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National Incident Management
System Incident Command
System
September 2010
RTA
UFEMA ICS Forms
NATIONAL INCIDENT MANAGEMENT SYSTEM
INCIDENT COMMAND SYSTEM
ICS FORMS BOOKLET
FEMA 502-2
September 2010
INTRODUCTION TO ICS FORMS
The National Incident Management System (NIMS) Incident Command System (ICS) Forms Booklet, FEMA 502-2, is
designed to assist emergency response personnel in the use of ICS and corresponding documentation during incident
operations. This booklet is a companion document to the NIMS ICS Field Operations Guide (FOG), FEMA 502-1, which
provides general guidance to emergency responders on implementing ICS. This booklet is meant to complement existing
incident management programs and does not replace relevant emergency operations plans, laws, and ordinances. These
forms are designed for use within the Incident Command System, and are not targeted for use in Area Command or in
multiagency coordination systems.
These forms are intended for use as tools for the creation of Incident Action Plans (IAPs), for other incident management
activities, and for support and documentation of ICS activities. Personnel using the forms should have a basic
understanding of NIMS, including ICS, through training and/or experience to ensure they can effectively use and
understand these forms. These ICS Forms represent an all-hazards approach and update to previously used ICS Forms.
While the layout and specific blocks may have been updated, the functionality of the forms remains the same. It is
recommended that all users familiarize themselves with the updated forms and instructions.
A general description of each ICS Form's purpose, suggested preparation, and distribution are included immediately after
the form, including block-by-block completion instructions to ensure maximum clarity on specifics, or for those personnel
who may be unfamiliar with the forms.
The ICS organizational charts contained in these forms are examples of how an ICS organization is typically developed
for incident response. However, the flexibility and scalability of ICS allow modifications, as needed, based on experience
and particular incident requirements.
These forms are designed to include the essential data elements for the ICS process they address. The use of these
standardized ICS Forms is encouraged to promote consistency in the management and documentation of incidents in the
spirit of NIMS, and to facilitate effective use of mutual aid. In many cases, additional pages can be added to the existing
ICS Forms when needed, and several forms are set up with this specific provision. The section after the ICS Forms List
provides details on adding appendixes or fields to the forms for jurisdiction- or discipline-specific needs.
It may be appropriate to compile and maintain other NIMS-related forms with these ICS Forms, such as resource
management and/or ordering forms that are used to support incidents. Examples of these include the following
Emergency Management Assistance Compact(EMAC)forms: REQ-A(Interstate Mutual Aid Request), Reimbursement
Form R-1 (Interstate Reimbursement Form), and Reimbursement Form R-2 (Intrastate Reimbursement Form).
ICS FORMS LIST
This table lists all of the ICS Forms included in this publication.
Notes:
• In the following table, the ICS Forms identified with an asterisk (*) are typically included in an IAP.
• Forms identified with two asterisks (**) are additional forms that could be used in the IAP.
• The other ICS Forms are used in the ICS process for incident management activities, but are not typically included in
the IAP.
• The date and time entered in the form blocks should be determined by the Incident Command or Unified Command.
Local time is typically used.
ICS Form #: Form Title: ypically Prepared by:
ICS 201 Incident Briefing Initial Incident Commander
*ICS 202 Incident Objectives Planning Section Chief
*ICS 203 Organization Assignment List Resources Unit Leader
*ICS 204 Assignment List Resources Unit Leader and Operations Section
Chief
*ICS 205 Incident Radio Communications Plan Communications Unit Leader
**ICS 205A Communications List Communications Unit Leader
*ICS 206 Medical Plan Medical Unit Leader(reviewed by Safety Officer)
ICS 207 Incident Organization Chart Resources Unit Leader
(wall-mount size, optional 8%"x 14')
**ICS 208 Safety Message/Plan Safety Officer
ICS 209 Incident Status Summary Situation Unit Leader
ICS 210 Resource Status Change Communications Unit Leader
ICS 211 Incident Check-In List Resources Unit/Check-In Recorder
(optional 8%"x 14"and 11"x 17')
ICS 213 General Message (3-part form) Any Message Originator
ICS 214 Activity Log (optional 2-sided form) All Sections and Units
ICS 215 Operational Planning Worksheet Operations Section Chief
(optional 8%"x 14"and 11"x 17')
ICS 215A Incident Action Plan Safety Analysis Safety Officer
ICS 218 Support Vehicle/Equipment Inventory Ground Support Unit
(optional 8%"x 14"and 11"x 17')
ICS 219-1 to ICS Resource Status Card (T-Card) Resources Unit
219-8, ICS 219-10 (may be printed on cardstock)
(Cards)
ICS 220 Air Operations Summary Worksheet Operations Section Chief or Air Branch Director
ICS 221 Demobilization Check-Out Demobilization Unit Leader
ICS 225 Incident Personnel Performance Supervisor at the incident
Rating
ICS FORM ADAPTION, EXTENSION, AND APPENDIXES
The ICS Forms in this booklet are designed to serve all-hazards, cross-discipline needs for incident management across
the Nation. These forms include the essential data elements for the ICS process they address, and create a foundation
within ICS for complex incident management activities. However, the flexibility and scalability of NIMS should allow for
needs outside this foundation, so the following are possible mechanisms to add to, extend, or adapt ICS Forms when
needed.
Because the goal of NIMS is to have a consistent nationwide approach to incident management,jurisdictions and
disciplines are encouraged to use the ICS Forms as they are presented here— unless these forms do not meet an
organization's particular incident management needs for some unique reason. If changes are needed, the focus on
essential information elements should remain, and as such the spirit and intent of particular fields or"information
elements"on the ICS Forms should remain intact to maintain consistency if the forms are altered. Modifications should be
clearly indicated as deviations from or additions to the ICS Forms. The following approaches may be used to meet any
unique needs.
ICS Form Adaptation
When agencies and organizations require specialized forms or information for particular kinds of incidents, events, or
disciplines, it may be beneficial to utilize the essential data elements from a particular ICS Form to create a more localized
or field-specific form. When this occurs, organizations are encouraged to use the relevant essential data elements and
ICS Form number, but to clarify that the altered form is a specific organizational adaptation of the form. For example, an
altered form should clearly indicate in the title that it has been changed to meet a specific need, such as "ICS 215A,
Hazard Risk Analysis Worksheet, Adapted for Story County Hazmat Program."
Extending ICS Form Fields
Particular fields on an ICS Form may need to include further breakouts or additional related elements. If such additions
are needed, the form itself should be clearly labeled as an adapted form (see above), and the additional sub-field
numbers should be clearly labeled as unique to the adapted form. Letters or other indicators may be used to label the
new sub-fields (if the block does not already include sub-fields).
Examples of possible field additions are shown below for the ICS 209:
• Block 2: Incident Number.
• Block 2A (adapted): Full agency accounting cost charge number for primary authority having jurisdiction.
• Block 29: Primary Materials or Hazards Involved (hazardous chemicals, fuel types, infectious agents, radiation, etc.).
• Block 29A(adapted): Indicate specific wildland fire fuel model number.
Creating ICS Form Appendixes
Certain ICS Forms may require appendixes to include additional information elements needed by a particular jurisdiction
or discipline. When an appendix is needed for a given form, it is expected that the jurisdiction or discipline will determine
standardized fields for such an appendix and make the form available as needed.
Any ICS Form appendixes should be clearly labeled with the form name and an indicator that it is a discipline-or
jurisdiction-specific appendix. Appendix field numbering should begin following the last identified block in the
corresponding ICS Form.
INCIDENT BRIEFING (ICS 201)
1. Incident Name: 2.Incident Number: 3. Date/Time Initiated:
Date: Time:
4. Map/Sketch (include sketch, showing the total area of operations, the incident site/area, impacted and threatened
areas, overflight results, trajectories, impacted shorelines, or other graphics depicting situational status and resource
assignment):
5. Situation Summary and Health and Safety Briefing (for briefings or transfer of command): Recognize potential
incident Health and Safety Hazards and develop necessary measures (remove hazard, provide personal protective
equipment, warn people of the hazard)to protect responders from those hazards.
