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Get the free Notification to the Governor’s Office of a Firefighter Line of Duty Death - calema ca

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This document serves as a notification to the Governor’s Office regarding a firefighter who has died in the line of duty, including information about the decedent and their family.
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How to fill out notification to form governors

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How to fill out Notification to the Governor’s Office of a Firefighter Line of Duty Death

01
Gather all pertinent information about the firefighter who passed away.
02
Complete the required sections of the Notification form, including personal details of the deceased.
03
Include date, time, and location of the incident leading to the death.
04
Describe the circumstances surrounding the line of duty death in detail.
05
Collect signatures from the appropriate officials, such as the chief of the fire department.
06
Ensure that all supporting documents are attached, such as incident reports and medical records.
07
Review the completed form for accuracy and clarity.
08
Submit the form to the Governor’s Office by the required deadline.

Who needs Notification to the Governor’s Office of a Firefighter Line of Duty Death?

01
The fire department leadership and officials are required to submit the Notification.
02
Families of the deceased firefighter may also need to be informed about the process.
03
Local government entities involved in emergency services may need to be aware of the notification.
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People Also Ask about

In 2023, there were 89 fatalities among firefighters while on duty in the United States, down from 97 in the previous year.
Line-of-Duty Death (LODD) Line-of-Duty Death (LODD) N.C. firefighter dies after on-duty medical emergency. A Hickory Fire Department firefighter died June 5 after suffering a medical emergency while on duty. June 06, 2025 08:14 AM.
Line of duty death (LODD): the firefighter died while on duty or died after an incident that was the direct cause of the later death. Full military-style honors.
The term Active On-Duty refers to any member who passes away while on duty but was not actively involved in a critical incident or suppression activities. This includes occupational diseases, heart attacks, and any death on-duty which does not occur on the active fire ground.
Line-of-Duty Death Defined Supporting Heroes defines line-of-duty death (LODD) as when “an individual's life is cut short as a direct result of his/her service.” Synonymous with 'ultimate' or 'supreme sacrifice,' it is something more than dying on duty or in uniform from a cause unrelated to duty.

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It is a formal report submitted to the Governor’s Office to inform them of a firefighter's death that occurred while performing their duties.
Typically, the fire department Chief or a designated representative is required to file this notification.
The notification must be filled out with details regarding the incident, including the date, cause of death, and information about the deceased firefighter.
The purpose is to officially notify state authorities about the line of duty death and to facilitate any necessary support or honors for the deceased firefighter and their family.
Information such as the firefighter's name, rank, department, date of death, circumstances of the incident, and any additional relevant details must be reported.
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