Request a Retirement Certificate from Fire Marshal

If you would like to request a signed retirement certificate for a Kansas Fire Department employee, please use the form below. 

**We will only recognize individuals whose retirement date falls within the current Fire Marshal’s tenure of 2012 to present.

***Allow two weeks to receive certificate.

  1. Jill Bronaugh

    Communication Manager

Retirement Recognition Request

  1. Creating an account or logging in to Form Center is optional and is not required to submit this form.

  2. Certificate is for:
  3. Requestor Information:
  4. Contact Jill Bronaugh, Public Information Officer, if you have any questions regarding the requested certificate

    jill.bronaugh@ks.gov   (785) 296-3403

  5. **We will only recognize individuals whose retirement date falls within the current Fire Marshal’s tenure of 2012 to present.
  6. ***Please allow two weeks to receive certificate.
  7. Leave This Blank:

  8. This field is not part of the form submission.