Navigating the intricacies of obtaining a Grandfathered Firefighter Certificate in Ohio demands a keen understanding of the EMS 0014 form, a critical document issued by the Ohio Department of Public Safety's Division of Emergency Medical Services. This form serves as an application for individuals seeking recognition as certified firefighters without the traditional completion of specific educational prerequisites, based on their previous service before set historical benchmarks. The EMS 0014 form requires detailed personal information, including but not limited to, full name, contact details, Social Security number (which is mandatory due to state and federal stipulations), and employment details with the firefighting department. This document also necessitates disclosure of the applicant's position within the department, whether as a volunteer or a full-time paid firefighter, alongside the date of their initial appointment. Significantly, to qualify, applicants must attach proof of membership in a Volunteer Fire Department prior to July 2, 1979, or as a Paid Full-Time Firefighter before July 2, 1970. Completeness and legibility, using either black or blue ink, are imperative as incomplete applications are not processed, emphasizing the form's role in formalizing one's credentials based on past contributions rather than recent achievements. Furthermore, the applicant's signature certifies the accuracy of the information provided, underscoring the seriousness with which applicants and the Ohio Department of Public Safety treat the certification process.
| Question | Answer |
|---|---|
| Form Name | Form Ems 0014 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | EMS0014 does ohio have a grandfather clause for firefighter form |
OHIO DEPARTMENT OF PUBLIC SAFETY
EMERGENCY MEDICAL SERVICES
APPLICATION FOR GRANDFATHERED FIREFIGHTER
CERTIFICATE IN LIEU OF COMPLETION
All Information MUST be included. Incomplete applications WILL NOT be processed.
(Please print legibly and use black or blue ink.)
LAST NAME |
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FIRST NAME |
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STREET ADDRESS |
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CITY |
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COUNTY OF RESIDENCE |
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HOME PHONE NUMBER |
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WORK PHONE NUMBER |
FAX NUMBER |
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SOCIAL SECURITY NUMBER |
Disclosure of social security number is mandatory |
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DATE OF BIRTH |
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pursuant to R.C. 3123.50 in furtherance of licensing |
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provision and any other state or federal requirements |
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EMPLOYING FIRE DEPARTMENT |
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PRIMARY DEPARTMENT |
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DEPARTMENT ADDRESS |
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DEPARTMENT PHONE NUMBER |
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POSITION |
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DATE OF APPOINTMENT |
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STATUS |
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FULL TIME PAID |
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VOLUNTEER |
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Attach proof that demonstrates you were a member of a Volunteer Fire Department prior to July 2, 1979 or a Paid Full Time Firefighter prior to July 2, 1970.
I attest that the information in this application is true and correct to the best of my knowledge. I hereby give permission to the Ohio Department of Public Safety, Division of Emergency Medical Services to verify any and all information.
APPLICANT SIGNATURE
X
DATE
Return to:
OHIO DEPARTMENT OF PUBLIC SAFETY
EMERGENCY MEDICAL SERVICES
P.O. Box 182073
Columbus, OH
(800)
EMS 0014 9/08