6. Prepared by: Name: Position/Title: Signature:
ICS 201, Page 1 Date/Time:
INCIDENT BRIEFING (ICS 201)
1. Incident Name: 2. Incident Number: 3. Date/Time Initiated:
Date: Time:
7. Current and Planned Objectives:
8. Current and Planned Actions, Strategies, and Tactics:
Time: Actions:
6. Prepared by: Name: Position/Title: Signature:
ICS 201, Page 2 Date/Time:
INCIDENT BRIEFING (ICS 201)
1. Incident Name: 2. Incident Number: 3. Date/Time Initiated:
Date: Time:
9. Current Organization (fill in additional organization as appropriate):
-I
Liaison Officer
Incident Commander(s)
-I Safety Officer
Public Information Officer
Operations Section Chief Planning Section Chief Logistics Section Chief Finance/Admin Section Chief
6. Prepared by: Name: Position/Title: Signature:
ICS 201, Page 3 Date/Time:
INCIDENT BRIEFING (ICS 201)
1. Incident Name: 2. Incident Number: 3. Date/Time Initiated:
Date: Time:
10. Resource Summary:
a)
Resource Date/Time
Resource Identifier Ordered ETA Q Notes (location/assignment/status)
6. Prepared by: Name: Position/Title: Signature:
ICS 201, Page 4 I Date/Time:
ICS 201
Incident Briefing
Purpose. The Incident Briefing (ICS 201) provides the Incident Commander(and the Command and General Staffs)with
basic information regarding the incident situation and the resources allocated to the incident. In addition to a briefing
document, the ICS 201 also serves as an initial action worksheet. It serves as a permanent record of the initial response
to the incident.
Preparation. The briefing form is prepared by the Incident Commander for presentation to the incoming Incident
Commander along with a more detailed oral briefing.
Distribution. Ideally, the ICS 201 is duplicated and distributed before the initial briefing of the Command and General
Staffs or other responders as appropriate. The "Map/Sketch" and "Current and Planned Actions, Strategies, and Tactics"
sections (pages 1-2) of the briefing form are given to the Situation Unit, while the "Current Organization" and "Resource
Summary"sections (pages 3-4) are given to the Resources Unit.
Notes:
• The ICS 201 can serve as part of the initial Incident Action Plan (IAP).
• If additional pages are needed for any form page, use a blank ICS 201 and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Incident Number Enter the number assigned to the incident.
3 Date/Time Initiated Enter date initiated (month/day/year) and time initiated (using the 24-
• Date, Time hour clock).
4 Map/Sketch (include sketch, Show perimeter and other graphics depicting situational status,
showing the total area of resource assignments, incident facilities, and other special information
operations, the incident on a map/sketch or with attached maps. Utilize commonly accepted
site/area, impacted and ICS map symbology.
threatened areas, overflight
results, trajectories, impacted If specific geospatial reference points are needed about the incident's
shorelines, or other graphics location or area outside the ICS organization at the incident, that
depicting situational status and information should be submitted on the Incident Status Summary(ICS
resource assignment) 209).
North should be at the top of page unless noted otherwise.
5 Situation Summary and Self-explanatory.
Health and Safety Briefing (for
briefings or transfer of
command): Recognize potential
incident Health and Safety
Hazards and develop necessary
measures (remove hazard,
provide personal protective
equipment, warn people of the
hazard)to protect responders
from those hazards.
6 Prepared by Enter the name, ICS position/title, and signature of the person
• Name preparing the form. Enter date (month/day/year) and time prepared
• Position/Title (24-hour clock).
• Signature
• Date/Time
7 Current and Planned Enter the objectives used on the incident and note any specific problem
Objectives areas.
Block Block Title Instructions
Number
8 Current and Planned Actions, Enter the current and planned actions, strategies, and tactics and time
Strategies, and Tactics they may or did occur to attain the objectives. If additional pages are
• Time needed, use a blank sheet or another ICS 201 (Page 2), and adjust
• Actions page numbers accordingly.
9 Current Organization (fill in • Enter on the organization chart the names of the individuals
additional organization as assigned to each position.
appropriate) • Modify the chart as necessary, and add any lines/spaces needed for
• Incident Commander(s) Command Staff Assistants, Agency Representatives, and the
• Liaison Officer organization of each of the General Staff Sections.
• Safety Officer • If Unified Command is being used, split the Incident Commander
• Public Information Officer box.
• Planning Section Chief • Indicate agency for each of the Incident Commanders listed if
• Operations Section Chief Unified Command is being used.
• Finance/Administration
Section Chief
• Logistics Section Chief
10 Resource Summary Enter the following information about the resources allocated to the
incident. If additional pages are needed, use a blank sheet or another
ICS 201 (Page 4), and adjust page numbers accordingly.
• Resource Enter the number and appropriate category, kind, or type of resource
ordered.
• Resource Identifier Enter the relevant agency designator and/or resource designator(if
any).
• Date/Time Ordered Enter the date (month/day/year) and time (24-hour clock)the resource
was ordered.
• ETA Enter the estimated time of arrival (ETA)to the incident(use 24-hour
clock).
• Arrived Enter an "X"or a checkmark upon arrival to the incident.
• Notes (location/ Enter notes such as the assigned location of the resource and/or the
assignment/status) actual assignment and status.
INCIDENT OBJECTIVES (ICS 202)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Objective(s):
4. Operational Period Command Emphasis:
General Situational Awareness
5. Site Safety Plan Required? Yes❑ No❑
Approved Site Safety Plan(s) Located at:
6. Incident Action Plan (the items checked below are included in this Incident Action Plan):
❑ ICS 203 n ICS 207 Other Attachments:
n ICS 204 n ICS 208 ❑
n ICS 205 ❑ Map/Chart 0
n ICS 205A n Weather Forecast/Tides/Currents 0
n ICS 206 ❑
7. Prepared by: Name: Position/Title: Signature:
8. Approved by Incident Commander: Name: Signature:
ICS 202 IAP Page Date/Time:
ICS 202
Incident Objectives
Purpose. The Incident Objectives (ICS 202) describes the basic incident strategy, incident objectives, command
emphasis/priorities, and safety considerations for use during the next operational period.
Preparation. The ICS 202 is completed by the Planning Section following each Command and General Staff meeting
conducted to prepare the Incident Action Plan (IAP). In case of a Unified Command, one Incident Commander(IC) may
approve the ICS 202. If additional IC signatures are used, attach a blank page.
Distribution. The ICS 202 may be reproduced with the IAP and may be part of the IAP and given to all supervisory
personnel at the Section, Branch, Division/Group, and Unit levels. All completed original forms must be given to the
Documentation Unit.
Notes:
• The ICS 202 is part of the IAP and can be used as the opening or cover page.
• If additional pages are needed, use a blank ICS 202 and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident. If needed, an incident
number can be added.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour
• Date and Time From clock) and end date and time for the operational period to which the
• Date and Time To form applies.
3 Objective(s) Enter clear, concise statements of the objectives for managing the
response. Ideally, these objectives will be listed in priority order.
These objectives are for the incident response for this operational
period as well as for the duration of the incident. Include alternative
and/or specific tactical objectives as applicable.
Objectives should follow the SMART model or a similar approach:
Specific— Is the wording precise and unambiguous?
Measurable— How will achievements be measured?
Action-oriented — Is an action verb used to describe expected
accomplishments?
Realistic— Is the outcome achievable with given available resources?
Time-sensitive—What is the timeframe?
4 Operational Period Command Enter command emphasis for the operational period, which may
Emphasis include tactical priorities or a general weather forecast for the
operational period. It may be a sequence of events or order of events
to address. This is not a narrative on the objectives, but a discussion
about where to place emphasis if there are needs to prioritize based
on the Incident Commander's or Unified Command's direction.
Examples: Be aware of falling debris, secondary explosions, etc.
General Situational Awareness General situational awareness may include a weather forecast,
incident conditions, and/or a general safety message. If a safety
message is included here, it should be reviewed by the Safety Officer
to ensure it is in alignment with the Safety Message/Plan (ICS 208).
