Rows A to C: transaction and location
Type of transaction, incident number, region number, date, day of week, alarm time, building name and address, building number, fixed property and mobile property type.
GSA53
Fire Incident Report
- Agency
- GSA
- Revision
- Rev. 3/1986
- Fillable fields
- 88
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 53: GSA Fire Incident Report
GSA Form 53, GSA Fire Incident Report, is a one-page General Services Administration form dated REV. 3-86 in its footer. GSA's page lists PBS P 5900.2C as its authority, and GSA hosts it in its forms library.
The form records a fire incident in five sections, with rows lettered A to S. Section I, Incident, is marked Complete for all incidents. Section II, Fire, is marked Complete for all fires, and Section III, Structure Fire, Complete if structure fires. Section IV covers mobile property and equipment involved in ignition, and Section V, Preparer of this report, holds the investigator's signature and date.
The form asks for the number of injuries and deaths, dollar losses split between GSA, other federal and non-federal, and accident numbers from GSA Form 3090 for all injuries and deaths. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 53
Rows D to G: what happened
Type of incident, whether occupants were not evacuated, evacuated, relocated or both, whether the fire department responded, how it was called and within how many minutes, a brief history, and actions taken and recommendations to prevent recurrence.
Rows H and I: injuries, deaths and losses
Number of injuries and deaths for GSA and other personnel, accident numbers, and dollar losses for building, contents, evacuation and other, under GSA, other federal and non-federal.
Section II, rows J to L: fire
Area of fire origin, equipment involved in ignition, form of heat of ignition, type and form of material ignited, method of extinguishment and level of fire origin.
Section III, rows M to P: structure fire
Extent of flame and smoke damage, detector and sprinkler performance and, if smoke spread beyond the room of origin, the material generating most smoke and the avenue of smoke travel.
Sections IV and V: property and preparer
Year, make, model and serial number of the mobile property, with license number if any, and of the equipment involved in ignition, with voltage if any, then the investigator's signature and date.
Rows are lettered A to S down the left edge of the form.
How to complete GSA Form 53
- 1
Pick the transaction type
In row A, check one: new report, modify report or delete report.
- 2
Complete Section I
The form says to complete Section I for all incidents, from the incident and building details in rows B and C to the losses in row I.
- 3
Write the brief history
The form says to cover all important details and attach additional sheets as needed, and that photos and/or sketches may be included.
- 4
List injury and death reports
In row H, enter the number of injuries and deaths and list the accident numbers. The form names GSA Form 3090 for all injuries and/or deaths.
- 5
Add the fire details
Complete Section II for all fires and Section III if it was a structure fire, then the property details in Section IV.
- 6
Sign as investigator
The investigator signs and dates Section V, Preparer of this report.
Why fill Form GSA53 on indox
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- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Routing and what the form says
Where it goes
The PDF gives no filing address or routing. Section V names the investigator as the preparer.
Authority
GSA's page lists PBS P 5900.2C as the authority or regulation.
Linked accident reports
Row H asks for accident numbers and names GSA Form 3090 for all injuries and/or deaths.
Notices
The PDF prints no Privacy Act notice, OMB number or burden estimate.
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Who fills out GSA Form 53?
The form prints no separate instructions. Its section headings say which parts apply, and Section V names the preparer.
Official sources and the blank
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Questions about Form GSA53
Who issues GSA Form 53?
It is printed as a General Services Administration form, dated REV. 3-86 in its footer. GSA's page lists PBS P 5900.2C as its authority.
Who signs GSA Form 53?
Section V, Preparer of this report, has a line for the investigator's signature and the date. No other signature line is printed.
Which sections apply to which incidents?
The form marks Section I Complete for all incidents, Section II Complete for all fires and Section III Complete if structure fires.
Can the form change an earlier report?
Row A has boxes for new report, modify report and delete report, and says to check one.
Can photos be attached?
The brief history block says to cover all important details, attach additional sheets as needed, and that photos and/or sketches may be included.
What does the form say about injuries?
Row H asks for the number of injuries and deaths for GSA and other personnel and for accident numbers, naming GSA Form 3090 for all injuries and/or deaths.