Skip to Main Content
Do Not Show Again
How Do I...
Select a Category
Board of Supervisors
Boards & Commissions
Commissioner of Revenue
The Franklin Center
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Request for Fire Incident Report
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Franklin County Department of Public Safety • 1488 Franklin Street • Rocky Mount, VA 24151 • 540-483-3091
Property Owners may request a fire incident report free of charge. Please complete this form and submit.
ALL OTHERS: The cost is $10.00. Please bring or mail your payment to the above address and make check payable to Franklin County Department of Public Safety.
Company Name (if applicable)
Phone Number where you can be reached
Date of Incident
Date of Incident
Address of Incident
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
* indicates a required field
Find our most popular services right here. All you need at your finger tips. Fast, safe and convenient.
Agendas & Minutes
Report a Concern
Government Websites by
Slideshow Left Arrow
Slideshow Right Arrow