Incident Number, Exposure. . . . . . . . . . . . . 11-10
Section M: Subject Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-10
Section N: Remarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-13
SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-14
EXAMPLE: Restaurant Fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-15
EXERCISE SCENARIO 11-1: Mattress Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-17
EXERCISE SCENARIO 11-2: Structure Fire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-22
Arson and Juvenile Firesetter Module Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33

NFIRS 5.0 Self-Study Program

Pretest #11 - Arson and Juvenile Firesetter Module
1. Arson is to unlawfully and intentionally damage, or attempt to damage, any real or personal
property by fire or incendiary device.

(a) True.

(b) False.

2. The Basic Module must be completed if the Arson and Juvenile Firesetter Module is completed.

(a) True.

(b) False.

3. The Arson and Juvenile Firesetter Module is a required NFIRS Module.

(a) True.

(b) False.

4. The Juvenile Firesetter Module is completed only for fires where the person involved in the ignition of the fire was under the age of 21.

(a) True.

(b) False.

5. The Juvenile Firesetter section of the module can be completed without completing the Arson
section.

(a) True.

(b) False.

11-3

NFIRS 5.0 Self-Study Program

Using the Arson and Juvenile Firesetter Module

A

n indispensable tool in the war against arson is the ability to identify when and where the crime
takes place, what form it takes, and the characteristics of its targets and perpetrators. Armed with
such information, fire service and law enforcement agencies can develop and implement arson prevention initiatives—allowing them to use their resources in the most efficient and effective manner.
The NFIRS 5.0 Arson Module (NFIRS-11) was developed with this goal in mind.
The optional Arson Module may be used whenever the Cause of Ignition, (NFIRS-2 E1) is coded
as “intentional,” or as “under investigation” without a distinction as to whether or not a crime has
occurred, or a determination of criminal intent. You also can use the Arson Module in cases where
the cause is “Undetermined after investigation.”
In addition, use the Arson Module to document juvenile-set fires, whether determined to be intentional or not. This information will permit analysis of juvenile firesetting trends, including intervention strategies and repeated activity.
ARSON—To unlawfully and intentionally damage, or attempt to damage, any real or personal property by fire or incendiary device.
NOTE: Nothing in this definition is meant to alter or affect compliance with State or local incident reporting requirements. In
States with mandatory reporting, the State Program Manager determines which optional modules (EMS, Hazardous Materials,
Wildland, Arson, etc.) are to be submitted to the State.
The Arson Module consists of two parts: a local investigation module, which permits a fire department or arson investigation unit to document certain details concerning the incident; and a juvenile
firesetter section, which identifies key items of information that could be used for local, State, and
national intervention programs.
Many arson investigation units use an arson information management system to collect and compile
information on arson incidents. This module is not intended to replace those systems, but to identify
data elements that could be exported to the NFIRS and be included as an integral part of the U.S. Fire
Administration (USFA) National Fire Database and the Bureau of Alcohol, Tobacco, Firearms, Arson
and Explosives (ATF) National Repository.

Section A: FDID, State, Incident Date, Station,
Incident Number, Exposure
MM

A
FDID

State

DD

YYYY

Incident Date

NFIRS–11
Arson

Delete
Station

Incident Number

Exposure

Change

None
Referred in
To Section
The
information
A is drawn from Section A of the Basic Module. Use the data in the Basic
B Agency
Street address
Their case number
Module to help you supply the requested
information. If you are using
an automated system the
data need to be entered only once, then they will be transferred automatically into other modules
Their ORI
City
thatAgency
usename
the data.

State

Agency phone number

C

Case Status
Investigation open
1
Investigation closed
2
Investigation inactive
3

ZIP code

11-4
4
5

Closed with arrest
Closed with exceptional
clearance

Their Federal Identifier (FID)

D

Availability of Material First Ignited
1
2
U

Transported to scene
Available at scene
Unknown

Their FDID

D

NFIRS 5.0 Self-Study Program
MM

A
FDID

B

State

Agency Referred To

DD

YYYY

Section B: Agency Referred To

Incident Date

Station

Incident Number

Exposure

NFIRS–11
Arson

Delete
Change

None
Street address

Their case number

Agency name

City

Their ORI

Agency phone number

State

ZIP code

Their Federal Identifier (FID)

Their FDID

Availability of Material First Ignited
Case Status
This
identifies the agency, if any, that the incidentDwas
referred to for followup investigation.
C 1section
Investigation open
Closed with arrest
4
1
to scene
This2could
be a lawclosed
enforcement
agency that has jurisdiction
forTransported
a criminal
investigation, or another
Investigation
Closed with exceptional
5
2
Available at scene
Investigation
inactive
fire 3department
that
may have been
requested to conduct the
clearance
U investigation.
Unknown

This Suspected
information
provides
necessary to contact the agency that conducted any follow up
Check up to three factors
Motivation
Factorsthe details
E
of the incident. It also allows for the collection, compilation,
and analysis
data associated with
Burglary
54 of all
42
Vanity/recognition
Homicide concealment
11
Extortion
22
Hate crime
61
43
Thrills
a specific
incident.
Burglary concealment
12
Labor unrest
23
Institutional
62
44
Attention/sympathy
Auto theft concealment
13
Insurance fraud
24
Societal
63
45
Sexual excitement
– is the unique 31identification
number 51
assigned
to law enforcement
agencies
(towns,
Destroy
records/evidence
14ORIIntimidation
Protest
64
Homicide
Other
suspected
motivation
15cities,
Voidcounties,
contract/lease
32
Civil
unrest
00
52
Suicide
State police agencies, and some colleges and universities) participating
in
Unknown motivation
21
Personal
41
Fireplay/curiosity
UU
53
Domestic violence

the FBI’s Uniform Crime Reporting (UCR) system or the National Incident Based Reporting
System (NIBRS).
Incendiary
Devices
Group Involvement
MM
DD
YYYY
F Apparent
No container
CONTAINER
None H
Check up to three factors
A identification
Select one from each category
FID
– is a two-character
number used by Federal departments to submit crime
Incident Date
Incident Number
FDID
Station
Exposure
1
group
Box
Bottle (glass)
Pressurized container 17
14
dataTerrorist
to UCR/NIBRS
gathered by 11
itsState
dependent
bureau/agencies.
2
Gang

State

ency Referred To

Change

Other Container
00
Bottle (plastic) 15
Can (not gas or fuel)
12
3
Anti-government group Agency Referred To
None
Unknown
Jug
or fueluniqueness
can UU
13
16 theGasoline
The
ORI
plus
the
FID
and
the
incident
number
provide
necessary
to
avoid the
B
4
Outlaw motorcycle organization
Street address
Their case number
5 duplication
Organized of
crime
reported incidents.
No device
IGNITION/DELAY DEVICE
6
Racial/ethnic hate group
11
Wick or fuse
17
Road flare/fuse
7
Religious hate group
12
Candle
18
Chemical componentTheir ORI
Agency name
City
8
Sexual preference hate group
13
Cigarette and matchbook
19
Trailer/streamer
0
Other group
14
Electronic component
20
Open flame source
U
Unknown
15
Mechanical device State
00
Other delay device Their Federal Identifier (FID)
ZIP code
Agency phone number
16
Remote control
UU
Unknown
G1 Entry Method
Availability
of Material First Ignited
None
Case Status
FUEL
D
C 1 Investigation open
Closed with arrest
4
1
Transported to scene
Entry Method
Pyrotechnic
11 closed
Ordinary combustibles
16
Investigation
2
Closed with exceptional
5
2 material
Available at scene
Explosive
12
Flammable gas clearance Delete
17
Involvement on
MM Extent
DD of Fire
YYYY
Investigation
inactive
NFIRS–11
3 Arrival
U material
Unknown
G2
14
Ignitable liquid
00
ArsonOther material
Change
Incident Date
Incident Number
Station
Unknown
15
IgnitableExposure
solid
UU
Check up to three factors
Suspected Motivation Factors
Extent of Fire Involvement

Section C: Case Status

NFI
A

Delete

Their FDID

Section C identifies theEstatus of the investigation at the time the report was filed. This information is
Burglary
54
42
Vanity/recognition
None
useful
in tracking
theInformation
closure
ofProperty
investigations
wellcrime
as Initial
providing
information
to other agencies
Ownership
Homicide concealme
11 rate
Extortion
22 as Hate
61
43
Thrills
Observations
Other
Investigative
J unrestbe linked
I
K they
address
Their case number
Burglary concealme
concerning
theStreetstatus
of cases
that
are
investigating.
12
Labormay
23 to cases
Institutional
62
44
Attention/sympathy
Check all
that apply
Check all that apply

Auto theft concealm
24
Societal
Insurance fraud
63
45
Sexual excitement
department forced entry
1 Windows ajar 551 Fire
1
Private
Destroy records/evid
Intimidation
31
Protest
64
Homicide
Their ORI
cy name
Doors ajar
forced prior to FD arrival Other suspected mo
City
2 unrest
652 Entry
1
Code violations
2
City, town, village,
Void
contract/lease
32 local
Civil
00
Suicide
system activated
3 Doors locked 753 Security
2
Structure for sale
3
County or parish
Unknown motivation
Personal
41
Fireplay/curiosity
UU
Domestic violence
4 Doors unlocked 8 Security system present
3
Structure vacant
4
State or province
(not activated)
4
Their FDID
State
Their Federal Identifier (FID)
cy phone number
Other crimes
involvedZIP code
5
Federal
Laboratory
Used
5
Check all that apply
Incendiary
Devices
Illicit drug activity
Apparent
Group
Involvement
6
Foreign
None
F Check up to three factors
No container
CONTAINER
L H
None
6
Change in insurance
7
Military
Availability of Material First IgnitedSelect one from each category
se Status
DOther
7
Financial problem
1
Local
3
ATF 5
6
Private
Other
0
Terrorist
group
Investigation open
Closed with arrest 1
4
1
Transported to scene 11
Box
(glass)
14
8
Criminal/civil actions pending
2
State Bottle
4
FBI
FederalPressurized container 17
2
Gang
Investigation closed
Closed with exceptional
5
2
Available at scene
Other Cont
00
Bottle (plastic) 15
Can
(not gas
or01/01/04
fuel)
12
NFIRS–11
Revision
3
Anti-government
group
Investigation inactive
clearance
U
Unknown
Unknown
Jug
Gasoline or fuel can UU
16
13
4
Outlaw motorcycle organization
5
Organized crime
No device
IGNITION/DELAY DEVICE
Check up to three factors
uspected Motivation Factors
6
Racial/ethnic hate group
11
Wick or fuse
17
Road
flare/fuse
Burglary
54
Vanity/recognition
7 42 Religious
hate group
12
Candle
18
Chemical component
Homicide concealment
Extortion
22
Hate crime
61
Thrills
8 43 Sexual
preference hate group
13
Cigarette and matchbook
19
Trailer/streamer
Burglary
concealment
Labor unrest
23
Institutional
62
Attention/sympathy
0 44 Other
group
14
Electronic component
20
Open flame source
Auto theft concealment
Insurance fraud
24
Societal
63
Sexual excitement
U 45 Unknown
15
Mechanical device
00
Other delay device
Destroy records/evidence
13
14
15
21

Section D: Availability of Material First Ignited

11-5

Arson
FDID

B

State

Incident Date

Agency Referred To

Incident Number

Station

Change

Exposure

None

NFIRS 5.0 Self-Study Program

Street address

Their case number

Their ORI
name
City
ThisAgency
section
identifies the availability
of an ignition source (including
matches and lighters) to the
initial ignition. This information permits analysis of firesetting methods and trends and can assist in
MM
DD
YYYY
the Agency
development
of prevention and
intervention
Their FDID
ZIP code strategies.
Their Federal Identifier (FID)
phone number
A State
FDID

