• HOME
  • LODD
    • LODD SUBMISSION FORM
    • CLAIM FORMS
    • BENEFICIARY FORMS
  • NAMES OF THE FALLEN
  • ABOUT
    • BOARD MEMBERS
    • WITH GRATEFUL THANKS
  • CONTACT
  • RESOURCES
  • FIRE PREVENTION
Annual Memorial Service on March 29th @ 1PM
Annual Memorial Service on March 29th @ 1PM
  • LODD
    • LODD SUBMISSION FORM
    • CLAIM FORMS
    • BENEFICIARY FORM
  • NAMES OF THE FALLEN
  • ABOUT
    • BOARD MEMBERS
    • WITH GRATEFUL THANKS
  • SHOP AFFM GEAR
  • CONTACT
  • RESOURCES
  • FIRE PREVENTION

CLAIM FORMS

These are the forms needed to file a claim with the Arkansas Claims Commission. 

List of Services

  • AR State Claims Commission Claim Form

    PDF size: 29KB

    Download List Item 1
Submit Online

Beneficiary FORM:

This is the Beneficiary Form that every department needs to have everyone of their members fill out and keep in a file. It only needs to be completed and filed one time, unless there is a change to the status of beneficiary.


List of Services

  • Employee Beneficiary and Emergency Contact Information Forms

    MS Word document (.docx) size: 54KB

    Download List Item 1

Supporting and instructional documentation

List of Services

  • Firefighter Definition

    PDF size: 23KB

    Download List Item 1
  • Filing a Claim

    PDF size: 37KB

    Download
  • Death and Disability Benefit Claims

    PDF size: 54KB

    Download
  • 2010 Arkansas Code title 6 Education 6-82-504

    PDF size: 69KB

    Download
  • 2010 Arkansas Code title 6 Education 6-82-505

    PDF size: 17KB

    Download
  • 2010 Arkansas Code Title 6 Education 6-82-507

    PDF size: 16KB

    Download
  • 2014 Arkansas Code Title 6 Education 6-82-503

    PDF size: 33KB

    Download
  • 2015 Arkansas Code Title 6 Education 6-82-506

    PDF size: 16KB

    Download
  • Information Regarding Death Benefits

    PDF size: 35KB

    Download
  • Information Regarding Cancer Death Benefits

    PDF size: 17KB

    Download
  • Information Regarding Disability Benefits

    PDF size: 42KB

    Download
  • Information Regarding Scholarship Benefits

    PDF size: 28KB

    Download
  • HOME
  • NAMES OF THE FALLEN
  • ABOUT
  • SHOP AFFM GEAR
  • CONTACT
  • RESOURCES
get involved

(870) 692-2886


Arkansas Fallen Firefighters Memorial

P.O. Box 56470

Little Rock, AR 72215


Designed by  hummingbird media.
remembering the fallen
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