"Smoke Alarm Request and Receipt Form" - Tennessee

Smoke Alarm Request and Receipt Form is a legal document that was released by the Tennessee Department of Commerce and Insurance - a government authority operating within Tennessee.

Form Details:

  • The latest edition currently provided by the Tennessee Department of Commerce and Insurance;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Tennessee Department of Commerce and Insurance.

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Smoke Alarm Request and Receipt Form
Fire Department:_____________________________________________
FDID:________________
Number of alarms requested: ____________
Date of Request:______________
Address:___________________________________________________________________________
Delivery option:
FedEx Delivery (1-2 weeks)
SFMO Delivery (4-6 weeks)
Organization Administrator:_________________________ Phone number:_____________________
Email:________________________________ Have you taken the online training class (Y/N):_______
Please email this form to Alex Daugherty at Alex.Daugherty@tn.gov
Allow 1-2 weeks for FedEx Delivery and 4-6 weeks for SFMO Delivery
(from the day the request is processed and approved).
To be completed upon delivery:
Delivered to:_______________________ Signature:___________________________________
Number of alarms received:________ Date of delivery:________
Must be installed by:_______
For administrative purposes:
Date received:___________ Transaction ID:__________
Needs training?:________ Missing alarms?:_______
Number of alarms unaccounted for:______
Date contacted:_____________ Notes:_____________________________________________
Date contacted:_____________ Notes:_____________________________________________
Date ready for delivery:__________________
Notes:________________________________________________________________________
Smoke Alarm Request and Receipt Form
Fire Department:_____________________________________________
FDID:________________
Number of alarms requested: ____________
Date of Request:______________
Address:___________________________________________________________________________
Delivery option:
FedEx Delivery (1-2 weeks)
SFMO Delivery (4-6 weeks)
Organization Administrator:_________________________ Phone number:_____________________
Email:________________________________ Have you taken the online training class (Y/N):_______
Please email this form to Alex Daugherty at Alex.Daugherty@tn.gov
Allow 1-2 weeks for FedEx Delivery and 4-6 weeks for SFMO Delivery
(from the day the request is processed and approved).
To be completed upon delivery:
Delivered to:_______________________ Signature:___________________________________
Number of alarms received:________ Date of delivery:________
Must be installed by:_______
For administrative purposes:
Date received:___________ Transaction ID:__________
Needs training?:________ Missing alarms?:_______
Number of alarms unaccounted for:______
Date contacted:_____________ Notes:_____________________________________________
Date contacted:_____________ Notes:_____________________________________________
Date ready for delivery:__________________
Notes:________________________________________________________________________