C

E

Case Status
Investigation open
1
Investigation closed
2
Investigation inactive
3

4
5

State

Closed with arrest
Referred To
B Agency
Closed
with exceptional
clearance

Incident Date

D

Station

Incident Number

Exposure

Availability of Material First Ignited

1
None

Transported to scene

2
Available at
scene
Section E: Suspected Motivation
Factors
U
Unknown

Suspected Motivation Factors

Check upAgency
to three
factors
name

Street address

Their case number

City

Their ORI

Burglary
54
42
Vanity/recognition
Homicide concealment
11
Extortion
22
Hate crime
61
43
Thrills
concealment
12
Labor unrest
23
Institutional
code
Their Federal Identifier (FID)
44
Attention/sympathyState 62 ZIPBurglary
Agency phone number
Auto theft concealment
13
Insurance fraud
24
Societal
63
45
Sexual excitement
Destroy records/evidence
14
Intimidation
31
Protest Case Status
64
51
Homicide
Availability of Material First Igni
D motivation
Other suspected
15
Void contract/lease 32
CivilCunrest
00
52
Suicide
Investigation open
1
Closed with arrestUnknown motivation
4
1
Transported to scene
21
Personal
41
Fireplay/curiosity
UU
53
Domestic violence
Investigation closed
2
Closed with exceptional
5
2
Available at scene
Investigation inactive
3
clearance
U
Unknown
Incendiary
Devices
Apparent
Group
Involvement
Indicates
the
suspected
stimulus
that
caused
the
subject(s)
to
burn,
or
attempt
to
burn,
any
real
or
F Check up to three factors
No container
CONTAINER
None H
Select oneMotivation
from each category
Check up to three factors
Suspected
Factors
personal property. This permits analysis
of arson trends based on the possible motivation for the
E
1
Terrorist group
Burglary
54
Vanity/recognition
Bottle (glass)
Pressurized container 1742 Box
11
14
crime.
You
may
select
up
to
three
factors.
2
Gang
Homicid
1112 Extortion
Hate
crime
61
Thrills
Container
0043 Other
Bottle (plastic) 1522 Can
(not
gas or fuel)
3
Anti-government group
Burglary
1213 Labor
Institutional
62
Attention/sympathy
Jugunrest
or fuel can UU44 Unknown
1623 Gasoline
4
Outlaw motorcycle organization
Auto the
13
Insurance fraud
24
Societal
63
45
Sexual excitement
5
Organized crime
Destroy
device
14
Intimidation
31
Protest DEVICE
64
51 No Homicide
IGNITION/DELAY
6
Racial/ethnic hate group
Other su
1511 Void
contract/lease
32
Civil unrest17
00
52
Suicide
Wick
or fuse
Road flare/fuse
7
Religious hate group
Unknow
2112 Personal
41
Fireplay/curiosity
UU
53
Domestic
violence
Candle
18
Chemical component
8
Sexual preference hate group
13
Cigarette and matchbook
19
Trailer/streamer
0
Other group
14
Electronic component
20
Open flame source
Incendiary Devices
Group Involvement
U
Unknown
15
Mechanical
device
F Apparent
Other delay device CONTAINER
None H00
Check up to three factors
one from each category
16
Remote control
UU SelectUnknown
1
Terrorist group
G1 Entry Method
Bottle (glass)None 14
Pressurized container 17
11
FUEL
2
Gang
00
Bottle (plastic) 15
Can (not gas or fuel)
12
3
Anti-government group
Entry Method
UU
Jug
Gasoline
or
fuel
can
13
16
Pyrotechnic
material
11
Ordinary
combustibles
16
4
Outlaw motorcycle organization
Explosive material
Flammable
gas
17
Extent of Fire Involvement on Arrival 5 12 Organized
crime
IGNITION/DELAY DEVICE
G2
Other material
Ignitable liquid
00
6 14 Racial/ethnic
hate group
11
Wick
or fuse
17
Road flare
Unknown
15
Ignitable
solid
UU
7
Religious hate group
12
Candle
18
Extent of Fire Involvement
Chemical
8
Sexual preference hate group
13
Cigarette and matchbook
19
Trailer/str
0
Other group
14
Electronic component
20
Open flam
Property Ownership
Initial
Observations
Other
Investigative
Information
J U Unknown
I
K Check all that apply 15 Mechanical device
00
Other dela
16
Remote control
UU
Check all that apply
Unknown
Entry Method
entry of
1 Windows
5 Fire
G1Private
This section identifies whether1 the
suspect(s) were motivated
to ajar
commit
thedepartment
arson actforced
because
FUEL
6 Entry forced prior to FD arrival
1
Code violations
2
City, town, village, local 2 Doors ajar
involvement
in
a
larger
group
or
organization
or
as
a
means
to
promote
the
cause
of
a
larger
group
Doors
locked
Security
system
activated
3
7
2
Entry Method
Structure for sale
3
County
or parish
Pyrotechni
11
Ordinary combustibles
16
4 Doors unlocked 8 Security system present
3 organization.
or
Structure vacant
4
State or province
Explosive m
12
Flammable
(not activated)gas
17
Extent
of Fire Involvement on Arrival
4
Other crimes involved
5 G2 Federal
Other mate
14
Ignitable liquid
00
Laboratory
Used
5
Check
that apply
This
information
will permit analysis
of arson trends based
on participation
in allcriminal
groupsNone
or UU Unknown
Illicit drug activity
6
Foreign
15
Ignitable
solid
L
6
Change in insurance
7 to Military
Extent of factors.
Fire Involvement
organizations.
You may check up
three
7
Financial problem
1
Local
3
ATF 5
6
Private
Other
0
Other
8
Criminal/civil actions pending
2
State
4
FBI
Federal
Property Ownership
Initial Observations
Other Investigative Information
NFIRS–11 Revision 01/01/04

Section F: Apparent Group Involvement

J

I

K

Check all that apply

Check all that apply

1
2
3
4
5
6
7
8

Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

11-6

1
2
3
4
5
6
7
0

Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

1
2
3
4

L
1
2

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

Fire departm
Entry force
Security sy
Security sy

(not activated)

Laboratory Used
Local
State

3
4

ATF
FBI

Check all that

5

Other
Federa

Group Involvement
F Apparent
Check up to three factors
MM
A1
Terrorist group

None
DD

H
YYYY

11
12
13

Incendiary Devices

CONTAINER

Select one from each category

Bottle (glass)
Pressurized container 17
14
Incident Number
Station
Exposure
00
Bottle (plastic) 15
Can (not gas or fuel)
Jug
Gasoline or fuel can UU
16

2 FDID Gang
Incident Date
State
5.0 Self-Study
Program
3 NFIRS
Anti-government
group
4
Outlaw motorcycle organization
None
Referredcrime
To
Organized
B 5 Agency
6
Racial/ethnic hate group
7
Religious hate group
8
Sexual preference hate group
0Agency name
Other group
U
Unknown

Street address

Entry
phoneMethod
number
G1Agency

State

Section G: Entry Method/
11
Wick or fuse
12
Candle
Cigarette and matchbook
Extent of Fire Involvement on 1314Arrival
Electronic component

IGNITION/DELAY DEVICE
Their case number

17
18
19
Their ORI
20
00
UU

City

15
16

Mechanical device
Remote control
ZIP code

Road flare
Chemical
Trailer/str
Open flam
Other del
Unknown

Their Federal Identifier (FID)

FUEL

Availability of Material First Igni

Case Status
D
Pyrotechni
C 1 Entry Method
11
Ordinary combustibles
16
Investigation open
Closed with arrest
4
1
Transported to Explosive
scene
m
12
Flammable gas
17
Extent
of
Fire
Involvement
on
Arrival
Investigation closed
Closed with exceptional
5
2
Available at scene
G2 2 gained
Other mate
14ThisIgnitable
liquid
00
Block G1 indicates how the offender(s)
entrance
to
the
property.
provides
additional
inforInvestigation
inactive
3
clearance
U
Unknown
Unknown
15
Ignitable solid
UU
mation on the case and tracks commonExtentmethods
of entry for later analysis
and
linking of cases.
of Fire Involvement
Suspected Motivation Factors

Check up to three factors

E Other Investigative Information
Property Ownership
42
J
I 11 Extortion
Entry Method 22
Hate crime

Burglary
54
Vanity/recognition
K Initial Observations
Homicid
61
43
Thrills Check all that apply
Check all that apply
Burglary
12
23
Institutional
Labor unrest
62
44
Attention/sympathy
1 Windows ajar 5 Fire departm
11  Door—open or unlocked
21 
Vent
1
Private
Auto
the
13
Insurance fraud
24
Societal
63 Entry
45
SexualDoors
excitement
ajar
force
2
6
1
violations
2
City, town, village,
Destroy
14 Code
Intimidation
31
Protest
64
51localHomicide
12  Door—forced2or broken
22  Attic/roof
3 Doors locked 7 Security sy
for sale
3 unrest
County or parish52
Othersy
su
15 Structure
Void contract/lease
32
Civil
SuicideDoors unlocked 00 Security
4
8
3
Structure
vacant
4
State
or
province
21
Personal
41
Fireplay/curiosity
UU
53
Domestic
violence
(not Unknow
activated)
13  Window—open
unlocked
4 or Other
crimes involved 23  Key5
Federal
Laboratory Used
5
Check all tha
Illicit drug activity
6
Foreign
L
14  Window—forced
brokenin insurance
24  Help7 from inside
6 or
Change
Military
Incendiary
Devices
Apparent
Group
Involvement
F7 Check
CONTAINER
H Select one from each category1 Local
Financial
3
ATF 5
Other
0 None Other
up to threeproblem
factors
15  Gate—open or
25  Wall
8 unlocked
Criminal/civil actions pending
2
State
4
FBI
Federa
1
Terrorist group
Bottle (glass)
Pressurized container 17
11
14
Gang
16  Gate—forced or2 broken
26  Crawl space12
00
Bottle (plastic) 15
Can (not gas or fuel)
3
Anti-government group
Jug
Gasoline or fuel can UU
13
16
17  Locks—pried 4
27  Hid in/on premises
Outlaw motorcycle organization
5
Organized crime
IGNITION/DELAY DEVICE
18  Locks—cut
00 Other
6
Racial/ethnic hate group
11
Wick or fuse
17
Road flare
7
Religious hate group
12
Candle
18
Chemical
19  Floor entry
Unknown 13
8
Sexual preference hateUU
group
Cigarette and matchbook
19
Trailer/str
0
Other group
14
Electronic component
20
Open flam
U
Unknown
15
Mechanical device
00
Other dela
16
Remote
control
UU
Unknown
G2 documents the fire department’s
observation
of
the
extent
of
the
fire’s
involvement
when
G1 Entry Method

Block
it arrived at the incident scene.

FUEL

Entry Method

G2

Extent of Fire Involvement on Arrival

11
12
14
15

Ordinary combustibles
Flammable gas
Ignitable liquid
Ignitable solid

16
17
00
UU

Pyrotechni
Explosive m
Other mate
Unknown

Extent of Fire Involvement

I
1
2
3
4
5
6
7
8

Other Investigative Information

J

Check
that apply
Extent
ofallFire
Involvement on Arrival

Code
0 
No violations
flame or smoke showing
Structure for sale
1 
Smoke vacant
only showing
Structure
Other crimes involved
2 
Flame
smoke showing
Illicit
drugand
activity
Change in insurance
3 
Fire through
roof
Financial
problem
Criminal/civil actions pending

4  Fully involved

1
2
3
4
5
6
7
0

Property Ownership

Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

K
1
2
3
4

L
1
2

Initial Observations
Check all that apply

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

(not activated)

Laboratory Used
Local
State

3
4

This provides information about the speed and the pattern of flame spread that is helpful to case
investigators.

11-7

Fire departm
Entry force
Security sy
Security sy

ATF
FBI

Check all that

5

Other
Federa

A
Incident Date
State
Their Federal Identifier (FID)

FDID
State

Agency phone number

Case Status
Investigation open
1
Investigation closed
2
Investigation inactive
3

C

Closed with arrest
Closed with exceptional
clearance

4
5

Exposure

Agency
Referred
Availability
of To
Material First Ignited
BD
NFIRS
5.0 Self-Study
Program
1
2
U

Transported to scene
Available at scene
Unknown

Street address

Their case number

Section H: Incendiary Devices
Agency name

Their ORI

City

Check up to three factors

Burglary
State
code
Their Federal Identifier (
54
42
Vanity/recognition
Agency phone number
This section
documents the container,
ignition
and delay
devices,
and
fuel
that ZIP
were
used to burn or
Homicide
concealment
Extortion
22
Hate crime
61
43
Thrills
Burglary concealment
any real or personal
property.
Labor unrestattempt23to burn
Institutional
62
44
Attention/sympathy
Availability of Material First
Case Status
D
Auto theft concealment
C
Insurance fraud
24
Societal
63
45
Sexual excitement
Investigation open
1
Closed
with
arrest
4
to scene
Destroy records/evidence
Intimidation This provides
31
Protest
64 common
additional details51 on Homicide
the2 case
and tracks
containers
and devices for12 laterTransported
Investigation
closed
Closed with
exceptional
5 suspected
Available at scene
Other
motivation
Void contract/lease 32
Civil unrest
00
52
Suicide
Investigation inactive
analysis41and Fireplay/curiosity
linking of cases. 53 Domestic
3
U
Unknown
Unknownclearance
motivation
Personal
UU
violence

Apparent Group Involvement

None

Check up to three factors

1
2
3
4
5
6
7
8
0
U

Incident Number

Station
Their FDID

None

Suspected Motivation Factors
11
12
13
14
15
21

ZIP code

Terrorist group
Gang
Anti-government group
Outlaw motorcycle organization
Organized crime
Racial/ethnic hate group
Religious hate group
Sexual preference hate group
Other group
Unknown

H
11
12
13

Suspected Motivation Factors

E
Incendiary Devices
Select one from each category

Bottle (glass)
Bottle (plastic)
Jug

Check up to three factors

No container

CONTAINER

11
Extortion
22
12
Labor
unrest container2317
Pressurized
14
13
Insurance
fraud
Can (not gas
or fuel) 2400
15
14
Intimidation
Gasoline or fuel can 31UU
16
15
Void contract/lease 32
21IGNITION/DELAY
Personal DEVICE
41

