Ontario County, NY · Ontario County
VFBL/VAWBL Incident Report
This incident report records a firefighter’s injury and how it occurred, along with contact information for the person completing the report.
At a glance
- Issued by
- City of Ontario County · Ontario County, Ontario County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- ontariocountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The VFBL/VAWBL Incident Report is a one-page form for documenting an injured firefighter and the circumstances of the injury. It asks for the firefighter’s name, injury date, injury description, how the injury occurred, and contact details including name, rank, and cell phone. The document does not state when the report must be filed or provide a filing deadline.
Who needs it
A person reporting an injured firefighter can use this form to record the injury and provide contact information.
How to submit it
Submit it to the Emergency Management Office; the form does not provide a mailing address, email, or portal, so check the county website for current contact details.
About notarization
No notary is required; the form lists no notary block, notarized attachment, or sworn step.
How to submit this form
- 1
Download the Report
Download the VFBL/VAWBL Incident Report PDF.
- 2
Complete the Incident Details
Enter the injured firefighter’s name, injury date, injury description, and how the injury occurred.
- 3
Add Contact Information
Provide the contact name, rank, and cell phone requested on the form.
- 4
Submit to the County Office
Submit the report to the Emergency Management Office; check the county website for current contact details.
Frequently asked questions
- What does the VFBL/VAWBL Incident Report record?
- It records the injured firefighter’s name, injury date, injury description, how the injury occurred, and contact information including name, rank, and cell phone.
- Who uses this incident report?
- A person reporting a firefighter injury can use the form to provide the incident details and contact information requested on the page.
- Do I need a notary for the VFBL/VAWBL Incident Report?
- No. The form has no notary block and lists no notarized attachment or sworn step.
- How do I submit the VFBL/VAWBL Incident Report?
- Submit it to the Emergency Management Office. The form does not list a mailing address, email, or portal; check the county website for current contact details.