5 Site Safety Plan Required? Safety Officer should check whether or not a site safety plan is
Yes❑ No❑ required for this incident.
Approved Site Safety Plan(s) Enter the location of the approved Site Safety Plan(s).
Located At
Block Block Title nstructions
Number
6 Incident Action Plan (the items Check appropriate forms and list other relevant documents that are
checked below are included in included in the IAP.
this Incident Action Plan):
❑ ICS 203 ❑ lCS 203—Organization Assignment List
❑ ❑ ICS 204—Assignment List
ICS 204 ❑
❑ ICS 205— Incident Radio Communications Plan
ICS 205 ❑
❑ ICS 205A ICS 205A— Communications List
❑ ICS 206 ❑ ICS 206— Medical Plan
❑ ❑ ICS 207— Incident Organization Chart
ICS 207
❑ ❑ ICS 208—Safety Message/Plan
ICS 208
❑ Map/Chart
❑ Weather Forecast/
Tides/Currents
Other Attachments:
7 Prepared by Enter the name, ICS position, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour
• Position/Title clock).
• Signature
8 Approved by Incident In the case of a Unified Command, one IC may approve the ICS 202.
Commander If additional IC signatures are used, attach a blank page.
• Name
• Signature
• Date/Time
ORGANIZATION ASSIGNMENT LIST (ICS 203)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Incident Commander(s) and Command Staff: 7. Operations Section:
IC/UCs Chief
Deputy
Deputy Staging Area
Safety Officer Branch
Public Info. Officer Branch Director
Liaison Officer Deputy
4. Agency/Organization Representatives: Division/Group
Agency/Organization Name Division/Group
Division/Group
Division/Group
Division/Group
Branch
Branch Director
Deputy
5. Planning Section: Division/Group
Chief Division/Group
Deputy Division/Group
Resources Unit Division/Group
Situation Unit Division/Group
Documentation Unit Branch
Demobilization Unit Branch Director
Technical Specialists Deputy
Division/Group
Division/Group
Division/Group
6. Logistics Section: Division/Group
Chief Division/Group
Deputy Air Operations Branch
Support Branch Air Ops Branch Dir.
Director
Supply Unit
Facilities Unit 8. Finance/Administration Section:
Ground Support Unit Chief
Service Branch Deputy
Director Time Unit
Communications Unit Procurement Unit
Medical Unit Comp/Claims Unit
Food Unit Cost Unit
9. Prepared by: Name: Position/Title: Signature:
ICS 203 IAP Page Date/Time:
ICS 203
Organization Assignment List
Purpose. The Organization Assignment List(ICS 203) provides ICS personnel with information on the units that are
currently activated and the names of personnel staffing each position/unit. It is used to complete the Incident
Organization Chart(ICS 207)which is posted on the Incident Command Post display. An actual organization will be
incident or event-specific. Not all positions need to be filled. Some blocks may contain more than one name. The size
of the organization is dependent on the magnitude of the incident, and can be expanded or contracted as necessary.
Preparation. The Resources Unit prepares and maintains this list under the direction of the Planning Section Chief.
Complete only the blocks for the positions that are being used for the incident. If a trainee is assigned to a position,
indicate this with a "T" in parentheses behind the name (e.g., "A. Smith (T)").
Distribution. The ICS 203 is duplicated and attached to the Incident Objectives (ICS 202) and given to all recipients as
part of the Incident Action Plan (IAP). All completed original forms must be given to the Documentation Unit.
Notes:
• The ICS 203 serves as part of the IAP.
• If needed, more than one name can be put in each block by inserting a slash.
• If additional pages are needed, use a blank ICS 203 and repaginate as needed.
• ICS allows for organizational flexibility, so the Intelligence/Investigations Function can be embedded in several
different places within the organizational structure.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year)and time (using the 24-hour clock)
• Date and Time From and end date and time for the operational period to which the form
• Date and Time To applies.
3 Incident Commander(s) Enter the names of the Incident Commander(s) and Command Staff.
and Command Staff Label Assistants to Command Staff as such (for example, "Assistant
• IC/UCs Safety Officer").
• Deputy For all individuals, use at least the first initial and last name.
• Safety Officer For Unified Command, also include agency names.
• Public Information Officer
• Liaison Officer
4 Agency/Organization Enter the agency/organization names and the names of their
Representatives representatives. For all individuals, use at least the first initial and last
• Agency/Organization name.
• Name
5 Planning Section Enter the name of the Planning Section Chief, Deputy, and Unit Leaders
• Chief after each position title. List Technical Specialists with an indication of
• Deputy specialty.
• Resources Unit If there is a shift change during the specified operational period, list both
• Situation Unit names, separated by a slash.
• Documentation Unit For all individuals, use at least the first initial and last name.
• Demobilization Unit
• Technical Specialists
Block Block Title Instructions
Number
6 Logistics Section Enter the name of the Logistics Section Chief, Deputy, Branch Directors,
• Chief and Unit Leaders after each position title.
• Deputy If there is a shift change during the specified operational period, list both
Support Branch names, separated by a slash.
• Director For all individuals, use at least the first initial and last name.
• Supply Unit
• Facilities Unit
• Ground Support Unit
Service Branch
• Director
• Communications Unit
• Medical Unit
• Food Unit
7 Operations Section Enter the name of the Operations Section Chief, Deputy, Branch
• Chief Director(s), Deputies, and personnel staffing each of the listed positions.
• Deputy For Divisions/Groups, enter the Division/Group identifier in the left column
• Staging Area and the individual's name in the right column.
Branch Branches and Divisions/Groups may be named for functionality or by
Branch Director geography. For Divisions/Groups, indicate Division/Group Supervisor.
• Use an additional page if more than three Branches are activated.
• Deputy
Division/Group If there is a shift change during the specified operational period, list both
• names, separated by a slash.
Air Operations Branch
Air Operations Branch For all individuals, use at least the first initial and last name.
• Director
8 Finance/Administration Enter the name of the Finance/Administration Section Chief, Deputy, and
Section Unit Leaders after each position title.
• Chief If there is a shift change during the specified operational period, list both
• Deputy names, separated by a slash.
• Time Unit For all individuals, use at least the first initial and last name.
• Procurement Unit
• Compensation/Claims
Unit
• Cost Unit
9 Prepared by Enter the name, ICS position, and signature of the person preparing the
• Name form. Enter date (month/day/year) and time prepared (24-hour clock).
• Position/Title
• Signature
• Date/Time
ASSIGNMENT LIST (ICS 204)
1. Incident Name: 2. Operational Period: 3.
Date From: Date To: Branch:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s) Division:
Operations Section Chief: Group:
Branch Director: Staging Area:
Division/Group Supervisor:
5. Resources Assigned: v, Reporting Location,
Special Equipment and
m Contact (e.g., phone, pager, radio Supplies, Remarks, Notes,
Resource Identifier Leader It o_ frequency, etc.) Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function _ Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page Date/Time:
ICS 204
Assignment List
Purpose. The Assignment List(s) (ICS 204) informs Division and Group supervisors of incident assignments. Once the
Command and General Staffs agree to the assignments, the assignment information is given to the appropriate Divisions
and Groups.
Preparation. The ICS 204 is normally prepared by the Resources Unit, using guidance from the Incident Objectives (ICS
202), Operational Planning Worksheet (ICS 215), and the Operations Section Chief. It must be approved by the Incident
Commander, but may be reviewed and initialed by the Planning Section Chief and Operations Section Chief as well.
Distribution. The ICS 204 is duplicated and attached to the ICS 202 and given to all recipients as part of the Incident
Action Plan (IAP). In some cases, assignments may be communicated via radio/telephone/fax. All completed original
forms must be given to the Documentation Unit.
Notes:
• The ICS 204 details assignments at Division and Group levels and is part of the IAP.
• Multiple pages/copies can be used if needed.
• If additional pages are needed, use a blank ICS 204 and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour
• Date and Time From clock) and end date and time for the operational period to which the
• Date and Time To form applies.
3 Branch This block is for use in a large IAP for reference only.
Division
Write the alphanumeric abbreviation for the Branch, Division, Group,
Group and StagingArea (e.g., "Branch 1," "Division D," "Group1A" large
) in9
Staging Area letters for easy referencing.