Hate crime
Institutional
Box
Societal
Other Container
Protest
Unknown
Civil unrest
No device
Fireplay/curiosity

42
43
44
45
51
52
53

Bur
Hom
Bur
Auto
Des
Oth
Unk

54
61
62
63
64
00
UU

Vanity/recognition
Thrills
Attention/sympathy
Sexual excitement
Homicide
Suicide
Domestic violence

11
12
13
14
15
16

Wick or fuse
17
Road flare/fuse
Candle
18
Chemical component
Incendiary Devices
Group Involvement
Cigarette and matchbook
F Apparent
CONTAINER
19
Trailer/streamer
None H
Check up to three factors
Select one from each category
Electronic component
20
Open flame source
Terrorist group
Mechanical device1
00
Other delay device11
Bottle (glass)
Pressurized container 1
14
Gang
Remote control 2
UU
Unknown
0
Bottle (plastic) 15
Can (not gas or fuel)
12
Entry Method
3
Anti-government group
G1
U
Jug
Gasoline
or
fuel
can
16
13
None
FUEL motorcycle organization
4
Outlaw
5
Organized crime
Entry Method
IGNITION/DELAY DEVICE
Pyrotechnic material
11
Ordinary combustibles
6
Racial/ethnic16hate group
Wick or fuse
17
Road
Explosive material 11
12
Flammable gas 7
17
Extent of Fire Involvement on Arrival
Religious hate group
12
Candle
G2
18
Chem
Other
material
14
Ignitable liquid 8
00
Sexual preference
hate group
13
Cigarette and matchbook
19
Traile
Unknown
15
Ignitable solid 0
UU
Other group
14
Electronic component
20
Open
Extent of Fire Involvement
U
Unknown
15
Mechanical device
00
Other
16
Remote control
UU
Unkno
This
section is divided
three categories:
container,
Propertyinto
Ownership
Initial
Observationsignition/delay device, and fuel. Select one
Entry
Method
Other Investigative
Information
J
GK
1
Check all that apply

item from each category.

Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

1
2
3
4
5
6
7
0

Check all that apply

1
Private
City, town, village, local 2
County or parish
G32
4
State or province
Federal
Foreign
L
Military
Other
I1
2

FUEL

Windows
5 Fire department forced entry
Entry
Method ajar
11
Ordinary combustibles
Doors ajar
6 Entry forced prior to FD arrival
12
Flammable gas
Extent
Fire Involvement
on Arrival
Doorsof
locked
system activated
7 Security
14
Doors unlocked 8 Security system present Ignitable liquid
15
Ignitable solid
(not activated)

16
17
00
UU

Section I: Other Investigative Information

1
2
3
4
5
6
7
8

Pyrotec
Explos
Other m
Unknow

Extent of Fire Involvement

Laboratory Used

Check all that apply

None

Property Ownership
Other
LocalInvestigative
3
ATFInformation
5
Private
Other J 6
State
Federal
Check all that4apply FBI
Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

1
2
3
4
5
6
7
0

NFIRS–11 Revision 01/01/04

Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

K
1
2
3
4

L
1
2

Initial Observations
Check all that apply

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

(not activ

Laboratory Used
Local
State

This section collects other useful investigative information pertinent to the case, such as code violations, whether the property was vacant or for sale, changes in insurance, etc. Mark all that apply.
Tracking of these possible indicators of arson will be helpful for later analysis and linking of cases.

11-8

Fire dep
Entry fo
Securit
Securit

3
4

ATF
FBI

Check

5

Ot
Fe

rtion
mber
or unrest
rance fraud
us
midation
stigation
open
contract/lease
stigation
closed
onal
stigation inactive

U

22
23
24
31
32 4
41 5

Unknown
15
Mechanical
Burglary device
54
42
Vanity/recognition
16
Remote
control
Homicide
concealment
Hate crime
61
43
Thrills
Their FDID
State
code
Their Federal Identifier (FID)
G1 EntryZIPMethod
Burglary concealment
Institutional
62
44
Attention/sympathy
FUEL
Auto theft concealment
Societal
63
45
Sexual excitement
Availability
of
Material
First
Ignited
NFIRS
5.0
Self-Study
Program
Entry Method
Destroy combustibles
records/evidence
Protest
64
51
Homicide
D
11
Ordinary
Closed
with arrest
1
Transported
to scene
Other
suspected
Civil
unrest
00
52
Suicide
12
Flammable
gas motivation
Extent of Fire Involvement on Arrival
Closed
exceptional
2 violence
Available at14
sceneIgnitable
Unknown
motivation
Gwith
2
Fireplay/curiosity
UU
53
Domestic
liquid
clearance
U
Unknown 15
Ignitable solid

Section J: Property Ownership

00
UU

Other delay device
Unknown
None

16
17
00
UU

Pyrotechnic material
Explosive material
Other material
Unknown

Extent of Fire Involvement

t Group Involvement
ed Motivation Factors

H

Incendiary Devices

Check
up to three factors
None
Select one from each category

ree factors

No container

CONTAINER

Property
Ownership
Initial Observations
Information J
Burglary
54
42
Vanity/recognition
I Other Investigative
K Check
orist group
Box
all that apply
17
Homicide
concealment
Bottle (glass)
Pressurized
container
11
14
rtion
22
Hate crime
61
43
Thrills
Check
all
that
apply
g
Other Container
00
concealment
Bottle (plastic)
Can (not gas or
12
15
23
Institutional
r unrest
62 fuel) Burglary
44
Attention/sympathy
1 Windows ajar 5 Fire department forced entry
-government group
1 or Private
UUtheft Unknown
concealment
Jug
Gasoline
fuel
16 excitement
ance fraud
24
Societal 13
63 can Auto
45
Sexual
2 Doors ajar
6 Entry forced prior to FD arrival
1
aw motorcycle organization
Code violations
2
City,
town,
village,
local
Destroy records/evidence
idation
31
Protest
64
51
Homicide
Doors locked 7 Security system activated
3
2
anized crime
Structure for sale
3
County
or
parish
No devicemotivation
IGNITION/DELAY DEVICE
Other suspected
contract/lease 32
Civil unrest
00
52
Suicide
4 Doors unlocked 8 Security system present
3
al/ethnic hate group
4
State
orRoad
province
11 Structure
Wick orvacant
fuse Domestic violence
Unknown
motivation
17
(not activated)
flare/fuse
onal
41
Fireplay/curiosity
UU
53
4 12 Other crimes involved
gious hate group
5
Federal
Candle
18
Chemical component
Laboratory
Used
5
Check all that apply
ual preference hate group
drug activity
6
Foreign
None
13 Illicit
Cigarette
and matchbook
19
Trailer/streamer L
6
erGroup
groupInvolvement
in insurance
7
Military
Incendiary
Devices
14 Change
Electronic
component CONTAINER
20
Open
flame
source
No container
None 7 H Financial problem
1
Local
3
ATF 5
6
Private
Other
0
Other
nown
ee factors
15 Select
one from each category
Mechanical
device
00
Other delay device
8 16 Criminal/civil actions pending
2
State
4
FBI
Federal
Remote
control
UU
Unknown
orist
group
ethod
Box
NFIRS–11 Revision 01/01/04
Bottle (glass)
Pressurized container 17
11
14
g
Other Container
This section
the ownership
ofgas
theor property
in the arson. Mark all that apply.
00 involved
None
Bottle (plastic)
Can
(not
fuel)
FUEL
12 documents
15
government group
Unknown
Jug
Gasoline or fuel can UU
13
16
d motorcycle organization
aw
Pyrotechnic material
11
Ordinary combustibles
16
nized
No device
Explosive material
12
Flammable gas IGNITION/DELAY DEVICE
17
f Fire crime
Involvement on Arrival
al/ethnic hate group
Other
14
Ignitable
liquid
11
Wick
or fuse
00
17
Road material
flare/fuse
ious hate group
Unknown
15
Ignitable solid
12
Candle
UU
18
Chemical component
preference hate group
eal
Involvement
13
Cigarette and matchbook
19
Trailer/streamer
r group
14
Electronic component
20
Open flame source
own
15
Mechanical
Property
Ownership device
00
Other delay device
Initial Observations
vestigative Information J
16
Remote control K Check all that apply UU
Unknown
ethod
that apply
Fire department
None forced entry
FUEL ajar 5
1 Windows
1
Private
6 Entry forced prior to FD arrival
olations
2
City, town, village, local 2 Doors ajar
material
11
Ordinary
Security system
activated
3 Doors locked 16 7 Pyrotechnic
re for sale
3
County
or parish combustibles
Explosive
material
12
Flammable
gas
Security
system
present
Doors
unlocked
17
Fire
Involvement
on
Arrival
4
8
re vacant
4
State or province
(not activated)
Other
material
14
Ignitable liquid
00
rimes involved
5
Federal
15
Ignitable solid
Laboratory UU
Used Unknown
Check all that apply
ug activity
6
Foreign
None
L initial observations
Involvement
This7section
identifies important
made at the incident scene relating to the propin insurance
Military
al problem
1
Local of3the ATF
5
Private
Other
0 secure
Otherstatus or circumvention
erty’s
security
systems,6 if present.
Mark all that apply.
Property
Ownership
Initial Observations
vestigative
Information
l/civil actions
pending J
2
State
4
FBI
Federal
K

Section K: Initial Observations

Check all that apply

NFIRS–11 Revision 01/01/04

hat apply

olations
e for sale
e vacant
imes involved
ug activity
in insurance
l problem
/civil actions pending

1
2
3
4
5
6
7
0

1
Private
City, town, village, local 2
3
County or parish
4
State or province
Federal
Foreign
L
Military
1
Other
2

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

Fire department forced entry
Entry forced prior to FD arrival
Security system activated
Security system present

Section L: Laboratory Used
(not activated)

Laboratory Used
Local
State

3
4

ATF
FBI

Check all that apply

5

Other
Federal

None

6

Private

NFIRS–11 Revision 01/01/04

This section identifies the laboratory(ies), if any, that conducted analysis of evidence. This information is helpful in the collection and analysis of all data associated with a specific incident. Mark all
appropriate boxes.

11-9

NFIRS 5.0 Self-Study Program

Juvenile Firesetter Module: NFIRS-11
Use this module to document information concerning juvenile-set fires, whether determined to
be intentional or not. This information will permit analysis of juvenile firesetting trends, including
intervention strategies and recidivism.
NOTE: This module is completed only for fires where the person(s) involved in the ignition of the fire was a child or juvenile
under the age of 18.

Section A: FDID, State, Incident Date, Station,
Incident Number, Exposure
MM

A
FDID

State

DD

YYYY

Delete

Incident Date

Station

Incident Number

NFIRS–11
Juvenile
Firesetter

Change

Exposure

Family Type
Race
or Date
of Birth
The information in SectionMA2 is Age
drawn
from
SectionMA4 of
the Basic Module. UseMthe
6 data in the Basic
MM
DD
YYYY
Module to help you supply the requested
If you are using an automated system the
White
A information.
1
Complete this section
African
American
Date
2 transferred
FDID will be
Station
Incident Number
StateBlack, Incident
dataif need
to be
entered
automatically
otherparent
modules
1into
Single
the person
involved
in only once, then they
Age (in years)
American Indian, Alaska
3
of the fire
that the
useignition
the data.
OR
Native
Foster parent(s)
2
was a child or Juvenile
Race
Asian
4
M2 Age or Date of Birth M4
under the age of 18
3

Native Hawaiian, Other

5

Complete this section
Pacific Islander
if the person
in multiracial
Other,
0 involved
Age (in years)
the ignition of theUndetermined
fire
U
was a child or Juvenile
under the age of 18

Section M: Subject Information
Month

Day

Year

Subject Number

4

OR
N

1 Complete
Gender in the fire’s ignition,
0
a separate
Section
M
IfMmore
than
one
subject
is 3involved
complete this section
M
M5 Ethnicity
form for each juvenile
Month
Day
Year
1
Hispanic or Latino
under age 18.
2
Female
1
Male
U
0

Subject Number

M7

Motivation/Risk Factors
1
2
3

M1

Check only one of codes 1–3
and then all others (4–9)
that apply

Non Hispanic or Latino

Two-parent
family
White
1
Black, African American
2
Extended family
American Indian, Alaska
3
Native
No family unit
Asian
4
Native
5
Other
family
type
for each subject Hawaiian, Other
Pacific Islander
Other, multiracial
0
Unknown
Undetermined
U

Subject Number
Disposition
of Person Under 18
Complete a separate Section
M
M3 Gender
8
form for each M
juvenile
1

Mild curiosity about fire
Moderate curiosity about fire
Extreme curiosity about fire

