Tickit on Demand - Department of Fire and Emergency Services

4.FFA WAIVER APPLICATION

Use this form to apply for a waiver of a false fire alarm fee or DFES attendance.

APPLICATION TO WAIVE A FALSE FIRE ALARM FEE

If you think you have been wrongly charged for a false fire alarm or that you have received an incorrect "Notification of Attendance" email, complete and submit this form. CONDITIONS FOR APPLICATION: 1. Must be submitted within 21 days of the date of the DFES invoice or Notification of Attendance email. 2. In line with the End User Agreement (EUA) for the Department of Fire and Emergency Services (DFES), applications will ONLY be accepted from the owner, building manager or other authorised person. The DBA premises owner/manager must submit the application on your behalf if you have been on-billedÂ a false fire alarm fee.

Is your Waiver Application being submitted within 21 days after the False Fire Alarm invoice or Notification of Attendance emailÂ date?^*

YesNo

Who is submitting the application? ^*

Must be the building owner/manager or other authorised person

OwnerBuilding or Strata ManagerOther authorised person

Premises Name^*

As per the false fire alarm invoice or Notification of Attendance email

Direct Brigade Alarm (DBA) number ^*

As per the false fire alarm invoice or Notification of Attendance email

APPLICANT DETAILS

Full name of person submitting the Waiver Application^*

Job title

Street address of premises^*

Postal address (if different from street address)

Email address^*

Email address 2

Contact phone number of applicant^*

Submitting for a Third Party ^*

Are you submitting the Waiver Application on behalf of a tenant, student, visitor or contractor, for example?

YesNo

THIRD PARTY APPLICANT DETAILS

Business name ^*

If being submitted on behalf of a contractor

Complete if 'Other" selected above

Details of Third Party applicant

Full name

Name of the Third Party for whom you are making the application

Contact telephone number

Contact number of the Third Party for whom you are making the application

Email address

Email of the Third Party for whom you are making the application

FALSE FIRE ALARM INCIDENT DETAILS

DFES invoice or incident number^*

As per the false fire alarm invoice or Notification of Attendance email

Invoice date or date the Notification of Attendance email was issued^*

Explain why you believe the false fire alarmÂ should be waived.^*

DOCUMENTATION TO SUPPORT THE APPLICATION

Supporting documentation (select all that apply)

Before selecting the submit button, please confirm that the supporting material is attached at the bottom of this form

Late applications

Waiver requests will not be accepted beyond 21 days from the invoice date or the DFES email verifying attendance. If there are extenuating circumstances that contributed to your application being late, please contact the False Fire Alarm Administrator at 9395 9823 or falsefirealarms@dfes.wa.gov.au