4 Operations Personnel Enter the name and contact numbers of the Operations Section Chief,
• Name, Contact Number(s) applicable Branch Director(s), and Division/Group Supervisor(s).
— Operations Section Chief
— Branch Director
— Division/Group Supervisor
5 Resources Assigned Enter the following information about the resources assigned to the
Division or Group for this period:
• Resource Identifier The identifier is a unique way to identify a resource (e.g., ENG-13,
IA-SCC-413). If the resource has been ordered but no identification
has been received, use TBD (to be determined).
• Leader Enter resource leader's name.
• #of Persons Enter total number of persons for the resource assigned, including the
leader.
• Contact(e.g., phone, pager, Enter primary means of contacting the leader or contact person (e.g.,
radio frequency, etc.) radio, phone, pager, etc.). Be sure to include the area code when
listing a phone number.
5 • Reporting Location, Special Provide special notes or directions specific to this resource. If
(continued) Equipment and Supplies, required, add notes to indicate: (1) specific location/time where the
Remarks, Notes, Information resource should report or be dropped off/picked up; (2)special
equipment and supplies that will be used or needed; (3)whether or not
the resource received briefings; (4)transportation needs; or(5) other
information.
Block Block Title Instruction
Number
6 Work Assignments Provide a statement of the tactical objectives to be achieved within the
operational period by personnel assigned to this Division or Group.
7 Special Instructions Enter a statement noting any safety problems, specific precautions to
be exercised, dropoff or pickup points, or other important information.
8 Communications (radio and/or Enter specific communications information (including emergency
phone contact numbers needed numbers)for this Branch/Division/Group.
for this assignment)
• Name/Function If radios are being used, enter function (command, tactical, support,
• Primary Contact: indicate etc.), frequency, system, and channel from the Incident Radio
Communications Plan (ICS 205).
cell, pager, or radio
(frequency/system/channel) Phone and pager numbers should include the area code and any
satellite phone specifics.
In light of potential IAP distribution, use sensitivity when including cell
phone number.
Add a secondary contact(phone number or radio) if needed.
9 Prepared by Enter the name, ICS position, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour
• Position/Title clock).
• Signature
• Date/Time
INCIDENT RADIO COMMUNICATIONS PLAN (ICS 205)
1. Incident Name: 2. Date/Time Prepared: 3. Operational Period:
Date: Date From: Date To:
Time: Time From: Time To:
4. Basic Radio Channel Use:
Channel
Zone Ch Name/Trunked Radio RX Freq RX TX Freq TX Mode Remarks
Grp. # Function System Talkgroup Assignment N or W Tone/NAC N or W Tone/NAC (A, D, or M)
5. Special Instructions:
6. Prepared by (Communications Unit Leader): Name: Signature:
ICS 205 I IAP Page Date/Time:
ICS 205
Incident Radio Communications Plan
Purpose. The Incident Radio Communications Plan (ICS 205) provides information on all radio frequency or trunked
radio system talkgroup assignments for each operational period. The plan is a summary of information obtained about
available radio frequencies or talkgroups and the assignments of those resources by the Communications Unit Leader for
use by incident responders. Information from the Incident Radio Communications Plan on frequency or talkgroup
assignments is normally placed on the Assignment List(ICS 204).
Preparation. The ICS 205 is prepared by the Communications Unit Leader and given to the Planning Section Chief for
inclusion in the Incident Action Plan.
Distribution. The ICS 205 is duplicated and attached to the Incident Objectives (ICS 202) and given to all recipients as
part of the Incident Action Plan (IAP). All completed original forms must be given to the Documentation Unit. Information
from the ICS 205 is placed on Assignment Lists.
Notes:
• The ICS 205 is used to provide, in one location, information on all radio frequency assignments down to the
Division/Group level for each operational period.
• The ICS 205 serves as part of the IAP.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Date/Time Prepared Enter date prepared (month/day/year) and time prepared (using the 24-hour
clock).
3 Operational Period I Enter the start date (month/day/year) and time (using the 24-hour clock) and
• Date and Time From end date and time for the operational period to which the form applies.
• Date and Time To
4 Basic Radio Channel Enter the following information about radio channel use:
Use
Zone Group
Channel Number Use at the Communications Unit Leader's discretion. Channel Number(Ch
#) may equate to the channel number for incident radios that are
programmed or cloned for a specific Communications Plan, or it may be
used just as a reference line number on the ICS 205 document.
Function Enter the Net function each channel or talkgroup will be used for(Command,
Tactical, Ground-to-Air, Air-to-Air, Support, Dispatch).
Channel Name/Trunked Enter the nomenclature or commonly used name for the channel or talk
Radio System Talkgroup group such as the National Interoperability Channels which follow DHS
frequency Field Operations Guide (FOG).
Assignment Enter the name of the ICS Branch/Division/Group/Section to which this
channel/talkgroup will be assigned.
RX (Receive) Frequency Enter the Receive Frequency(RX Freq) as the mobile or portable subscriber
(N or W) would be programmed using xxx.xxxx out to four decimal places, followed by
an "N" designating narrowband or a "W" designating wideband emissions.
The name of the specific trunked radio system with which the talkgroup is
associated may be entered across all fields on the ICS 205 normally used
for conventional channel programming information.
RX Tone/NAC Enter the Receive Continuous Tone Coded Squelch System (CTCSS)
subaudible tone (RX Tone)or Network Access Code (RX NAC)for the
receive frequency as the mobile or portable subscriber would be
programmed.
Block Block Title Instructions
Number
4 TX (Transmit) Enter the Transmit Frequency(TX Freq) as the mobile or portable subscriber
(continued) Frequency(N or W) would be programmed using xxx.xxxx out to four decimal places, followed by
an "N" designating narrowband or a "W" designating wideband emissions.
TX Tone/NAC I Enter the Transmit Continuous Tone Coded Squelch System (CTCSS)
subaudible tone (TX Tone) or Network Access Code (TX NAC)for the
transmit frequency as the mobile or portable subscriber would be
programmed.
Mode (A, D, or M) Enter"A"for analog operation, "D"for digital operation, or"M"for mixed
mode operation.
Remarks Enter miscellaneous information concerning repeater locations, information
concerning patched channels or talkgroups using links or gateways, etc.
5 Special Instructions Enter any special instructions (e.g., using cross-band repeaters, secure-
voice, encoders, private line (PL)tones, etc.) or other emergency
communications needs). If needed, also include any special instructions for
handling an incident within an incident.
6 Prepared by Enter the name and signature of the person preparing the form, typically the
(Communications Unit Communications Unit Leader. Enter date (month/day/year) and time
Leader) prepared (24-hour clock).
• Name
• Signature
• Date/Time
COMMUNICATIONS LIST (ICS 205A)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Basic Local Communications Information:
Method(s)of Contact
Incident Assigned Position Name (Alphabetized) (phone, pager, cell, etc.)
4. Prepared by: Name: Position/Title: Signature:
ICS 205A IAP Page Date/Time:
ICS 205A
Communications List
Purpose. The Communications List (ICS 205A) records methods of contact for incident personnel. While the Incident
Radio Communications Plan (ICS 205) is used to provide information on all radio frequencies down to the Division/Group
level, the ICS 205A indicates all methods of contact for personnel assigned to the incident (radio frequencies, phone
numbers, pager numbers, etc.), and functions as an incident directory.
Preparation. The ICS 205A can be filled out during check-in and is maintained and distributed by Communications Unit
personnel. This form should be updated each operational period.
Distribution. The ICS 205A is distributed within the ICS organization by the Communications Unit, and posted as
necessary. All completed original forms must be given to the Documentation Unit. If this form contains sensitive
information such as cell phone numbers, it should be clearly marked in the header that it contains sensitive information
and is not for public release.
Notes:
• The ICS 205A is an optional part of the Incident Action Plan (IAP).
• This optional form is used in conjunction with the ICS 205.
• If additional pages are needed, use a blank ICS 205A and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour
• Date and Time From clock) and end date and time for the operational period to which the
• Date and Time To form applies.