Male

2

Exposure

M5
Female

Subject Number

Ethnicity
1
0

Hispanic or Latino
Non Hispanic or Latino

Handled within department
1
Released to parent/guardian
2
Check only one of codes 1–3
Disposition of Person Und
Motivation/Risk
Factors
Use Block M1 to assign a number to each
juvenile
subject
under
the
of(4–9)
18 involved inMthe
Referred
toage
other
authority
3
and then
all
others
8 fire’s
M7
that
apply
treatment/counseling
Diagnosed
(or of
suspected)
ADD/ADHD
4 The
DD
YYYY
ignition.
purpose
this field
is MM
to allow
tracking
of4 anyReferred
subjecttoless
than 18 yearsprogram
of age,
and NFIRS–11
Delete
A of trouble outside school
Arrested,
History
5
5
Mild curiosity
about
fire charged as adult
1
Juvenile
analysis
and
tracking
of
juvenile
firesetter
trends.
Incident Date
Incidentto
Number
Exposure programChange
Referred
firesetter intervention
Firesetter
State
HistoryFDID
of stealing or shoplifting
6Station
Handled
within depa
6
Moderate
curiosity
about
fire
1
2
Other
History of physically assaulting others
Released to parent/
7
Extreme0curiosity
about fire
2
3
UnknownRace
History of fireplay or firesetting
U
8
3FamilyReferred
Type to other au
Date of Birth
M6 4
M4 ADD/ADHD
M2 4Age or Diagnosed
Transiency
Referred to treatme
9
(or suspected)
White
1
Other
Arrested, charged a
0
History of trouble outside
school
5
5
Complete this section
Black, African American
2or shoplifting
Unknown
Referred
U
History
of
stealing
6
1
Single
parentto firesette
6
if the person involved in
Age (in years)
American
Indian, Alaska
3 assaulting
Other
History of physically
others
0
7
the ignition of the fire
OR of fireplay or firesetting
Native
2 U Foster
parent(s)
Unknown
History
8
was a child or Juvenile
Asian
4
Transiency
9
N Remarks (local use)
under the age of 18
3
Two-parent family
Native Hawaiian, Other
5
Other
0
Month
Day Unknown
Year
Pacific
Islander
U
4
Extended family
Other, multiracial
0
Undetermined

U

M1

Subject Number
Complete a separate Section M
form for each juvenile

N
M3
1

Subject Number

Remarks (local use)

11-10

Gender
Male

2

M5
Female

Ethnicity
1
0

Hispanic or Latino
Non Hispanic or Latino

N

No family unit

0

Other family type

U

Unknown

FDID

State

Incident Date

M2

Station

Age or Date of Birth

NFIRS 5.0 Self-Study Program

Incident Number

Race

M4

Change

Exposure

M6

Firesetter

Family Type

White

1

Complete this section
Black, African American
2
Single parent
1
if the person involved in
Age (in years)
American Indian, Alaska
3
the ignition of the fire
2 This
Foster parent(s)
Block M2 documents
(or date of birth) of theOR
subject in years atNative
the time of the incident.
was a the
childage
or Juvenile
Asian
4
age ofother
18
information can beunder
usedthewith
demographic information to identify arson problems in certain
Native Hawaiian, Other

3

Two-parent family

N

No family unit

0

Other family type

U

Unknown

5
segments of the population and to target Month
arsonDayprevention
programs
for
certain
audiences. This data
Year
Pacific
Islander
4
Extended family
Other, multiracial
0
element is particularly useful in tracking juvenile firesetter trends.
Undetermined

U

M1

Subject Number

M3

Complete a separate Section M
form for each juvenile

1

Gender
Male

M5
2

Female

Subject Number

A
FDID

A

Ethnicity
1
0

Hispanic or Latino
Non Hispanic or Latino

Block M3 identifiesMotivation/Risk
the genderFactors
of the subject.
gender can
be used
withUnder
other18demoCheck only oneThe
of codes subject’s
1–3
Disposition
of Person
and then all others (4–9)
M8 of the population and to target
M7DD toYYYY
that apply
MM
graphic information
identify arson problems
in certain segmentsDelete
NFIRS–11
Juvenile
Mild for
curiosity
about
fire
1
arson
prevention
programs
certain
audiences.
Change
Incident Date
Station
Incident Number
Exposure
Firesetter
State

Moderate curiosity about fire
2
Extreme curiosity about fire
3
Race
Age or Date of Birth
M4
M2
Diagnosed
(or
suspected)
ADD/ADHD
4
White
1
DD
YYYY
Complete this section MM
History of trouble outside school
5
Black, African American
2
if the person involved in
History Station
of stealingIncident
or shoplifting
6
Incident Date
FDID
Number
Age (in years)
State
American Indian,Exposure
Alaska
3
the ignition of the fire
History
others
7
OR of physically assaulting
Native
was a child or Juvenile
History of fireplay or firesetting
8
Asian
4 Race
under the age of 18
Age
or Date
of Birth
Transiency
9
M5 4 Native Hawaiian, Other
M2
0 Day Other
Month
Year
White
Pacific Islander
1
Complete this section
Unknown
U
Other,African
multiracial
Black,
American
20

if the person involved in
the ignition of the fire
wasSubject
a childNumber
or Juvenile
M1 under
the
age
of 18MM4
Complete
a separate
Section
Block
form for each juvenile

Handled within department
1
Released to parent/guardian
2
Family
Type
Referred
to other authority
3
M6
Referred to treatment/counseling program
4
NFIRS–11
Delete
Arrested,
charged as adult
5
1
Single
parent
Juvenileto firesetter intervention program
Referred
6
Change
Firesetter
Other
0
Foster parent(s)
2
Unknown
U
Family Type
Two-parent family
M36
4
1

Extended family
Single parent

Undetermined
American
Indian, Alaska
No family unit
N
Native
Foster parent(s)
2
Remarks
(local
use)
N
Asian
4
Ethnicity
0
Other family
type
identifies
the subject as a certain
race based on U.S. Census
Bureau
categories.
This inforM3 Gender
M
3
Two-parent
family
Native Hawaiian, Other
5 5
1
Hispanic
or
Latino
can beMonth
used
with
other
demographic
information
to
identify
arson
problems
in
certain
segDay
Pacific Islander
2 YearFemale
1
Male
Unknown
U
Extended family
Nonmultiracial
Hispanic or Latino 4
0 0 Other,
3U

Age (in years)

OR

mation
ments of the population and to target arson prevention programs for certain audiences.

Subject Number

Undetermined
No family unit
N
Disposition
of Person Under 18
Motivation/Risk
Subject
Number Factors
M8
M17 Complete a separate Section M
M
0
Other family type
M3
M5 Ethnicity
form for each juvenile
1
Hispanic or Latino
Mild curiosity about fire
1
2
Female
1
Male
Unknown
U
0 1 NonHandled
department
Moderate curiosity about fire
Hispanicwithin
or Latino
2Subject Number
Released to parent/guardian
Extreme curiosity about fire
2
3
Referred to other authority
3
Check only one of
codes ethnicity
1–3
DispositionEthnicity
of Person Under
Motivation/Risk
Factors
Block
M5 identifies
the
of M
the
subject.
is an18ethnic classification
or affiliation.
Referred to treatment/counseling
program
and then allADD/ADHD
others (4–9)
Diagnosed (or suspected)
4
8
M7 4
that apply
“Hispanic”
is
the
only
U.S.
Census
Bureau
classification.
Hispanic
is
not
considered
a
race,
because a
Arrested,
charged
as
adult
History
of
trouble
outside
school
5
5
Mild
curiosity
about
fire
16
Referred
to
firesetter
intervention
program
History
of
stealing
or
shoplifting
6
person can be black and Hispanic, white and Hispanic, etc.
Handled
Moderate
about
fire
10
27
Other within department
History ofcuriosity
physically
assaulting
others
Released
to parent/guardian
Extreme
curiosity
about
fire
2
38
Unknown
History
of fireplay or firesetting
U
Ethnicity—Designation
of a population subgroup
that
has common cultural heritage, as distinReferred to other authority
3
Transiency
9
guished
by
customs,
characteristics,
language,
common
history,
etc.
Referred to treatment/counseling program
Diagnosed
(or suspected) ADD/ADHD
4
40
Other
Arrested, charged as adult
History
trouble outside school
5U
Unknown
Thisofinformation
can be used with other 5demographic
information to identify arson problems in
Referred to firesetter intervention program
History of stealing or shoplifting
6
6
certain
segments
of
the
population
and
to
target
arson
prevention
programs for certain audiences.
Other
History of physically assaulting others
0
7
Remarks
(local
use)
Unknown
History of fireplay or firesetting
U
N 8
Transiency
9
Other
0
Unknown
U
U

Check only one of codes 1–3
and then all others (4–9)
that applyGender

N

Remarks (local use)

11-11

MM

DD

YYYY

NFIRS–11

Delete

Juvenile
NFIRS 5.0 Self-Study
Program

ncident Date

M2

Station

Age or Date of Birth

Incident Number

Race

M4

OR
4
5
Month

Day

M6

Family Type
MM

DD

YYYY

A
White
Date
FDID
Station
Black, African American
1 StateSingle Incident
parent
American Indian, Alaska
Native
2
Foster parent(s) Age or Date of Birth
M2
Asian
3
Two-parent family
Native Hawaiian, Other
Complete this section
Pacific Islander
if the person
in
4 involved
Extended
family
Other, multiracial
Age (in years)
the ignition of the fire
OR
Undetermined
was a childNor Juvenile
No family unit

1
2
3

Age (in years)

Firesetter

Change

Exposure

Year

0
U

under the age of 18

M3
1

Gender
Male

M5
2

Female

Ethnicity
1
0

0

Hispanic or Latino
Non Hispanic or Latino

Other family type
Month

U

Day

Delete
Incident Number

M4
1
2
3
4
5

Year

Unknown

0
U

Change

Exposure

Race

M6

White
Black, African American
American Indian, Alaska
Native
Asian
Native Hawaiian, Other
Pacific Islander
Other, multiracial
Undetermined

Number
Block M6 describes
the subject’s
familyseparate
type.
InformationGender
on family type will assist
researchers
M1 Subject
Check only one of codes 1–3
Ethnicity
Complete
Section M
Disposition of Person
Undera 18
s
M
3
M
5
and then all others (4–9)
for each
juvenilebe a predictor of juvenile firesetting, delinquency, and
M8 those risk factors form
in determining
that
may
that apply
1
Hispanic or Latino
2
Female
1
Male
adult
arson.
0
Non Hispanic or Latino
bout fire

Family

1

Sin

2

Fos

3

Tw

4

Ext

N

No

0

Oth

U

Un

Subject Number

sity about fire
ity about fire

suspected) ADD/ADHD
ble outside school
ing or shoplifting
ically assaulting others
lay or firesetting

1
2
3
4
5
6
0
U

Handled within department
Released to parent/guardian
Check only one of codes 1–3
Motivation/Risk Factors
ReferredM
to7other authority
and then all others (4–9)
that apply
Referred to treatment/counseling program
Mild curiosity about fire
1 as adult
Arrested, charged
Moderate curiosity
about fire
2
Referred to firesetter
intervention
program
Extreme curiosity about fire
3
Other
Unknown
Diagnosed (or suspected) ADD/ADHD
4
History of trouble outside school
5
History of stealing or shoplifting
6
History of physically assaulting others
7
History of fireplay or firesetting
8
Transiency
9
Other
0
Unknown
U

M8

Disposition of Person Under 18

1
2
3
4
5
6
0
U

Handled within department
Released to parent/guardian
Referred to other authority
Referred to treatment/counseling
Arrested, charged as adult
Referred to firesetter intervention
Other
Unknown

Block M7 documents the stimulus
and/or risk factors that were present and constituted a possible
N Remarks (local use)
motivation for the subject(s) to burn, or attempt to burn, any real or personal property.
The risk factors listed are those that research has shown to be predictors of juvenile firesetting, delinquency and adult arson. However, data on juvenile firesetters is extremely limited, and this information will be useful in determining if these risk factors are valid or if others are more predictive. This
information also will be helpful in tracking juvenile firesetting trends and in the development of
prevention and intervention strategies.
Of the motivation and risk factors listed, only one should be selected concerning “Curiosity about
fire” (codes 1 to 3). All other motivation and risk factors that apply then should be selected.

