ICS Forms - West Virginia Division of Homeland Security

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DEMOBILIZATION CHECK-OUT (ICS 221)1. Incident Name: 2. Incident Number:3. Planned Release Date/Time:Date:Time:4. Resource or Personnel Released: 5. Order Request Number:6. Resource or Personnel:You and your resources are in the process of being released. Resources are not released until the checked boxesbelow have been signed off by the appropriate overhead and the Demobilization Unit Leader (or Planning Sectionrepresentative).LOGISTICS SECTIONUnit/Manager Remarks Name Signature Supply UnitCommunications UnitFacilities UnitGround Support UnitSecurity ManagerFINANCE/ADMINISTRATION SECTIONUnit/Leader Remarks Name Signature Time UnitOTHER SECTION/STAFFUnit/Other Remarks Name SignaturePLANNING SECTIONUnit/Leader Remarks Name SignatureDocumentation LeaderDemobilization Leader7. Remarks:8. Travel Information: Room Overnight: Yes NoEstimated Time of Departure:Destination:Travel Method:Manifest: Yes NoNumber:9. Reassignment Information: Yes NoIncident Name:Location:Actual Release Date/Time:Estimated Time of Arrival:Contact Information While Traveling:Area/Agency/Region Notified:Incident Number:Order Request Number:10. Prepared by: Name: Position/Title: Signature:ICS 221Date/Time:
ICS 221Demobilization Check-OutPurpose. The Demobilization Check-Out (ICS 221) ensures that resources checking out of the incident have completedall appropriate incident business, and provides the Planning Section information on resources released from the incident.Demobilization is a planned process and this form assists with that planning.Preparation. The ICS 221 is initiated by the Planning Section, or a Demobilization Unit Leader if designated. TheDemobilization Unit Leader completes the top portion of the form and checks the appropriate boxes in Block 6 that mayneed attention after the Resources Unit Leader has given written notification that the resource is no longer needed. Theindividual resource will have the appropriate overhead personnel sign off on any checked box(es) in Block 6 prior torelease from the incident.Distribution. After completion, the ICS 221 is returned to the Demobilization Unit Leader or the Planning Section. Allcompleted original forms must be given to the Documentation Unit. Personnel may request to retain a copy of the ICS221.Notes:Members are not released until form is complete when all of the items checked in Block 6 have been signed off.If additional pages are needed for any form page, use a blank ICS 221 and repaginate as needed.BlockNumberBlock TitleInstructions1 Incident Name Enter the name assigned to the incident.2 Incident Number Enter the number assigned to the incident.3 Planned Release Date/Time Enter the date (month/day/year) and time (using the 24-hour clock) ofthe planned release from the incident.4 Resource or PersonnelReleasedEnter name of the individual or resource being released.5 Order Request Number Enter order request number (or agency demobilization number) of theindividual or resource being released.6 Resource or PersonnelYou and your resources are inthe process of being released.Resources are not released untilthe checked boxes below havebeen signed off by theappropriate overhead and theDemobilization Unit Leader (orPlanning Sectionrepresentative).Unit/Leader/Manager/OtherRemarksNameSignatureLogistics Section Supply Unit Communications Unit Facilities Unit Ground Support Unit Security ManagerResources are not released until the checked boxes below have beensigned off by the appropriate overhead. Blank boxes are provided forany additional unit requirements as needed (e.g., Safety Officer,Agency Representative, etc.).The Demobilization Unit Leader will enter an "X" in the box to the left ofthose Units requiring the resource to check out.Identified Unit Leaders or other overhead are to sign the appropriateline to indicate release.
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National IncidentManagement SystemI
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INCIDENT BRIEFING (ICS 201)1. Incid
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INCIDENT BRIEFING (ICS 201)1. Incid
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BlockNumberBlock Title8 Current and
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ICS 202Incident ObjectivesPurpose.
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ORGANIZATION ASSIGNMENT LIST (ICS 2
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BlockNumberBlock TitleInstructions6
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ICS 204Assignment ListPurpose. The
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1. Incident Name: 2. Date/Time Prep
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BlockNumber4(continued)Block TitleT
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ICS 205ACommunications ListPurpose.
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ICS 206Medical PlanPurpose. The Med
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3. Organization ChartINCIDENT ORGAN
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SAFETY MESSAGE/PLAN (ICS 208)1. Inc
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INCIDENT STATUS SUMMARY (ICS 209)*1
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INCIDENT STATUS SUMMARY (ICS 209)*1
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ICS 209Incident Status SummaryPurpo
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BlockNumberBlock TitleInstructions2
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BlockNumberBlock TitleAPPROVAL & RO
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BlockNumberBlock Title27 Note any e
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BlockNumberBlock TitleInstructionsA
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BlockNumber*32(continued)Block Titl
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BlockNumberBlock Title35 Weather Co
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BlockNumberBlock Title39 Critical R
Page 53 and 54: BlockNumberBlock Title47 Remarks (o
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Page 57 and 58: ICS 210Resource Status ChangePurpos
Page 59 and 60: ICS 211Incident Check-In ListPurpos
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Page 63 and 64: ICS 213General MessagePurpose. The
Page 65 and 66: ACTIVITY LOG (ICS 214)1. Incident N
Page 67 and 68: 3. Branch4. Division, Group,or Othe
Page 71 and 72: ICS 215AIncident Action Plan Safety
Page 73 and 74: ICS 218Support Vehicle/Equipment In
Page 75 and 76: ICS 219Resource Status Card (T-Card
Page 77 and 78: ICS 219-1: Header CardBlock TitlePr
Page 79 and 80: ICS 219-2: Crew/Team CardBlock Titl
Page 81 and 82: ST/Unit: LDW: # Pers: Order #:ST/Un
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Page 85 and 86: ICS 219-4: Helicopter CardBlock Tit
Page 87 and 88: ICS 219-5: Personnel CardBlock Titl
Page 95 and 96: ICS 219-8: Miscellaneous Equipment/
Page 101 and 102: 1. Incident Name: 2. Operational Pe
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Page 109 and 110: INCIDENT PERSONNEL PERFORMANCE RATI
Page 113 and 114: ICS 209, Page 1 of ___StructuresOth
Page 115 and 116: BAYVIEW TORNADO ICS-209*1. Incident
Page 117: FinanceLogisticsRequestorRESOURCE R
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ICS Forms - West Virginia Division of Homeland Security

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