3 Basic Local Communications Enter the communications methods assigned and used for personnel
Information by their assigned ICS position.
• Incident Assigned Position Enter the ICS organizational assignment.
• Name Enter the name of the assigned person.
• Method(s)of Contact For each assignment, enter the radio frequency and contact number(s)
(phone, pager, cell, etc.) to include area code, etc. If applicable, include the vehicle license or
ID number assigned to the vehicle for the incident(e.g., HAZMAT 1,
etc.).
4 Prepared by Enter the name, ICS position, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour
• Position/Title clock).
• Signature
• Date/Time
MEDICAL PLAN (ICS 206)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Medical Aid Stations:
Contact Paramedics
Name Location Number(s)/Frequency on Site?
❑yes ❑No
❑Yes ❑No
❑Yes ❑No
❑Yes ❑No
❑Yes ❑No
❑Yes ❑No
4. Transportation (indicate air or ground):
Contact
Ambulance Service Location Number(s)/Frequency Level of Service
❑ALS ❑BLS
❑ALS ❑BLS
❑ALS ❑BLS
El ALS ❑BLS
5. Hospitals:
Address, Contact Travel Time
Latitude & Longitude Number(s)/ Trauma Burn
Hospital Name if Helipad Frequency Air Ground Center Center Helipad
Eyes nYes Eyes
Level: ❑No ❑No
Eyes Eyes Eyes
Level: n No ❑No
Eyes Yes nYes
Level: _No ENO
Eyes Eyes Eyes
Level: No No
❑Yes Eyes Eyes
Level: ❑No ❑No
6. Special Medical Emergency Procedures:
❑ Check box if aviation assets are utilized for rescue. If assets are used, coordinate with Air Operations.
7. Prepared by (Medical Unit Leader): Name: _ Signature: _
8. Approved by(Safety Officer): Name: Signature:
ICS 206 IAP Page I Date/Time:
ICS 206
Medical Plan
Purpose. The Medical Plan (ICS 206) provides information on incident medical aid stations, transportation services,
hospitals, and medical emergency procedures.
Preparation. The ICS 206 is prepared by the Medical Unit Leader and reviewed by the Safety Officer to ensure ICS
coordination. If aviation assets are utilized for rescue, coordinate with Air Operations.
Distribution. The ICS 206 is duplicated and attached to the Incident Objectives (ICS 202) and given to all recipients as
part of the Incident Action Plan (IAP). Information from the plan pertaining to incident medical aid stations and medical
emergency procedures may be noted on the Assignment List(ICS 204). All completed original forms must be given to the
Documentation Unit.
Notes:
• The ICS 206 serves as part of the IAP.
• This form can include multiple pages.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour clock)
• Date and Time From and end date and time for the operational period to which the form
• Date and Time To applies.
3 Medical Aid Stations Enter the following information on the incident medical aid station(s):
• Name Enter name of the medical aid station.
• Location Enter the location of the medical aid station (e.g., Staging Area, Camp
Ground).
• Contact Enter the contact number(s) and frequency for the medical aid
Number(s)/Frequency station(s).
• Paramedics on Site? Indicate (yes or no) if paramedics are at the site indicated.
❑Yes ❑No
4 Transportation (indicate air or Enter the following information for ambulance services available to the
ground) incident:
• Ambulance Service Enter name of ambulance service.
• Location Enter the location of the ambulance service.
• Contact Enter the contact number(s) and frequency for the ambulance service.
Number(s)/Frequency
• Level of Service Indicate the level of service available for each ambulance, either ALS
❑ALS ❑BLS (Advanced Life Support)or BLS (Basic Life Support).
Block Block Title Instructions
Number
5 Hospitals Enter the following information for hospital(s)that could serve this
incident:
• Hospital Name Enter hospital name and identify any predesignated medivac aircraft by
name a frequency.
• Address, Latitude & Enter the physical address of the hospital and the latitude and longitude
Longitude if Helipad if the hospital has a helipad.
• Contact Number(s)/ Enter the contact number(s) and/or communications frequency(s)for
Frequency the hospital.
• Travel Time Enter the travel time by air and ground from the incident to the hospital.
• Air
• Ground
• Trauma Center Indicate yes and the trauma level if the hospital has a trauma center.
❑Yes Level:
• Burn Center Indicate (yes or no) if the hospital has a burn center.
❑Yes ❑No
• Helipad Indicate (yes or no) if the hospital has a helipad.
❑Yes ❑No Latitude and Longitude data format need to compliment Medical
Evacuation Helicopters and Medical Air Resources
6 Special Medical Emergency Note any special emergency instructions for use by incident personnel,
Procedures including (1)who should be contacted, (2) how should they be
contacted; and (3)who manages an incident within an incident due to a
rescue, accident, etc. Include procedures for how to report medical
emergencies.
❑ Check box if aviation assets Self explanatory. Incident assigned aviation assets should be included
are utilized for rescue. If in ICS 220.
assets are used, coordinate
with Air Operations.
7 Prepared by (Medical Unit Enter the name and signature of the person preparing the form, typically
Leader) the Medical Unit Leader. Enter date (month/day/year) and time
• Name prepared (24-hour clock).
• Signature
8 Approved by (Safety Officer) Enter the name of the person who approved the plan, typically the
• Name Safety Officer. Enter date (month/day/year)and time reviewed (24-hour
• Signature clock).
• Date/Time
INCIDENT ORGANIZATION CHART (ICS 207)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Organization Chart
--I Liaison Officer
Incident Commander(s)
I
Safety Officer
Operations Section
Chief
Public Information Officer
Staging Area
Manager
I I 1
Planning Section Logistics Section Finance/Admin
Chief Chief Section Chief
Resources Unit Ldr. Support Branch Dir. Time Unit Ldr.
-I
Situation Unit Ldr. Supply Unit Ldr. Procurement Unit Ldr.
Documentation Unit Ldr. Facilities Unit Ldr. Comp./Claims Unit Ldr.
Demobilization Unit Ldr. Ground Spt.Unit Ldr. Cost Unit Ldr.
Service Branch Dir.
—]
Comms Unit Ldr.
Medical Unit Ldr.
Food Unit Ldr.
-I
ICS 207 IAP Page_ 4. Prepared by: Name: Position/Title: Signature: Date/Time:
ICS 207
Incident Organization Chart
Purpose. The Incident Organization Chart(ICS 207) provides a visual wall chart depicting the ICS organization position
assignments for the incident. The ICS 207 is used to indicate what ICS organizational elements are currently activated
and the names of personnel staffing each element. An actual organization will be event-specific. The size of the
organization is dependent on the specifics and magnitude of the incident and is scalable and flexible. Personnel
responsible for managing organizational positions are listed in each box as appropriate.
Preparation. The ICS 207 is prepared by the Resources Unit Leader and reviewed by the Incident Commander.
Complete only the blocks where positions have been activated, and add additional blocks as needed, especially for
Agency Representatives and all Operations Section organizational elements. For detailed information about positions,
consult the NIMS ICS Field Operations Guide. The ICS 207 is intended to be used as a wall-size chart and printed on a
plotter for better visibility. A chart is completed for each operational period, and updated when organizational changes
occur.
Distribution. The ICS 207 is intended to be wall mounted at Incident Command Posts and other incident locations as
needed, and is not intended to be part of the Incident Action Plan (IAP). All completed original forms must be given to the
Documentation Unit.
Notes:
• The ICS 207 is intended to be wall mounted (printed on a plotter). Document size can be modified based on individual
needs.
• Also available as 8%x 14 (legal size) chart.
• ICS allows for organizational flexibility, so the Intelligence/Investigative Function can be embedded in several different
places within the organizational structure.
• Use additional pages if more than three branches are activated. Additional pages can be added based on individual
need (such as to distinguish more Division/Groups and Branches as they are activated).
Block Block Title Instructions
Number
1 Incident Name Print the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the
• Date and Time From 24-hour clock) and end date and time for the operational
• Date and Time To period to which the form applies.
3 Organization Chart • Complete the incident organization chart.
• For all individuals, use at least the first initial and last
name.