11-12

Undetermined

U

A
MFDID
3

bject Number

plete a separate Section M
for each juvenile

1

MM

Gender
State

Male

2

Female

Complete this section
if the person involved in
the ignition of the fire
Mild curiosity about fire
was a child or Juvenile
Moderate curiosity about fire
under the age of 18
Check only one of codes 1–3
and then all others (4–9)
that apply

Extreme curiosity about fire

Diagnosed (or suspected) ADD/ADHD
History of trouble outside school
History of stealing or shoplifting
Subject Number
History of physically
others
M1assaulting
Complete a separate Section M
form for each juvenile
History of fireplay or firesetting
Transiency
Number
Other
8 is a description
Block MSubject
Unknown

arks (local use)

M

Incident Date
5

bject Number

tivation/Risk Factors

DD

N

No family unit

0

Other family type

YYYY

NFIRS–11

Delete

Ethnicity
Station

Incident Number

Change

Exposure

1
0

Hispanic or Latino
Unknown
U
NFIRS 5.0 Self-Study Program
Non Hispanic or Latino
Race
Age or Date of Birth
M4
M2
White
1
Disposition of Person Under 18
Black, African American
2
M8
Age (in years)
American Indian, Alaska
3
OR
Native
Handled within department
1
Asian
4
Released to parent/guardian
2
Native Hawaiian, Other
5
to other authorityPacific Islander
Month 3 Day Referred
Year
Referred to treatment/counseling
program
Other, multiracial
0
4
Arrested, charged U
as adultUndetermined
5
Referred to firesetter intervention program
6
Other
0
M3 Gender
M5 Ethnicity
Unknown
U
1
Hispanic or Latino
2
Female
1
Male
0
Non Hispanic or Latino

M6

Juvenile
Firesetter

Family Type

1

Single parent

2

Foster parent(s)

3

Two-parent family

4

Extended family

N

No family unit

0

Other family type

U

Unknown

of how the juvenile firesetter was handled at the end of the incident. The
purpose
of this field is to track
the disposition of any subject
under 18 years of age. This data eleCheck only one of codes 1–3
Disposition of Person Under 18
Motivation/Risk Factors
and then all others (4–9)
M
8handled and is particularly useful in tracking
M7 permits analysis of how
ment
juvenile
offenders
are
that apply
juvenile
firesetter
trends.
At
the local level, this field also is useful in determining who repeat offendMild curiosity about fire
1
Handled within department
Moderate
about
1
2 been
ers have
turnedcuriosity
over to
in fire
the past.
3

Extreme curiosity about fire

Diagnosed (or suspected) ADD/ADHD
4
History of trouble outside school
5
History of stealing or shoplifting
6
History of physically assaulting others
7
History of fireplay or firesetting
8
The supplemental
“Remarks” section on paper
Transiency
9
Other
0
this module.
Unknown
U

2
3
4
5
6
0
U

Released to parent/guardian
Referred to other authority
Referred to treatment/counseling program
Arrested, charged as adult
Referred to firesetter intervention program
Other
Unknown

Section N: Remarks

N

forms is additional area for comments concerning

Remarks (local use)

11-13

NFIRS 5.0 Self-Study Program

SUMMARY
The Arson Module may be used whenever the Cause of Ignition (NFIRS-2 E1) is coded as “Intentional,”
or as “Under investigation” without any distinction made as to whether or not a crime has occurred,
or a determination of criminal intent. The Arson Module also may be used when the fire is under
investigation or in cases where the cause is “Undetermined after investigation.”
The Arson Module also may be used to document juvenile-set fires, whether determined to be intentional or not. This information will permit analysis of juvenile firesetting trends, including intervention strategies and repeated activity.

11-14

NFIRS 5.0 Self-Study Program

EXAMPLE: Restaurant Fire
Directions:  Read the call information in the example below. Then look at the completed Arson and Juvenile Firesetter Module
form. Look at each section and follow along with the proper use of the information as applicable to the Arson and Juvenile
Firesetter Module.
Department FDID #TR100 received Box Alarm 1-12 at 2:15 a.m. on May 20, 2000, for a reported
building fire at the corner of 1st and 15th Ave., Kansas City, KS. The fire was reported by police
on a routine patrol. Incident #9300324 was assigned. Engine 1 arrived on the scene and reported
heavy fire coming from the rear of a restaurant. After forcible entry through the front door, a
semiconscious victim was found lying near the entrance. The victim was taken outside where he
identified himself as the store owner.
The fire was brought under control within 25 minutes. However, two firefighters received minor
burns on their hands and necks. A fire investigator was called to the scene. During the overhaul
process a 5-gallon gasoline container was found near the point of a rescue. Through radio communications, the scene commander was advised that the fire investigator was 1 hour away. The
captain also was advised to start a preliminary investigation. The captain found the back door
of the restaurant had been forced open, the cash register had been broken into, and the office
area had been ransacked. He also noted that a strong odor of gasoline was present and found the
remainder of a flare in the office area.
The restaurant layout was divided into three areas - a kitchen with an attached office, a serving
area, and a dining area. The investigator learned that the restaurant was being forced to close due
to several fire and health code violations. When the investigator called the alarm monitoring
company, he was told that the alarm system contract had been canceled due to lack of payment.
A car was found in the rear of the restaurant that contained several bottles of alcohol and computer equipment that seemed to have been removed from the restaurant. Later in the investigation, evidence was found showing that the owner had filed for bankruptcy but had continued
paying fire insurance payments. The owner was arrested and charged with arson.

11-15

NFIRS 5.0 Self-Study Program

A TR100

KS

FDID

State

Agency Referred To

B

MM

DD

05

YYYY

20

2000

0 0 1

Incident Date

Station

9 3 0 0 3 2 4
Incident Number

Change

Exposure

X None
Street address

Their case number

Agency name

City

Their ORI

Agency phone number

State

Case Status
Investigation open
1
Investigation closed
2
Investigation inactive
3

C

11
12
13
14
15
21

F

X

Extortion
Labor unrest
Insurance fraud
Intimidation
Void contract/lease
Personal

22
23
24
31
32
41

Check up to three factors

G1

Hate crime
Institutional
Societal
Protest
Civil unrest
Fireplay/curiosity

X

None

Entry Method

X Transported to scene

1
2
U

42
43
44
45
51
52
53

Available at scene
Unknown

54
61
62
63
64
00
UU

Vanity/recognition
Thrills
Attention/sympathy
Sexual excitement
Homicide
Suicide
Domestic violence

H

Incendiary Devices

11
12
13

Bottle (glass)
Bottle (plastic)
Jug

11
12
13
14
15
16

Wick or fuse
Candle
Cigarette and matchbook
Electronic component
Mechanical device
Remote control

X

Burglary
Homicide concealment
Burglary concealment
Auto theft concealment
Destroy records/evidence
Other suspected motivation
Unknown motivation

No container

CONTAINER

Select one from each category

14
15
16

X

Door–Forced Open

Extent of Fire Involvement on Arrival

3

Availability of Material First Ignited

No device

Flame and Smoke Showing

X Road flare/fuse

17
18
19
20
00
UU

Chemical component
Trailer/streamer
Open flame source
Other delay device
Unknown
None

FUEL

11
12
14
15

Box
Other Container
Unknown

Pressurized container 17
00
Can (not gas or fuel)
Gasoline or fuel can UU

IGNITION/DELAY DEVICE

Entry Method

G2

D

Check up to three factors

Terrorist group
Gang
Anti-government group
Outlaw motorcycle organization
Organized crime
Racial/ethnic hate group
Religious hate group
Sexual preference hate group
Other group
Unknown

1 2

Their FDID

Their Federal Identifier (FID)

Closed with exceptional
clearance

5

Apparent Group Involvement
1
2
3
4
5
6
7
8
0
U

ZIP code

4 X Closed with arrest

Suspected Motivation Factors

E

NFIRS–11
Arson

Delete

000

X Ordinary combustibles

Pyrotechnic material
Explosive material
Other material
Unknown

16
17
00
UU

Flammable gas
Ignitable liquid
Ignitable solid

Extent of Fire Involvement

Other Investigative Information

I

J

Property Ownership

K

Initial Observations
Check all that apply

Check all that apply

1
2
3
4
5
6
7
8

X

Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

1
2
3
4
5
6
7
0

X Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

1
2
3
4

L
1
2

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

X Fire department forced entry
Entry forced prior to FD arrival
Security system activated
Security system present
(not activated)

Laboratory Used
Local
State

3
4

ATF
FBI

X

Check all that apply

5

Other
Federal

6

None

Private

NFIRS–11 Revision 01/01/04

11-16

NFIRS 5.0 Self-Study Program

EXERCISE SCENARIO 11-1: Mattress Fire
Directions:  Read the call information in the exercise below. Use the information provided to complete the Arson and Juvenile
Firesetter Module form. If your answers are different from the ones provided, read over the Arson and Juvenile Firesetter
Module again.
At 1000 hours on Saturday, the 23rd of May, 1998, engine 25 from station 2 of the Anytown, MD Fire
Department (FDID TR100/Incident # 4369) was dispatched to a fire reported in a residence at 400 Liberty
Way. Upon arrival, a mattress was observed smoldering on the curb. The crew from engine 25 also observed
a woman in her mid thirties on the front lawn, apparently scolding a young boy.
The woman approached engine 25’s captain and identified herself as Susan Davis. She tells the captain that her
7-year old son, Kevin was “playing with matches” in his bedroom, and set his mattress on fire. She was able
to extinguish the fire with a bucket of water and her neighbors helped her pull the mattress out to the curb,
but the bedroom still smells of smoke.
Engine 25’s crew entered the house to investigate, check for extension, and ventilate the room, while the
captain continued to interview the mother. Ms. Davis told the captain that Kevin has been a lot of trouble ever
since his father disappeared. She confided to the captain that her husband was laid off from his job and has
not been seen or heard from for more than a year. She told the captain that Kevin was recently diagnosed as
ADHD and has been in trouble for shoplifting, but he has never intentionally started a fire. According to Ms.
Davis, her son recently exhibited some curiosity about fire, but she was quick to point out that this fire was
an “accident,” as was the fire he started in the bushes last week. Ms. Davis stated “the field fire last month was
Bobby’s fault, not Kevin’s.”
After receiving permission from Ms. Davis the captain interviewed Kevin. Kevin explained to the captain that
he was “bored” and was “playing with matches” when one burned his fingers and he dropped it on the mattress. Kevin admits having set two or three other fires, but says they were all “accidents.”
Engine 25’s crew found no fire extension, but they found some evidence of a previous fire in the closet. They
also report finding a lighter next to the bed frame and box springs. The mattress also appeared to have been
ignited by direct flame contact on the side, which would not have been caused by a dropped match.
The captain advised Ms. Davis of his findings and explained to her that a public education officer would be
calling her to discuss the department’s juvenile firesetter intervention program.
Upon returning to the station the captain called the fire prevention bureau and referred Kevin Davis to the
public education officer on duty. The address of the Fire Prevention Bureau is 123 Jump St., Anytown MD
88858-5555. The Bureau’s telephone number is 555-555-5555.
Fire Prevention Bureau Case information:
Case #: 384
ORI #: 567
FiD#: 12
FDID #: TR100

11-17

NFIRS 5.0 Self-Study Program
MM

A
FDID

State

YYYY
Station

Incident Number

Change

Exposure

None
Street address

Their case number

Agency name

City

Their ORI

Agency phone number

State

Case Status
Investigation open
1
Investigation closed
2
Investigation inactive
3

C

11
12
13
14
15
21

F

Extortion
Labor unrest
Insurance fraud
Intimidation
Void contract/lease
Personal

22
23
24
31
32
41

Hate crime
Institutional
Societal
Protest
Civil unrest
Fireplay/curiosity

None

Check up to three factors

G1

Terrorist group
Gang
Anti-government group
Outlaw motorcycle organization
Organized crime
Racial/ethnic hate group
Religious hate group
Sexual preference hate group
Other group
Unknown
Entry Method

D

Availability of Material First Ignited
1
2
U

Transported to scene
Available at scene
Unknown

42
43
44
45
51
52
53

H

Incendiary Devices

11
12
13

Bottle (glass)
Bottle (plastic)
Jug

11
12
13
14
15
16

Wick or fuse
Candle
Cigarette and matchbook
Electronic component
Mechanical device
Remote control

Burglary
Homicide concealment
Burglary concealment
Auto theft concealment
Destroy records/evidence
Other suspected motivation
Unknown motivation

54
61
62
63
64
00
UU

Vanity/recognition
Thrills
Attention/sympathy
Sexual excitement
Homicide
Suicide
Domestic violence

No container

CONTAINER

Select one from each category

Extent of Fire Involvement on Arrival

No device

IGNITION/DELAY DEVICE

11
12
14
15

Box
Other Container
Unknown

Pressurized container 17
00
Can (not gas or fuel)
Gasoline or fuel can UU

14
15
16

17
18
19
20
00
UU

Road flare/fuse
Chemical component
Trailer/streamer
Open flame source
Other delay device
Unknown
None

FUEL
Entry Method

G2

Their FDID

Their Federal Identifier (FID)

Check up to three factors

Apparent Group Involvement
1
2
3
4
5
6
7
8
0
U

ZIP code

Closed with arrest
Closed with exceptional
clearance

4
5

Suspected Motivation Factors

E

NFIRS–11
Arson

Delete

Incident Date

Agency Referred To

B

DD

Ordinary combustibles
Flammable gas
Ignitable liquid
Ignitable solid

16
17
00
UU

Pyrotechnic material
Explosive material
Other material
Unknown

Extent of Fire Involvement

I

Other Investigative Information

J

Property Ownership

K

Initial Observations
Check all that apply

Check all that apply

1
2
3
4
5
6
7
8

Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

1
2
3
4
5
6
7
0

Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

1
2
3
4

L
1
2

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

Fire department forced entry
Entry forced prior to FD arrival
Security system activated
Security system present
(not activated)

