Division of Hotels and Restaurants

Elevator Forms

All information on this page is current and was last reviewed by the division on February 27, 2013.

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On Completing the Forms Electronically. . .

Accident Report Forms

FILE ONLINE

DBPR's new Online Services now allows elevator owners to file accident reports directly from their online account. You can also change address information, renew your license and maintain service maintenance contract information with the online service. Just go to Renew/Maintain a License above to create your account and maintain your license(s). You do not need to complete the form below if you file electronically using our online service.

Elevator Owners Accident Report Form - Word / Fill-in PDF

DBPR HR-7016, form required to be filed in instances of elevator accident within 5 days of the incident. (October 14, 2009)

Fill in the accident report form in either Word or PDF format, save to your local drive and:

• Send by email to: dhr.elevators@dbpr.state.fl.us
• Send by mail to the address on the form.

Application Packets and Forms

For all classes of vertical conveyances, including elevators, escalators, moving walks, dumbwaiters, material lifts, chair lifts, etc. Also, for elevator credential licensing and registration.

This page contains helpful information about elevators. To apply for an elevator-related license using a paper application, please click this APPLY link.

Course Provider Registration and Course Approval - Word / Fill-in PDF

DBPR Form HR 5023-017, application for registering as a continuing education provider and obtaining approval for a continuing education course. (August 15, 2011)

Petition for Variance - Word / Fill-in PDF

DBPR Form HR 5023-018, optional application for elevator hardship variances. For more information, see our variance page. (October 14, 2010)

Disciplinary Citation and Stop Work Order - PDF

DBPR Form HR 5023-059 is a sample citation and stop work order that the division issues for unlicensed activity. (September 29, 2011)

Inspection Forms

Elevator Inspection Report Form - PDF

DBPR Form HR 5023-003, is the approved conveyance inspection report used by Florida elevator inspectors. See our website for more information regarding inspection submittal. (July 2010)

Scantron Scanner & Forms Store is the distributor of the elevator inspection report forms. DBPR Form HR 5023-003, Elevator Inspection Report, can be purchased from Scantron's Internet store under specialty form number 283209.

Scantron sells the form in packages of 100 and requires payment by credit card. Inspectors must register as an individual account before completing a purchase.

Step-by-step Instructions for Completing the Elevator Inspection Report - PDF

DBPR Form HR 5023-055, is a detailed guide for filling out the Elevator Inspection Report. (August 6, 2010)

Instructions for Completing the Elevator Inspection Report - PDF

DBPR Form HR 5023-053, is a quick reference for filling out the Elevator Inspection Report. (August 6, 2010)

Tips for Completing Scannable Inspection Reports - PDF

DBPR Form HR 5020-023, contains instructions and graphical examples for ensuring the scannable inspection reports are completed correctly. Following these guidelines will minimize the amount of forms returned to the inspector. (June 7, 2002)

Temporary Operating Permit/Temporary Certificate - PDF

DBPR Form HR 5023-005, is a print master of the required notice that must be posted on all Temporary Operation Inspection (TOI) elevators and all elevators with satisfactory initial acceptance inspections. Inspectors are encouraged to have copies printed on brightly colored paper stock. Instructions for use are included in the step-by-step instructions above.
(October 8, 2012)

Acceptance Inspection Procedure - PDF

DBPR Form HR 5023-052, is an instruction sheet for performing acceptance inspections. (December 11, 2007)