• List agency where it is appropriate, such as for Unified
Commanders.
• If there is a shift change during the specified operational
period, list both names, separated by a slash.
4 Prepared by Enter the name, ICS position, and signature of the person
• Name preparing the form. Enter date (month/day/year) and time
• Position/Title prepared (24-hour clock).
• Signature
• Date/Time
SAFETY MESSAGE/PLAN (ICS 208)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Safety Message/Expanded Safety Message, Safety Plan, Site Safety Plan:
4. Site Safety Plan Required? YesL NoL
Approved Site Safety Plan(s) Located At:
5. Prepared by: Name: Position/Title: Signature:
ICS 208 IAP Page Date/Time:
ICS 208
Safety Message/Plan
Purpose. The Safety Message/Plan (ICS 208) expands on the Safety Message and Site Safety Plan.
Preparation. The ICS 208 is an optional form that may be included and completed by the Safety Officer for the Incident
Action Plan (IAP).
Distribution. The ICS 208, if developed, will be reproduced with the IAP and given to all recipients as part of the IAP. All
completed original forms must be given to the Documentation Unit.
Notes:
• The ICS 208 may serve (optionally) as part of the IAP.
• Use additional copies for continuation sheets as needed, and indicate pagination as used.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
Operational Period Enter the start date (month/day/year) and time (using the 24-hour
2 • Date and Time From clock) and end date and time for the operational period to which the
• Date and Time To form applies.
Safety Message/Expanded Enter clear, concise statements for safety message(s), priorities, and
Safety Message, Safety Plan, key command emphasis/decisions/directions. Enter information such
3 Site Safety Plan as known safety hazards and specific precautions to be observed
during this operational period. If needed, additional safety message(s)
should be referenced and attached.
4 Site Safety Plan Required? Check whether or not a site safety plan is required for this incident.
Yes❑ No❑
Approved Site Safety Plan(s) Enter where the approved Site Safety Plan(s) is located.
Located At
Prepared by Enter the name, ICS position, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour
5 • Position/Title clock).
• Signature
• Date/Time
SITE SAFETY AND 1. Incident Name: 2. Date Prepared: 3. Operational Period:
CONTROL PLAN Time:
ICS 208 HM
Section I. Site Information
4. Incident Location:
Section II. Organization
5. Incident Commander: 6. HM Group Supervisor: 7. Tech. Specialist- HM Reference:
8. Safety Officer: 9. Entry Leader: 10. Site Access Control Leader:
11. Asst. Safety Officer - HM: 12. Decontamination Leader: 13. Safe Refuge Area Mgr:
14. Environmental Health: 15. 16.
17. Entry Team: (Buddy System) 18. Decontamination Element:
Name: PPE Level Name: PPE Level
Entry 1 Decon 1
Entry 2 Decon 2
Entry 3 Decon 3
Entry 4 Decon 4
Section III. Hazard/Risk Analysis
19. Material: Container Qty. Phys. pH IDLH F.P. I.T. V.P. V.D. S.G. LEL UEL
type State
Comment:
Section IV. Hazard Monitoring
20. LEL Instrument(s): 21. OZ Instrument(s):
22. Toxicity/PPM Instrument(s): 23. Radiological Instrument(s):
Comment:
Section V. Decontamination Procedures
24. Standard Decontamination Procedures: YES: n NO:
Comment:
Section VI. Site Communications
25. Command Frequency: 26. Tactical Frequency: 27. Entry Frequency:
Section VII. Medical Assistance
28. Medical Monitoring: YES: NO: 29. Medical Treatment and Transport In-place: YES:n NO:I
Comment:
ICS 208 HM Page 1 3/98
Section VIII. Site Map
30. Site Map:
Weather n Command Post n Zones ❑ Assembly Areas n Escape Routes n Other n
Section IX. Entry Objectives
31. Entry Objectives:
Section X. SOP S and Safe Work Practices
32. Modifications to Documented SOP s or Work Practices: YES: —1 NO:
Comment:
Section XI. Emergency Procedures
33. Emergency Procedures:
Section XII. Safety Briefing
34. Asst. Safety Officer- HM Signature: Safety Briefing Completed (Time):
35. HM Group Supervisor Signature: 36. Incident Commander Signature:
ICS 208 HM Page 2 3/98
INSTRUCTIONS FOR COMPLETING THE SITE SAFETY AND CONTROL PLAN
ICS 208 HM
A Site Safety and Control Plan must be completed by the Hazardous Materials Group Supervisor and reviewed by all
within the Hazardous Materials Group prior to operations commencing within the Exclusion Zone.
Item Number Item Title Instructions
1. Incident Name/Number Print name and/or incident number.
2. Date and Time Enter date and time prepared.
3. Operational Period Enter the time interval for which the form applies.
4. Incident Location Enter the address and or map coordinates of the incident.
5 - 16. Organization Enter names of all individuals assigned to ICS positions. (Entries 5 &
8 mandatory). Use Boxes 15 and 16 for other functions: i.e. Medical
Monitoring.
17 - 18. Entry Team/Decon Enter names and level of PPE of Entry & Decon personnel. (Entries 1
Element - 4 mandatory buddy system and back-up.)
19. Material Enter names and pertinent information of all known chemical
products. Enter UNK if material is not known. Include any which
apply to chemical properties. (Definitions: ph = Potential for Hydrogen
(Corrosivity), IDLH = Immediately Dangerous to Life and Health,
F.P. = Flash Point, I.T. = Ignition Temperature, V.P. = Vapor Pressure,
V.D. = Vapor Density, S.G. = Specific Gravity, LEL = Lower Explosive
Limit, UEL = Upper Explosive Limit)
20 - 23. Hazard Monitoring List the instruments which will be used to monitor for chemical.
24. Decontamination Check NO if modifications are made to standard decontamination
Procedures procedures and make appropriate Comments including type of
solutions.
25 - 27. Site Communications Enter the radio frequency(ies) which apply.
28 - 29. Medical Assistance Enter comments if NO is checked.
30. Site Map Sketch or attach a site map which defines all locations and layouts of
operational zones. (Check boxes are mandatory to be identified.)
31. Entry Objectives List all objectives to be performed by the Entry Team in the
Exclusion Zone and any parameters which will alter or stop entry
operations.
32 - 33. SOP s, Safe Work List in Comments if any modifications to SOP s and any emergency
Practices, and procedures which will be affected if an emergency occurs while
Emergency personnel are within the Exclusion Zone.
Procedures
34 - 36. Safety Briefing Have the appropriate individual place their signature in the box once
the Site Safety and Control Plan is reviewed.
Note the time in box 34 when the safety briefing has been completed.
ICS 208 HM Page 3 3/98
INCIDENT STATUS SUMMARY (ICS 209)
*1. Incident Name: 2. Incident Number:
*3. Report Version (check *4. Incident Commander(s)& 5. Incident *6. Incident Start Date/Time:
one box on left): Agency or Organization: Management Date:
O
Initial Rpt# Organization:
Update (if used): Time:
Final Time Zone:
7. Current Incident Size 8. Percent(%) *9. Incident 10. Incident *11. For Time Period:
or Area Involved (use unit Contained Definition: Complexity
label—e.g., "sq mi,""city Level: From Date/Time:
block"):
Completed To Date/Time:
Approval&Routing Information
*12. Prepared By: *13. Date/Time Submitted:
Print Name: ICS Position:
Time Zone:
Date/Time Prepared:
*14.Approved By: *15. Primary Location, Organization, or
Print Name: ICS Position: Agency Sent To:
Signature:
Incident Location Information
*16. State: *17. County/Parish/Borough: *18. City:
19. Unit or Other: *20. Incident Jurisdiction: 21. Incident Location Ownership
(if different than jurisdiction):
22. Longitude(indicate format): 23. US National Grid Reference: 24. Legal Description (township,section,
range):
Latitude(indicate format):
*25. Short Location or Area Description(list all affected areas or a reference point): 26. UTM Coordinates:
27. Note any electronic geospatial data included or attached (indicate data format, content, and collection time information and
labels):
Incident Summary
*28. Significant Events for the Time Period Reported (summarize significant progress made, evacuations, incident growth, etc.):
29. Primary Materials or Hazards Involved (hazardous chemicals,fuel types, infectious agents, radiation, etc.):
30. Damage Assessment Information (summarize A. Structural B.#Threatened C.# D.#
damage and/or restriction of use or availability to Summary (72 hrs) Damaged Destroyed
residential or commercial property, natural resources, E. Single Residences
critical infrastructure and key resources, etc.):
F. Nonresidential
Commercial Property
Other Minor
Structures
Other
ICS 209, Page 1 of *Required when applicable.