Laboratory Used
Local
State

3
4

ATF
FBI

Check all that apply

5

Other
Federal

None

6

Private

NFIRS–11 Revision 01/01/04

11-18

NFIRS 5.0 Self-Study Program
MM

A
FDID

State

DD

YYYY

Incident Date

M2
Complete this section
if the person involved in
the ignition of the fire
was a child or Juvenile
under the age of 18

Station

Age or Date of Birth

Incident Number

4
5
Day

Year

0
U

M1

Subject Number
Complete a separate Section M
form for each juvenile

M3
1

Gender
Male

M5
2

Female

Subject Number

M7

N

Motivation/Risk Factors

Check only one of codes 1–3
and then all others (4–9)
that apply

1
2
3

Mild curiosity about fire
Moderate curiosity about fire
Extreme curiosity about fire

4
5
6
7
8
9
0
U

Diagnosed (or suspected) ADD/ADHD
History of trouble outside school
History of stealing or shoplifting
History of physically assaulting others
History of fireplay or firesetting
Transiency
Other
Unknown

M8

Ethnicity
1
0

Hispanic or Latino
Non Hispanic or Latino

11-19

Juvenile
Firesetter

Family Type

1

Single parent

2

Foster parent(s)

3

Two-parent family

4

Extended family

N

No family unit

0

Other family type

U

Unknown

Disposition of Person Under 18

1
2
3
4
5
6
0
U

Remarks (local use)

M6

White
Black, African American
American Indian, Alaska
Native
Asian
Native Hawaiian, Other
Pacific Islander
Other, multiracial
Undetermined

OR

Change

Exposure

Race

M4
1
2
3

Age (in years)

Month

NFIRS–11

Delete

Handled within department
Released to parent/guardian
Referred to other authority
Referred to treatment/counseling program
Arrested, charged as adult
Referred to firesetter intervention program
Other
Unknown

NFIRS 5.0 Self-Study Program

A TR100
FDID

MM

MD

23

YYYY

1998

Station

5 5 5

5 5 5 5

F

Extortion
Labor unrest
Insurance fraud
Intimidation
Void contract/lease
Personal

22
23
24
31
32
41

TR100
Their FDID

Their Federal Identifier (FID)

D

Closed with arrest
Closed with exceptional
clearance

X

Hate crime
Institutional
Societal
Protest
Civil unrest
Fireplay/curiosity

X

None

Terrorist group
Gang
Anti-government group
Outlaw motorcycle organization
Organized crime
Racial/ethnic hate group
Religious hate group
Sexual preference hate group
Other group
Unknown
Entry Method

Availability of Material First Ignited
1
2
U

Transported to scene

X Available at scene
Unknown

42
43
44
45
51
52
53

H

Incendiary Devices

11
12
13

Bottle (glass)
Bottle (plastic)
Jug

11
12
13
14
15
16

Wick or fuse
Candle
Cigarette and matchbook
Electronic component
Mechanical device
Remote control

Burglary
Homicide concealment
Burglary concealment
Auto theft concealment
Destroy records/evidence
Other suspected motivation
Unknown motivation

54
61
62
63
64
00
UU

Vanity/recognition
Thrills
Attention/sympathy
Sexual excitement
Homicide
Suicide
Domestic violence

X

CONTAINER

Select one from each category

Extent of Fire Involvement on Arrival

X

IGNITION/DELAY DEVICE

11
12
14
15

No container

Box
Other Container
Unknown

Pressurized container 17
00
Can (not gas or fuel)
Gasoline or fuel can UU

14
15
16

17
18
19
20
00
UU

X Ordinary combustibles

None

16
17
00
UU

Flammable gas
Ignitable liquid
Ignitable solid

No device

Road flare/fuse
Chemical component
Trailer/streamer
Open flame source
Other delay device
Unknown

FUEL
Entry Method

G2

12

5 5 5 5

ZIP code

Check up to three factors

Check up to three factors

G1

567

88858

MD

4
5

Apparent Group Involvement
1
2
3
4
5
6
7
8
0
U

384
Their case number

Their ORI

State

Suspected Motivation Factors
11
12
13
14
15
21

Change

Anytown

Case Status
1 X Investigation open
Investigation closed
2
Investigation inactive
3

NFIRS–11
Arson

Delete

000
Exposure

City

Agency phone number

E

Incident Number

Street address

Agency name

C

0 0 0 4 3 6 9

123 Jump St.

None

Fire Prevention
Bureau
5 5 5

0 0 2

Incident Date

State

Agency Referred To

B

DD

05

Pyrotechnic material
Explosive material
Other material
Unknown

Extent of Fire Involvement

I

Other Investigative Information

J

Property Ownership

K

Initial Observations
Check all that apply

Check all that apply

1
2
3
4
5
6
7
8

Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

1
2
3
4
5
6
7
0

X Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

1
2
3
4

L
1
2

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

Fire department forced entry
Entry forced prior to FD arrival
Security system activated
Security system present
(not activated)

Laboratory Used
Local
State

3
4

ATF
FBI

X

Check all that apply

5

Other
Federal

6

None

Private

NFIRS–11 Revision 01/01/04

11-20

NFIRS 5.0 Self-Study Program

A TR100
FDID

MD
State

MM

DD

05

23

YYYY

1998

0 0 2

Incident Date

M2
Complete this section
if the person involved in
the ignition of the fire
was a child or Juvenile
under the age of 18

0 0 0 4 3 6 9

Station

Age or Date of Birth

Incident Number

1
2
3

07
Age (in years)

OR
4
5
Month

Day

Year

0
U

M1

Subject Number
Complete a separate Section M
form for each juvenile

0 0 1

M3
1

Gender

X Male

M5
2

Female

Subject Number

M7

Motivation/Risk Factors
1
2
3
4
5
6
7
8
9
0
U

N

Check only one of codes 1–3
and then all others (4–9)
that apply

M8

X

M6

White
Black, African American
American Indian, Alaska
Native
Asian
Native Hawaiian, Other
Pacific Islander
Other, multiracial
Undetermined

Ethnicity
1
0

Change

Exposure

Race

M4

Hispanic or Latino
Non Hispanic or Latino

NFIRS–11

Delete

000

1

Juvenile
Firesetter

Family Type

X Single parent

2

Foster parent(s)

3

Two-parent family

4

Extended family

N

No family unit

0

Other family type

U

Unknown

Disposition of Person Under 18

Mild curiosity about fire

X Moderate curiosity about fire

1
2
3
4
5
6
0
U

Extreme curiosity about fire

X Diagnosed (or suspected) ADD/ADHD
History of trouble outside school

X History of stealing or shoplifting
X

History of physically assaulting others
History of fireplay or firesetting
Transiency
Other
Unknown

X

Handled within department
Released to parent/guardian
Referred to other authority
Referred to treatment/counseling program
Arrested, charged as adult
Referred to firesetter intervention program
Other
Unknown

Remarks (local use)

Found 7-year-old male playing with matches who appeared to have set
a mattress on fire, passed on all information to the public education
officer on duty.

11-21

NFIRS 5.0 Self-Study Program

EXERCISE SCENARIO 11-2: Structure Fire
Directions:  Read the call information in the exercise below. Use the information provided to complete the entire Arson and
Juvenile Firesetter Module form and other required forms. Compare your work to the answers provided in Appendix A. If your
answers are different from the ones provided, read over the Arson and Juvenile Firesetter Module again.
The Alberta Fire Department (FDID 92188) received a call of a reported house fire at 222
Main St., Queen Creek, Arizona 85242 on June 25, 2005. The dispatcher assigned the incident
#444999 and dispatched Engine 1, Engine 3, and Truck 2 at 3:00 p.m. C shift was on duty
which was comprised of 13 personnel that went out with the suppression units. The units
arrived on location at 3:07 p.m. and reported fire showing from the second floor of a twostory, single-family dwelling (3,200 square feet.). Crews worked to extinguish the fire in a
second-floor bedroom. The second floor received heavy damage; there was no fire damage to
the first floor. D/C Barry Storms placed the fire under control at 3:45 p.m. and called for a fire
investigator to the scene. The home is owned and occupied by Mr. and Mrs. Joe Stable. They
have a 16-year-old son named Stash.
Fire Investigator Thomas Houston (Badge No. 99) discovered that the cause of the fire was not
accidental. He opened an investigation when he found a glass jar that reeked of gasoline in the
bedroom. After questioning, Mr. Storms’s son admitted to starting the fire. He said that he was
depressed and needed his parents’ attention. Stash used matches to ignite the gasoline that he
poured under his bed on clothes that he piled there. Mr. Stable said that his son, Stash has been
diagnosed with ADD/ADHD, was extremely curious about fires, and was involved in setting a
field on fire 6 months ago. Investigator Mills turned over his evidence to State law enforcement
officials and Arizona State child welfare officials. Estimated damage to the home was $30,000.
Captain Joe Mill (ID #333) was the Incident Commander and filed the report. The last unit
cleared the incident at 1700 hrs.

11-22

NFIRS 5.0 Self-Study Program
MM

A

C

Delete

Incident Date

State

Location Type

Station

Incident Number

Exposure

NFIRS–1

Street address
Intersection
In front of
Rear of
Adjacent to
Directions
US National Grid

Number/Milepost

Prefix

Basic

No Activity

Check this box to indicate that the address for this incident is provided on the Wildland Fire
Module in Section B, “Alternative Location Specification." Use only for wildland fires.

Census Tract

-

Street or Highway

Street Type

Suffix

Apt./Suite/Room

City

State

ZIP Code

Cross Street, Directions or National Grid, as applicable

Incident Type

E1

Incident Type

D

YYYY

Change
FDID

B

DD

Aid Given or Received

None

Dates and Times

Midnight is 0000

Month

Check boxes if
dates are the
same as Alarm
Date.

Day

Year

Hour

E2

Min

Shifts and Alarms
Local Option

ALARM always required

Shift or
Platoon

Alarm

Alarms

District

ARRIVAL required, unless canceled or did not arrive

1
2
3
4
5

Mutual aid received
Auto. aid received
Mutual aid given
Auto. aid given
Other aid given

Their FDID

Last Unit
Cleared

G1

Resources

Primary Action Taken (1)

G2

Apparatus

Personnel

Suppression
Additional Action Taken (2)

EMS

Civilian Fire Cas.–4
Fire Service Cas.–5
EMS–6
HazMat–7
Wildland Fire–8
Apparatus–9
Personnel–10
Arson–11

Check box if resource counts include aid
received resources.

H1

Casualties

None

Deaths Injuries
Fire
Service
Civilian

H2
1
2
U

Detector
Required for confined fires.

Detector alerted occupants
Detector did not alert them
Unknown

H3
1
2
3
4
5
6
7
8
0

Special
Study Value

Estimated Dollar Losses and Values

LOSSES:

Required for all fires if known.
Optional for non-fires.

Property

$

,

,

Contents

$

,

,

None

PRE-INCIDENT VALUE: Optional

Other
Additional Action Taken (3)

Special
Study ID#

LAST UNIT CLEARED, required except for wildland fires

Check this box and skip this block if an
Apparatus or Personnel Module is used.

Fire–2
Structure Fire–3

Local Option

Controlled

Actions Taken

Completed Modules

Special Studies

CONTROLLED optional, except for wildland fires

Their
State

Their Incident Number

F

E3

Arrival

Property

$

,

,

Contents

$

,

,

Hazardous Materials Release

None

Natural gas: slow leak, no evacuation or HazMat actions
Propane gas: <21-lb tank (as in home BBQ grill)
Gasoline: vehicle fuel tank or portable container
Kerosene: fuel burning equipment or portable storage
Diesel fuel/fuel oil: vehicle fuel tank or portable storage
Household solvents: home/office spill, cleanup only
Motor oil: from engine or portable container
Paint: from paint cans totaling <55 gallons
Other: special HazMat actions required or spill > 55 gal
(Please complete the HazMat form.)

I

Mixed Use
Property
10
20
33
40
51
53
58
59
60
63
65
00

Not mixed

Assembly use
Education use
Medical use
Residential use
Row of stores
Enclosed mall
Business & residential
Office use
Industrial use
Military use
Farm use
Other mixed use

Property Use
None
Structures
Church, place of worship
131
Restaurant or cafeteria
161
Bar/tavern or nightclub
162
Elementary school, kindergarten
213
High school, junior high
215
College, adult education
241
Nursing home
311
Hospital
331

341
342
361
419
429
439
449
459
464
519

Clinic, clinic-type infirmary
Doctor/dentist office
Prison or jail, not juvenile
1- or 2-family dwelling
Multifamily dwelling
Rooming/boarding house
Commercial hotel or motel
Residential, board and care
Dormitory/barracks
Food and beverage sales

539
571
579
599
615
629
700
819
882
891

Household goods, sales, repairs
Gas or service station
Motor vehicle/boat sales/repairs
Business office
Electric-generating plant
Laboratory/science laboratory
Manufacturing plant
Livestock/poultry storage (barn)
Non-residential parking garage
Warehouse

Outside
Playground or park
124
Crops or orchard
655
Forest (timberland)
669
Outdoor storage area
807
Dump or sanitary landfill
919
Open land or field
931

936
938
946
951
960
961
962

Vacant lot
Graded/cared for plot of land
Lake, river, stream
Railroad right-of-way
Other street
Highway/divided highway
Residential street/driveway

981
984

Construction site
Industrial plant yard

J

11-23

Look up and enter a
Property Use code and
description only if you
have NOT checked a
Property Use box.

