CLAIM FORMS
These are the forms needed to file a claim with the Arkansas Claims Commission.
AR State Claims Commission Claim Form
List of Services
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.
Supporting and instructional documentation
List of Services
-
Firefighter DefinitionList Item 1
PDF size: 23KB
-
Filing a Claim
PDF size: 37KB
-
Death and Disability Benefit Claims
PDF size: 54KB
-
2010 Arkansas Code title 6 Education 6-82-504
PDF size: 69KB
-
2010 Arkansas Code title 6 Education 6-82-505
PDF size: 17KB
-
2010 Arkansas Code Title 6 Education 6-82-507
PDF size: 16KB
-
2014 Arkansas Code Title 6 Education 6-82-503
PDF size: 33KB
-
2015 Arkansas Code Title 6 Education 6-82-506
PDF size: 16KB
-
Information Regarding Death Benefits
PDF size: 35KB
-
Information Regarding Cancer Death Benefits
PDF size: 17KB
-
Information Regarding Disability Benefits
PDF size: 42KB
-
Information Regarding Scholarship Benefits
PDF size: 28KB
get involved
(870) 692-2886
Arkansas Fallen Firefighters Memorial
P.O. Box 56470
Little Rock, AR 72215