INCIDENT STATUS SUMMARY (ICS 209)
*1. Incident Name: 2. Incident Number:
Additional Incident Decision Support Information
A.#This A.#This
Reporting B.Total# Reporting B.Total#
*31. Public Status Summary: Period to Date *32. Responder Status Summary: Period to Date
C. Indicate Number of Civilians(Public)Below: C. Indicate Number of Responders Below:
D. Fatalities D. Fatalities
E.With Injuries/Illness E.With Injuries/Illness
F.Trapped/In Need of Rescue F.Trapped/In Need of Rescue
G. Missing (note if estimated) G. Missing
H. Evacuated (note if estimated) H. Sheltering in Place
I. Sheltering in Place.note if estimated) I. Have Received Immunizations
J. In Temporary Shelters(note if est) J. Require Immunizations
K. Have Received Mass Immunizations K. In Quarantine
L. Require Immunizations(note if est)
M. In Quarantine
N. Total#Civilians(Public)Affected: N. Total#Responders Affected:
33. Life,Safety,and Health Status/Threat Remarks: *34. Life, Safety, and Health Threat
Management: A.Check if Active
A. No Likely Threat ❑
B. Potential Future Threat ❑
C. Mass Notifications in Progress ❑
D. Mass Notifications Completed ❑
E. No Evacuation(s) Imminent ❑
F. Planning for Evacuation ❑
G. Planning for Shelter-in-Place ❑
35.Weather Concerns (synopsis of current and predicted H. Evacuation(s)in Progress ❑
weather; discuss related factors that may cause concern): I. Shelter-in-Place in Progress ❑
J. Repopulation in Progress ❑
K. Mass Immunization in Progress ❑
L. Mass Immunization Complete ❑
M. Quarantine in Progress ❑
N.Area Restriction in Effect ❑
36. Projected Incident Activity, Potential, Movement, Escalation,or Spread and influencing factors during the next operational
period and in 12-, 24-,48-, and 72-hour timeframes:
12 hours:
24 hours:
48 hours:
72 hours:
Anticipated after 72 hours:
37. Strategic Objectives (define planned end-state for incident):
ICS 209, Page 2 of *Required when applicable.
INCIDENT STATUS SUMMARY (ICS 209)
I *1. Incident Name: 12. Incident Number:
Additional Incident Decision Support Information(continued)
38. Current Incident Threat Summary and Risk Information in 12-, 24-,48-, and 72-hour timeframes and beyond. Summarize
primary incident threats to life, property, communities and community stability, residences, health care facilities,other critical
infrastructure and key resources, commercial facilities, natural and environmental resources, cultural resources, and continuity of
operations and/or business. Identify corresponding incident-related potential economic or cascading impacts.
12 hours:
24 hours:
48 hours:
72 hours:
Anticipated after 72 hours:
39. Critical Resource Needs in 12-, 24-,48-, and 72-hour timeframes and beyond to meet critical incident objectives. List resource
category, kind, and/or type, and amount needed, in priority order:
12 hours:
24 hours:
48 hours:
72 hours:
Anticipated after 72 hours:
40. Strategic Discussion: Explain the relation of overall strategy, constraints,and current available information to:
1)critical resource needs identified above,
2)the Incident Action Plan and management objectives and targets,
3)anticipated results.
Explain major problems and concerns such as operational challenges, incident management problems, and social,
political,economic, or environmental concerns or impacts.
41. Planned Actions for Next Operational Period:
42. Projected Final Incident Size/Area(use unit label—e.g., "sq mi"):
43.Anticipated Incident Management Completion Date:
44. Projected Significant Resource Demobilization Start Date:
45. Estimated Incident Costs to Date:
46. Projected Final Incident Cost Estimate:
47. Remarks(or continuation of any blocks above—list block number in notation):
ICS 209, Page 3 of *Required when applicable.
U���U����� ������ �%�U�U���� �U��� ����
^^~~~^~~^-^~ ^ STATUS^^^ ~~^~ SUMMARY v^~~~" ~-~~�
1. Incident Name: 2. Incident Number:
Incident Resource Commitment Summary
'
49. Resources (summarize resources hy category, kind, and/or type; show#of ---------
resources on top}6of box, show#of personnel associated with resource on 51.Toto|
bottom 1/2of box): Personnel
0. (includes those
'Fa associated
with resources
-e.g,aircraft
or engines-
40 Agency or *c � � and individual
��- oni�adion� 6 '� � overhead):
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
----`------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------
52. Total
Resources .
5%.Additional Cooperating and Assisting Organizations Not Listed Above:
ICS 209
Incident Status Summary
Purpose. The ICS 209 is used for reporting information on significant incidents. It is not intended for every incident, as
most incidents are of short duration and do not require scarce resources, significant mutual aid, or additional support and
attention. The ICS 209 contains basic information elements needed to support decisionmaking at all levels above the
incident to support the incident. Decisionmakers may include the agency having jurisdiction, but also all multiagency
coordination system (MACS) elements and parties, such as cooperating and assisting agencies/organizations, dispatch
centers, emergency operations centers, administrators, elected officials, and local, tribal, county, State, and Federal
agencies. Once ICS 209 information has been submitted from the incident, decisionmakers and others at all incident
support and coordination points may transmit and share the information (based on its sensitivity and appropriateness)for
access and use at local, regional, State, and national levels as it is needed to facilitate support.
Accurate and timely completion of the ICS 209 is necessary to identify appropriate resource needs, determine allocation
of limited resources when multiple incidents occur, and secure additional capability when there are limited resources due
to constraints of time, distance, or other factors. The information included on the ICS 209 influences the priority of the
incident, and thus its share of available resources and incident support.
The ICS 209 is designed to provide a"snapshot in time"to effectively move incident decision support information where it
is needed. It should contain the most accurate and up-to-date information available at the time it is prepared. However,
readers of the ICS 209 may have access to more up-to-date or real-time information in reference to certain information
elements on the ICS 209. Coordination among communications and information management elements within ICS and
among MACS should delineate authoritative sources for more up-to-date and/or real-time information when ICS 209
information becomes outdated in a quickly evolving incident.
Reporting Requirements. The ICS 209 is intended to be used when an incident reaches a certain threshold where it
becomes significant enough to merit special attention, require additional resource support needs, or cause media
attention, increased public safety threat, etc. Agencies or organizations may set reporting requirements and, therefore,
ICS 209s should be completed according to each jurisdiction or discipline's policies, mobilization guide, or preparedness
plans. It is recommended that consistent ICS 209 reporting parameters be adopted and used by jurisdictions or
disciplines for consistency over time, documentation, efficiency, trend monitoring, incident tracking, etc.
For example, an agency or MAC (Multiagency Coordination) Group may require the submission of an initial ICS 209 when
a new incident has reached a certain predesignated level of significance, such as when a given number of resources are
committed to the incident, when a new incident is not completed within a certain timeframe, or when impacts/threats to life
and safety reach a given level.
Typically, ICS 209 forms are completed either once daily or for each operational period — in addition to the initial
submission. Jurisdictional or organizational guidance may indicate frequency of ICS 209 submission for particular
definitions of incidents or for all incidents. This specific guidance may help determine submission timelines when
operational periods are extremely short (e.g., 2 hours)and it is not necessary to submit new ICS 209 forms for all
operational periods.
Any plans or guidelines should also indicate parameters for when it is appropriate to stop submitting ICS 209s for an
incident, based upon incident activity and support levels.
