FEMA Form FF-FY-US National Fire Department Registry - Online Version

National Fire Department Registry
Registration Form
OMB. No. 1660-0070 expires June 30, 2022

Registration completed by
Name

Phone number

Fax number

Email address

DRAFT

Fire department information
Fire department name

Fire department ID (FDID)

Headquarters address line 1

Headquarters address line 2

FEMA Form FF-USFA-FY-21-110 (formerly 070-0-0-1)

City

State

ZIP code

County

Mailing address
P.O. Box

Mailing address line 1

Mailing address line 2

City

DRAFT

State

ZIP code

Headquarters phone

Do not enter your home or mobile number.

Headquarters fax

FEMA Form FF-USFA-FY-21-110 (formerly 070-0-0-1)

Fire department’s email address

Do not enter your personal email address.

Fire department’s website address

Total number of stations within your department

Please include the headquarters location in this count.

Add station address
Organization type:
Local (includes career, combination, and volunteer)

State government

DRAFT

Transportation authority or airport fire department
Federal government (Executive branch)

Federal government (Department of Defense)
Private or industrial fire brigade
Contract fire department
Other
Other

Unknown
Is your fire department the primary agency responsible for emergency management in your
community?
Please read before answering this question: Emergency Management is the integration and coordination of all-hazards
mitigation, prevention, preparedness, response and recovery activities within a community for all (or most) agencies such as fire,
Emergency Medical Services, public works, public information, volunteer service, etc.

Yes

No

If No, what agency is the primary agency responsible for emergency management in your
community?

FEMA Form FF-USFA-FY-21-110 (formerly 070-0-0-1)

Population protected
Provide the total permanent resident population protected by your department.

Source of information
U.S. Census
Estimate
Other

Unknown
Area protected in square miles
Provide an estimate of the total primary response area in square miles protected by your department.

Staff
Active firefighters
Career.

DRAFT

Enter the total number of full-time paid fire officers and firefighters. Use numeric values only. Enter a value of 0 if there are no
firefighters of this type in your department.

Volunteer.

Enter the total number of firefighters who receive no compensation for their services. Use numeric values only. Enter a value of 0 if
there are no firefighters of this type in your department.

Paid per call.

Enter the total number of firefighters in the department who are not full-time paid firefighters but receive compensation for their
participation. Use numeric values only. Enter a value of 0 if there are no firefighters of this type in your department.

Nonfirefighting
Nonfirefighting volunteers.

FEMA Form FF-USFA-FY-21-110 (formerly 070-0-0-1)

Use numeric values only. Enter a value of 0 if there are no nonfirefighting volunteers in your department.

Civilian employees (full-time and part-time).

Use numeric values only. Enter a value of 0 if there are no civilian employees in your department.

Specialized services
Services provided
Check all that apply.
Wildfire/Wildland Urban Interface

Airport/Aviation
Fireboat
EMS transport
EMS nontransport
Basic Life Support

DRAFT

Advanced Life Support

Hazardous Materials Team (technician)
Vehicle extrication
Technical rescue
Fire inspection/Code enforcement
Fire prevention/Public education
Training academy
Fire investigation
Sworn fire investigator(s)

Juvenile firesetter intervention program

USFA programs
Is your fire department familiar with U.S. Fire Administration programs and publications?
Yes

No

If yes how?
FEMA Form FF-USFA-FY-21-110 (formerly 070-0-0-1)

If yes, how?
Check all that apply.

Website (www.usfa.fema.gov)
Publications
National Fire Academy courses
National Fire Incident Reporting System (NFIRS)
Public fire education programs
Other

Next

DRAFT

Paperwork burden disclosure notice

Initial online registration
Public reporting burden for this data collection is estimated to average 25 minutes per response. The
burden estimate includes the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and submitting this survey. This information
collection is voluntary. You are not required to respond to this collection of information unless a valid
OMB control number is displayed on this survey. Send comments regarding the accuracy of the burden
estimate and any suggestions for reducing the burden to: Information Collections Management,
Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW,
Washington, DC 20472, Paperwork Reduction Project (1660-0070) NOTE: Do not send your completed
form to this address.