FY 18 EMS Annual Service Report & Local Funding
It is that time of the Year!
On the websites you will find the new and revised EMS Fund Act Local Funding Program Application and the new and revised EMS Annual Service Report (which
must be completed by All New Mexico EMS Services and Fire Departments with an EMS component. Please take the time to read these applications carefully, as there may be changes.
The Service Report is very important as it is utilized to collect required information (resources, staffing, apparatus, NMEMSCOM etc.,) which assists us with disaster/emergency preparedness planning. Also it is a requirement for all Certified Ambulances to submit for PRC. In addition to your application, if you are a PRC Certified Service you must submit a copy of your Annual Safety Inspection Sheets, if you are a Med. Rescue you must submit a copy of your Certificate. This year there is the same brief Mandatory survey that must be completed or the application will be considered incomplete. This is to determine any change.
Your Application and Annual Report must be postmarked or hand-delivered to the EMS Bureau by 5:00pm on Friday, January 20, 2017. Please adhere to the following instructions, as incomplete applications will not be processed:
- Submit an ORIGINAL AND THREE (3) COPIES, of both ASR and Application failure to make copies will result in an incomplete application and will not be accepted. (Faxed or emailed applications will not be accepted as well.)
- NO SPECIAL BINDING (one staple in the left top corner only, no paperclips unless it is necessary)
- Be sure to have necessary SIGNATURES NOTARIZED AND ALL ATTACHMENTS!
- If requesting an extension to file (this request must be made in writing (fax or email)before the January 20th deadline not on!
If you have any questions or comments regarding this application, please do not hesitate to contact me at 505.476.8233 or by email Ann.Martinez1@State.NM.US Also, general information and technical assistance is available from your EMS Regional Office:
Region I: Carlton Albert Sr. (505) 862-1365
Region II: Doug Campion (575) 524-2167
Region III: Donnie Roberts (575) 769-2639
FY18 Fund Act Application
FY18 EMS Service Report Application