Property Use
Code
Property Use Description
NFIRS–1 Revision 01/01/05

NFIRS 5.0 Self-Study Program
Person/Entity Involved

K1

Local Option

Check this box if same
address as incident
Location (Section B).
Then skip the three
duplicate address
lines.

Business Name (if applicable)

Mr., Ms., Mrs.

First Name

Number

Prefix

Post Office Box

State

Area Code

MI

Phone Number

Last Name

Suffix

Street or Highway

Street Type

Apt./Suite/Room

Suffix

City

ZIP Code

More people involved? Check this box and attach Supplemental Forms (NFIRS–1S) as necessary.

Owner

K2

Local Option

Check this box if same
address as incident
Location (Section B).
Then skip the three
duplicate address
lines.

Same as person involved?
Then check this box and skip
the rest of this block.

Mr., Ms., Mrs.

Business Name (if applicable)

First Name

Number

MI

Prefix

Post Office Box

State

Area Code

Phone Number

Last Name

Suffix

Street or Highway

Street Type

Apt./Suite/Room

Suffix

City

ZIP Code

Remarks:

L

Local Option

Fire Module Required?
Check the box that applies and then complete the Fire Module
based on Incident Type, as follows:
Complete Fire & Structure Modules
Complete Fire Module &
Section I, Structure Module
Basic Module Only
Confined 113–118
Complete Fire Module
Mobile property 120–123
Complete Fire Module
Vehicle 130–138
Complete Fire or Wildland Module
Vegetation 140–143
Outside rubbish fire 150–155 Basic Module Only
Complete Fire or Wildland Module
Special outside fire 160
Special outside fire 161–163 Complete Fire Module
Complete Fire or Wildland Module
Crop fire 170–173
Buildings 111
Special structure 112

ITEMS WITH A

MUST ALWAYS BE COMPLETED!

More remarks? Check this box and attach Supplemental Forms (NFIRS–1S) as necessary.

M

Authorization

Check box if
same as
Officer in
charge.

Officer in charge ID

Signature

Position or rank

Assignment

Month

Day

Year

Member making report ID

Signature

Position or rank

Assignment

Month

Day

Year

11-24

NFIRS 5.0 Self-Study Program

K

MM
FDID

K1

State

DD

Incident Date

Station

Business Name (if applicable)

Local Option

Number

State

MI

Prefix

Supplemental

Phone Number

Last Name

Suffix

Street or Highway

Apt./Suite/Room

Street Type

Suffix

City

ZIP Code

Area Code

Business Name (if applicable)

Local Option

Mr., Ms., Mrs.

First Name

Number

MI

Prefix

Post Office Box

State

Last Name

Suffix

Street or Highway

Apt./Suite/Room

Phone Number

Street Type

Suffix

City

ZIP Code

Person/Entity Involved
Business Name (if applicable)

Local Option

Check this box if
same address as
incident location.
Then skip these three
duplicate address
lines.

Mr., Ms., Mrs.

MI

Prefix

Number

State

Area Code

First Name

Post Office Box

Last Name

Suffix

Street or Highway

Apt./Suite/Room

Phone Number

Street Type

Suffix

City

ZIP Code

Person/Entity Involved
Area Code

Business Name (if applicable)

Local Option

Check this box if
same address as
incident location.
Then skip these three
duplicate address
lines.

Mr., Ms., Mrs.

First Name

Number

MI

Prefix

Post Office Box

State

K1

NFIRS–1S

Change

Person/Entity Involved

Check this box if
same address as
incident location.
Then skip these
these duplicate
address lines.

K1

Exposure

Area Code

First Name

Mr., Ms., Mrs.

Post Office Box

K1

Incident Number

Delete

Person/Entity Involved

Check this box if
same address as
incident location.
Then skip these three
duplicate address
lines.

K1

YYYY

Last Name

Suffix

Street or Highway

Apt./Suite/Room

Phone Number

Street Type

Suffix

City

ZIP Code

Person/Entity Involved
Business Name (if applicable)

Area Code

Phone Number

Local Option

Check this box if
same address as
incident location.
Then skip these three
duplicate address
lines.

Mr., Ms., Mrs.

First Name

Number

Prefix

Post Office Box

State

MI

Street or Highway

Apt./Suite/Room

Last Name

Suffix

Street Type

Suffix

City

ZIP Code

NFIRS–1S Revision 01/01/04

11-25

NFIRS 5.0 Self-Study Program

E3

Supplemental

Local Option

1

2
Special
Study ID#

Special
Study Value

Special
Study ID#

Special
Study Value

3
Special
Study ID#

Special
Study Value

Special
Study ID#

Special
Study Value

6

5

L

NFIRS–1S

Supplemental Special Studies

4
Special
Study ID#

Special
Study Value

Special
Study ID#

Special
Study Value

7

Special
Study ID#

Special
Study Value

Special
Study ID#

Special
Study Value

8

Remarks:
Local Option

NFIRS-1S Revision 01/01/04

11-26

NFIRS 5.0 Self-Study Program

A

MM
FDID

B

DD

YYYY

Incident Date

State

Station

Property Details

B1

C
Not Residential

Incident Number

On-Site Materials
or Products

Change

Exposure

None

Enter up to three codes. Check one box for each code
entered.

On-Site Materials
Storage Use

On-site material (1)

1
2
3
4
U

Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

On-site material (2)

1
2
3
4
U

Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

1
2
3
4
U

Bulk storage or warehousing
Processing or manufacturing
Packaged goods for sale
Repair or service
Undetermined

Buildings not involved
Number of buildings involved

B3

None

,

Less than one acre

Acres burned (outside fires)

On-site material (3)

D
D1
D2

Ignition

Area of fire origin

Heat source

D3
Item first ignited

1

Check box if fire spread was
confined to object of origin.

E1

Cause of Ignition

1
2
3
4
5
U

Intentional
Unintentional
Failure of equipment or heat source
Act of nature
Cause under investigation
Cause undetermined after investigation

E2

Factors Contributing to Ignition

Skip to
Section G

Check box if this is an exposure report.

E3

3
4
5
None
6

Required only if item first
ignited code is 00 or <70

Equipment Involved in Ignition
None

Age was a factor

Estimated age of
person involved
1

Factor contributing to ignition (2)

F1

F2

None

Asleep
Possibly impaired by
alcohol or drugs
Unattended person
Possibly mentally disabled
Physically disabled
Multiple persons involved

1
2

Factor contributing to ignition (1)
Type of material first ignited

Human Factors
Contributing to Ignition

Check all applicable boxes

7

D4

Fire

Complete if there were any significant amounts of
commercial, industrial, energy, or agricultural products or
or materials on the property, whether or not they became involved

Estimated number of residential living units in
building of origin whether or not all units
became involved

B2

NFIRS–2

Delete

Equipment Power Source

G

2

Male

Fire Suppression Factors

Female

None

Enter up to three codes.

If equipment was not involved, skip to
Section G
Equipment Power Source

Equipment Involved

F3

Brand
Model
Serial #

Equipment Portability
1

Portable

2

Stationary

Portable equipment normally can be moved by
one or two persons, is designed to be used in
multiple locations, and requires no tools to install.

Year

H1

Mobile Property Involved

1

Not involved in ignition, but burned

2

Involved in ignition, but did not burn

3

Involved in ignition and burned

None

H2

Fire suppression factor (1)

Fire suppression factor (2)

Fire suppression factor (3)

Mobile Property Type and Make

Local Use
Pre-Fire Plan Available
Some of the information presented in this report may be
based upon reports from other agencies:

Mobile property type

Mobile property make

Mobile property model

License Plate Number

Year

State

Arson report attached
Police report attached
Coroner report attached
Other reports attached

VIN

Structure fire? Please be sure to complete the Structure Fire form (NFIRS–3).
NFIRS–2 Revision 01/01/05

11-27

NFIRS 5.0 Self-Study Program
Structure Type

I1

If fire was in an enclosed building or a
portable/mobile structure, complete the
rest of this form.

1
2
3
4
5
6
7
8
0

Enclosed building
Portable/mobile structure
Open structure
Air-supported structure
Tent
Open platform (e.g., piers)
Underground structure (work areas)
Connective structure (e.g., fences)
Other type of structure
Fire Origin

J1

I2

Building Status

1
2
3
4
5
6
7
0
U

Under construction
Occupied & operating
Idle, not routinely used
Under major renovation
Vacant and secured
Vacant and unsecured
Being demolished
Other
Undetermined

J3

Number of stories w/significant damage
(25 to 49% flame damage)

N

None Present

1

Present

U

Undetermined

Detector Type

1
2
3
4
5
0
U

Smoke
Heat
Combination smoke and heat
Sprinkler, water flow detection
More than one type present
Other
Undetermined

M1

Number of stories w/extreme damage
(75 to 100% flame damage)

Detector Power Supply

1
2
3
4
5
6
7
0
U

0
U

L4

Detector Operation

1

Fire too small to activate

2

Operated

Complete
Block L5

3

Failed to operate

Complete
Block L6

U

Undetermined

Type of Automatic Extinguishing System
Required if fire was within designed range of AES

Wet-pipe sprinkler
Dry-pipe sprinkler
Other sprinkler system
Dry chemical system
Foam system
Halogen-type system
Carbon dioxide (CO2) system
Other special hazard system
Undetermined

Width in feet

Type of Material Contributing Most
to Flame Spread
Check if no flame spread OR if
same as Material First Ignited (Block D4,
Fire Module) OR if unable to determine.

K1

Skip to
Section L

Item contributing most to flame spread

M3

K2
Type of material contributing
most to flame spread

L5

Battery only
Hardwire only
Plug-in
Hardwire with battery
Plug-in with battery
Mechanical
Multiple detectors & power
supplies
Other
Undetermined

1
2
3
4
5
6
7

Presence of Automatic Extinguishing System
None Present
N
Present
1
Complete rest of
Section M
2
Partial System Present
U
Undetermined

M2

K

,

BY

Length in feet

Number of stories w/heavy damage
(50 to 74% flame damage)

L3
Skip to
Section M

,

,
Total square feet

,

Total number of stories
below grade

Fire Spread

(In area of the fire)

NFIRS–3
Structure
Fire

OR

Number of stories w/minor damage
(1 to 24% flame damage)

Presence of Detectors

L2

Total number of stories at or
above grade

Story of
fire origin

Confined to room of origin
Confined to floor of origin
Confined to building of origin
Beyond building of origin

L1

Main Floor Size

I4

Count the roof as part of the
highest story.

Count the roof as part of the highest story.

If fire spread was confined to object of origin,
do not check a box (Ref. Block D3, Fire Module).

2
3
4
5

Building
Height

Number of Stories Damaged by Flame

Below grade

J2

I3

1
2
3
4
U

L6

Detector Effectiveness
Required if detector operated.

Alerted occupants, occupants responded
Alerted occupants, occupants failed
to respond
There were no occupants
Failed to alert occupants
Undetermined
Detector Failure Reason
Required if detector failed to operate

1
2
3
4
5
6
0
U

Power failure, shutoff, or disconnect
Improper installation or placement
Defective
Lack of maintenance, includes
not cleaning
Battery missing or disconnected
Battery discharged or dead
Other
Undetermined

Operation of Automatic
Extinguishing System

M5

Required if fire was within designed range

Operated/effective (go to M4)
Operated/not effective (go to M4)
Fire too small to activate
Failed to operate (go to M5)
Other
Undetermined

1
2
3
4
0
U

M4

Number of Sprinkler
Heads Operating

Required if system operated

Required only if item
contributing code is 00 or <70.

Reason for Automatic
Extinguishing System Failure

Required if system failed or not effective

1
2
3
4
5
6
7
8
0
U

System shut off
Not enough agent discharged
Agent discharged but did not
reach fire
Wrong type of system
Fire not in area protected
System components damaged
Lack of maintenance
Manual intervention
Other
Undetermined

Number of sprinkler heads operating
NFIRS–3 Revision 01/01/06

11-28

NFIRS 5.0 Self-Study Program
MM

A

FDID

YYYY

Incident Date

State

Number of Patients

B

DD

Station

Patient Number

Provider Impression/Assessment

10
11
12
13
14
15
16
17

E1

Age or Date of Birth

F1

Months (for infants)

Age

Month

E2
1

H1

OR
Day

0
U

Year

Gender
Male 2

F2
Female

26
27
28
29
30
31
32
33

34
35
36
37
38
00

Hypovolemia
Inhalation injury
Obvious death
OD/poisoning
Pregnancy/OB
Respiratory arrest
Respiratory distress
Seizure
Human Factors

White
Black, African American
Am. Indian, Alaska Native
Asian
Native Hawaiian, Other
Pacific Islander
Other, multiracial
Undetermined

Ethnicity
Hispanic or Latino
Non Hispanic or Latino

Body Site of Injury

H2

List up to five body sites

Hour/Min

None/no patient or refused treatment

Chest pain
Diabetic symptom
Do not resuscitate
Electrocution
General illness
Hemorrhaging/bleeding
Hyperthermia
Hypothermia

1
2

Year

EMS

Time of Patient Transfer

Race
1
2
3
4
5

Day

NFIRS–6

Change

Time Arrived at Patient

Check one box only

18
19
20
21
22
23
24
25

Abdominal pain
Airway obstruction
Allergic reaction
Altered LOC
Behavioral/psych
Burns
Cardiac arrest
Cardiac dysrhythmia

Exposure
Month

Date/Time

Check if same date
as Alarm date

Use a separate form for each patient

D

C

Incident Number

Delete

Sexual assault
Sting/bite
Stroke/CVA
Syncope
Trauma
Other

None

G1 Contributing to Injury

G2

None

If an illness, not an
injury, skip G2 and
go to H3

Check all applicable boxes

Asleep
Unconscious
Possibly impaired by alcohol
Possibly impaired by drug
Possibly mentally disabled
Physically disabled
Physically restrained
Unattended person

1
2
3
4
5
6
7
8

Other
Factors

1
2
3

Injury Type

Accidental
Self-inflicted
Inflicted, not self

H3

List one injury type for each body site listed under H1

Cause of
Illness/Injury

Cause of illness/injury

I
01
02
03
04
05
06
07
08
09
10
11
12
13

L1
1
2
3
4
0
N

Procedures Used

Check all applicable boxes

Airway insertion
Anti-shock trousers
Assist ventilation
Bleeding control
Burn care
Cardiac pacing
Cardioversion (defib) manual
Chest/abdominal thrust
CPR
Cricothyroidotomy
Defibrillation by AED
EKG monitoring
Extrication
Initial Level of
Provider
First Responder
EMT-B (Basic)
EMT-I (Intermediate)
EMT-P (Paramedic)
Other provider
No Training

L2
1
2
3
4
0

14
15
16
17
18
19
20
21
22
23
24
00

No treatment

Intubation (EGTA)
Intubation (ET)
IO/IV therapy
Medications therapy
Oxygen therapy
OB care/delivery
Prearrival instructions
Restrain patient
Spinal immobilization
Splinted extremities
Suction/aspirate
Other

Highest Level of Care
Provided On Scene
First Responder
EMT-B (Basic)
EMT-I (Intermediate)
EMT-P (Paramedic)
Other provider

None

M

J

Safety
Equipment

Pre-arrival arrest?

1

If pre-arrival arrest, was it:

1
2
3
4
5
6
0
U

Safety/seat belts
Child safety seat
Airbag
Helmet
Protective clothing
Flotation device
Other
Undetermined

Patient Status
Improved
Remained same
Worsened

Check if:

11-29

Cardiac Arrest

K

Check all applicable boxes

Used or deployed by patient.
Check all applicable boxes.

1
2
3
1
2

None

Pulse on transfer
No pulse on transfer

2

1

Witnessed?

2

Bystander CPR?
Post-arrival arrest?

Initial Arrest Rhythm
1
0
U

N
1
2
3
4
0

V-Fib/V-Tach
Other
Undetermined

EMS
Disposition

Not transported

FD transport to ECF
Non-FD transport
Non-FD trans/FD attend
Non-emergency transfer
Other
NFIRS–6 Revision 01/01/04

NFIRS 5.0 Self-Study Program
MM

A
FDID

DD

YYYY

Delete

Incident Date

State

Station

Incident Number

HazMat ID

B

DOT Hazard
Classification

UN Number

Container
Type

C1

None

C2

Estimated Container Capacity

D1

More hazardous
materials? Use
additional sheets.

Complete the remainder
of this form only for the
first hazardous material
involved in this incident.

C3

Units: Capacity

11
12
13
14
15
16

VOLUME
Ounces
Gallons
Barrels: 42 gal.
Liters
Cubic feet
Cubic meters

Population Density

F2
1
2
3

Urban
Suburban
Rural

Check all applicable boxes
Below grade

1

Inside/on structure
Story of release

2

Outside of structure

G1

Area Affected

1
2
3

D2

WEIGHT
Ounces
Pounds
Grams
Kilograms

G2

Area Evacuated

Blocks

G4

,

1
2
3
4
5
U

Intentional
Unintentional release
Container/containment failure
Act of nature
Cause under investigation
Cause undetermined after
investigation

K

Estimated Number of
Buildings Evacuated
None

,

Enter measurement

Factors Contributing to Release

L

Enter up to three contributing factors

M

Equipment Involved
in Release

Equipment involved in release

Brand

Enter up to three actions taken

Additional action taken (2)

If fire or explosion is involved with a
release, which occurred first?

I
1
2

Ignition
Release

Factor contributing to release (3)

Factor or impediment (3)

None

Release

O
1
2
3
4
5
6
7
8

Mobile property type

Mobile property make

Model
Year

Serial #
License plate number

State

Year
DOT number/ ICC number

11-30

Undetermined

None

Enter up to three factors or impediments that affected the
mitigation of the incident

Factor or impediment (2)

Mobile Property Involved in

U

Factors Affecting Mitigation

Factor contributing to release (2)

Model

Released into

HazMat Actions Taken

H

Factor or impediment (1)

N

Released Into

Enter Code

Factor contributing to release (1)

None

E2

Additional action taken (3)

,

Square miles

WEIGHT
Ounces
Pounds
Grams
Kilograms
MICRO UNITS

21
22
23
24

Solid
Liquid
Gas
Undetermined

Primary action taken (1)

Estimated Number of
People Evacuated

Blocks

Cause of Release

None

Enter
measurement

Square miles

G3

Check one box

1
2
3
U

,

Square feet

Square feet

J

Units: Released
VOLUME
Ounces
Gallons
Barrels: 42 gal.
Liters
Cubic feet
Cubic meters

11
12
13
14
MICRO UNITS 15
Enter Code 16

1
2
3

Released From

F1

,

,

Amount released: by volume or weight

Check one box

21
22
23
24

HazMat

State
E1 Physical
When Released

Estimated Amount Released

,

Capacity: by volume or weight
Container Type

Change

Haz No.

Chemical
Name

CAS Registration Number

,

Exposure

NFIRS–7

P

HazMat Disposition
Completed by fire service only
Completed w/fire service present
Released to local agency
Released to county agency
Released to state agency
Released to federal agency
Released to private agency
Released to property owner or
manager
HazMat Civilian Casualties
Deaths

Injuries
NFIRS–7
Revision 01/01/06

NFIRS 5.0 Self-Study Program
MM

A
FDID

State

YYYY
Station

Incident Number

Change

Exposure

None
Street address

Their case number

Agency name

City

Their ORI

Agency phone number

State

Case Status
Investigation open
1
Investigation closed
2
Investigation inactive
3

C

11
12
13
14
15
21

F

Extortion
Labor unrest
Insurance fraud
Intimidation
Void contract/lease
Personal

22
23
24
31
32
41

Hate crime
Institutional
Societal
Protest
Civil unrest
Fireplay/curiosity

None

Check up to three factors

G1

Terrorist group
Gang
Anti-government group
Outlaw motorcycle organization
Organized crime
Racial/ethnic hate group
Religious hate group
Sexual preference hate group
Other group
Unknown
Entry Method

D

Availability of Material First Ignited
1
2
U

Transported to scene
Available at scene
Unknown

42
43
44
45
51
52
53

H

Incendiary Devices

11
12
13

Bottle (glass)
Bottle (plastic)
Jug

11
12
13
14
15
16

Wick or fuse
Candle
Cigarette and matchbook
Electronic component
Mechanical device
Remote control

Burglary
Homicide concealment
Burglary concealment
Auto theft concealment
Destroy records/evidence
Other suspected motivation
Unknown motivation

54
61
62
63
64
00
UU

Vanity/recognition
Thrills
Attention/sympathy
Sexual excitement
Homicide
Suicide
Domestic violence

No container

CONTAINER

Select one from each category

Extent of Fire Involvement on Arrival

No device

IGNITION/DELAY DEVICE

11
12
14
15

Box
Other Container
Unknown

Pressurized container 17
00
Can (not gas or fuel)
Gasoline or fuel can UU

14
15
16

17
18
19
20
00
UU

Road flare/fuse
Chemical component
Trailer/streamer
Open flame source
Other delay device
Unknown
None

FUEL
Entry Method

G2

Their FDID

Their Federal Identifier (FID)

Check up to three factors

Apparent Group Involvement
1
2
3
4
5
6
7
8
0
U

ZIP code

Closed with arrest
Closed with exceptional
clearance

4
5

Suspected Motivation Factors

E

NFIRS–11
Arson

Delete

Incident Date

Agency Referred To

B

DD

Ordinary combustibles
Flammable gas
Ignitable liquid
Ignitable solid

16
17
00
UU

Pyrotechnic material
Explosive material
Other material
Unknown

Extent of Fire Involvement

I

Other Investigative Information

J

Property Ownership

K

Initial Observations
Check all that apply

Check all that apply

1
2
3
4
5
6
7
8

Code violations
Structure for sale
Structure vacant
Other crimes involved
Illicit drug activity
Change in insurance
Financial problem
Criminal/civil actions pending

1
2
3
4
5
6
7
0

Private
City, town, village, local
County or parish
State or province
Federal
Foreign
Military
Other

1
2
3
4

L
1
2

Windows ajar 5
Doors ajar
6
Doors locked 7
Doors unlocked 8

Fire department forced entry
Entry forced prior to FD arrival
Security system activated
Security system present
(not activated)

Laboratory Used
Local
State

3
4

ATF
FBI

Check all that apply

5

Other
Federal

None

6

Private

NFIRS–11 Revision 01/01/04

11-31

NFIRS 5.0 Self-Study Program
MM

A
FDID

State

DD

YYYY

Incident Date

M2
Complete this section
if the person involved in
the ignition of the fire
was a child or Juvenile
under the age of 18

Station

Age or Date of Birth

Incident Number

4
5
Day

Year

0
U

M1

Subject Number
Complete a separate Section M
form for each juvenile

M3
1

Gender
Male

M5
2

Female

Subject Number

M7

N

Motivation/Risk Factors

Check only one of codes 1–3
and then all others (4–9)
that apply

1
2
3

Mild curiosity about fire
Moderate curiosity about fire
Extreme curiosity about fire

4
5
6
7
8
9
0
U

Diagnosed (or suspected) ADD/ADHD
History of trouble outside school
History of stealing or shoplifting
History of physically assaulting others
History of fireplay or firesetting
Transiency
Other
Unknown

M8

Ethnicity
1
0

Hispanic or Latino
Non Hispanic or Latino

11-32

Juvenile
Firesetter

Family Type

1

Single parent

2

Foster parent(s)

3

Two-parent family

4

Extended family

N

No family unit

0

Other family type

U

Unknown

Disposition of Person Under 18

1
2
3
4
5
6
0
U

Remarks (local use)

M6

White
Black, African American
American Indian, Alaska
Native
Asian
Native Hawaiian, Other
Pacific Islander
Other, multiracial
Undetermined

OR

Change

Exposure

Race

M4
1
2
3

Age (in years)

Month

NFIRS–11

Delete

Handled within department
Released to parent/guardian
Referred to other authority
Referred to treatment/counseling program
Arrested, charged as adult
Referred to firesetter intervention program
Other
Unknown

NFIRS 5.0 Self-Study Program

Arson and Juvenile Firesetter Module Test
1. The Arson Module may be used when (check all that apply):

(a) cause of Ignition is coded as intentional.

(b) cause of Ignition is coded as under investigation.

(c) cause of Ignition is coded as undetermined after investigation.

(d) documenting juvenile-set fires, whether intentional or not.

2. In the Arson Module, ORI and FID are examples of this data element:

(a) Agency Referred To.

(b) Laboratory Used.

(c) Section A Information.

(d) Other Investigative Information.

3. Extortion and curiosity are examples of this data element.

(a) Apparent Group Involvement.

(b) Case Status.

(c) Actions Taken.

(d) Suspected Motivation Factors.

4. Closed with exceptional clearance and investigation closed are examples of this data element.

(a) Case Status.

(b) Initial Observations.

(c) Actions Taken.

(d) Entry Method.

5. This data element is used to describe how the juvenile firesetter was handled at the end of the
incident.

(a) Initial Observations.

(b) Case Status.

(c) Disposition.

(d) Actions Taken.

11-33