Preparation. When an Incident Management Organization (such as an Incident Management Team) is in place, the
Situation Unit Leader or Planning Section Chief prepares the ICS 209 at the incident. On other incidents, the ICS 209
may be completed by a dispatcher in the local communications center, or by another staff person or manager. This form
should be completed at the incident or at the closest level to the incident.
The ICS 209 should be completed with the best possible, currently available, and verifiable information at the time it is
completed and signed.
This form is designed to serve incidents impacting specific geographic areas that can easily be defined. It also has the
flexibility for use on ubiquitous events, or those events that cover extremely large areas and that may involve many
jurisdictions and ICS organizations. For these incidents, it will be useful to clarify on the form exactly which portion of the
larger incident the ICS 209 is meant to address. For example, a particular ICS 209 submitted during a statewide outbreak
of mumps may be relevant only to mumps-related activities in Story County, Iowa. This can be indicated in both the
incident name, Block 1, and in the Incident Location Information section in Blocks 16-26.
While most of the "Incident Location Information" in Blocks 16-26 is optional, the more information that can be submitted,
the better. Submission of multiple location indicators increases accuracy, improves interoperability, and increases
information sharing between disparate systems. Preparers should be certain to follow accepted protocols or standards
when entering location information, and clearly label all location information. As with other ICS 209 data, geospatial
information may be widely shared and utilized, so accuracy is essential.
If electronic data is submitted with the ICS 209, do not attach or send extremely large data files. Incident geospatial data
that is distributed with the ICS 209 should be in simple incident geospatial basics, such as the incident perimeter, point of
origin, etc. Data file sizes should be small enough to be easily transmitted through dial-up connections or other limited
communications capabilities when ICS 209 information is transmitted electronically. Any attached data should be clearly
labeled as to format content and collection time, and should follow existing naming conventions and standards.
Distribution. ICS 209 information is meant to be completed at the level as close to the incident as possible, preferably at
the incident. Once the ICS 209 has been submitted outside the incident to a dispatch center or MACS element, it may
subsequently be transmitted to various incident supports and coordination entities based on the support needs and the
decisions made within the MACS in which the incident occurs.
Coordination with public information system elements and investigative/intelligence information organizations at the
incident and within MACS is essential to protect information security and to ensure optimal information sharing and
coordination. There may be times in which particular ICS 209s contain sensitive information that should not be released
to the public (such as information regarding active investigations, fatalities, etc.). When this occurs, the ICS 209 (or
relevant sections of it)should be labeled appropriately, and care should be taken in distributing the information within
MACS.
All completed and signed original ICS 209 forms MUST be given to the incident's Documentation Unit and/or maintained
as part of the official incident record.
Notes:
• To promote flexibility, only a limited number of ICS 209 blocks are typically required, and most of those are required
only when applicable.
• Most fields are optional, to allow responders to use the form as best fits their needs and protocols for information
collection.
• For the purposes of the ICS 209, responders are those personnel who are assigned to an incident or who are a part of
the response community as defined by NIMS. This may include critical infrastructure owners and operators,
nongovernmental and nonprofit organizational personnel, and contract employees (such as caterers), depending on
local/jurisdictional/discipline practices.
• For additional flexibility only pages 1-3 are numbered, for two reasons:
o Possible submission of additional pages for the Remarks Section (Block 47), and
o Possible submission of additional copies of the fourth/last page (the "Incident Resource Commitment Summary")to
provide a more detailed resource summary.
Block Block Title Instructions
Number
*1 Incident Name REQUIRED BLOCK.
• Enter the full name assigned to the incident.
• Check spelling of the full incident name.
• For an incident that is a Complex, use the word "Complex" at the end of
the incident name.
• If the name changes, explain comments in Remarks, Block 47.
• Do not use the same incident name for different incidents in the same
calendar year.
Block Block Title Instructions
Number
2 Incident Number • Enter the appropriate number based on current guidance. The incident
number may vary by jurisdiction and discipline.
• Examples include:
o A computer-aided dispatch (CAD) number.
o An accounting number.
o A county number.
o A disaster declaration number.
o A combination of the State, unit/agency ID, and a dispatch system
number.
o A mission number.
o Any other unique number assigned to the incident and derived by
means other than those above.
• Make sure the number entered is correct.
• Do not use the same incident number for two different incidents in the
same calendar year.
• Incident numbers associated with host jurisdictions or agencies and
incident numbers assigned by agencies represented in Unified Command
should be listed, or indicated in Remarks, Block 47.
*3 Report Version (check REQUIRED BLOCK.
one box on left) • This indicates the current version of the ICS 209 form being submitted.
• If only one ICS 209 will be submitted, check BOTH "Initial" and "Final" (or
check only"Final").
❑ Initial Check "Initial" if this is the first ICS 209 for this incident.
❑ Update Check "Update" if this is a subsequent report for the same incident. These
can be submitted at various time intervals (see "Reporting Requirements"
above).
❑ Final • Check "Final" if this is the last ICS 209 to be submitted for this incident
(usually when the incident requires only minor support that can be
supplied by the organization having jurisdiction).
• Incidents may also be marked as "Final" if they become part of a new
Complex (when this occurs, it can be indicated in Remarks, Block 47).
Report# (if used) Use this optional field if your agency or organization requires the tracking of
ICS 209 report numbers. Agencies may also track the ICS 209 by the
date/time submitted.
*4 Incident Commander(s) REQUIRED BLOCK.
&Agency or • Enter both the first and last name of the Incident Commander.
Organization • If the incident is under a Unified Command, list all Incident Commanders
by first initial and last name separated by a comma, including their
organization. For example:
L. Burnett—Minneapolis FD, R. Domanski—Minneapolis PD,
C. Taylor—St. Paul PD, Y. Martin—St. Paul FD,
S. McIntyre—U.S. Army Corps, J. Hart!—NTSB
5 Incident Management Indicate the incident management organization for the incident, which may
Organization be a Type 1, 2, or 3 Incident Management Team (IMT), a Unified Command,
a Unified Command with an IMT, etc. This block should not be completed
unless a recognized incident management organization is assigned to the
incident.
Block Block Title Instructions
Number
*6 Incident Start Date/Time REQUIRED.
This is always the start date and time of the incident(not the report date and
time or operational period).
Date Enter the start date (month/day/year).
Time Enter the start time (using the 24-hour clock).
Time Zone Enter the time zone of the incident(e.g., EDT, PST).
7 Current Incident Size or • Enter the appropriate incident descriptive size or area involved (acres,
Area Involved (use unit number of buildings, square miles, hectares, square kilometers, etc.).
label—e.g., "sq mi," "city • Enter the total area involved for incident Complexes in this block, and list
block") each sub-incident and size in Remarks (Block 47).
• Indicate that the size is an estimate, if a more specific figure is not
available.
• Incident size may be a population figure rather than a geographic figure,
depending on the incident definition and objectives.
• If the incident involves more than one jurisdiction or mixed ownership,
agencies/organizations may require listing a size breakdown by
organization, or including this information in Remarks (Block 47).
• The incident may be one part of a much larger event(refer to introductory
instructions under"Preparation). Incident size/area depends on the area
actively managed within the incident objectives and incident operations,
and may also be defined by a delegation of authority or letter of
expectation outlining management bounds.
8 Percent(%) Contained • Enter the percent that this incident is completed or contained (e.g., 50%),
or Completed (circle one) with a % label.
• For example, a spill may be 65% contained, or flood response objectives
may be 50% met.
*9 Incident Definition REQUIRED BLOCK.
Enter a general definition of the incident in this block. This may be a general
incident category or kind description, such as "tornado," "wildfire," "bridge
collapse," "civil unrest," "parade," "vehicle fire," "mass casualty," etc.
10 Incident Complexity Identify the incident complexity level as determined by Unified/Incident
Level Commanders, if available or used.
*11 For Time Period REQUIRED BLOCK.
• Enter the time interval for which the form applies. This period should
include all of the time since the last ICS 209 was submitted, or if it is the
initial ICS 209, it should cover the time lapsed since the incident started.
• The time period may include one or more operational periods, based on
agency/organizational reporting requirements.
From Date/Time • Enter the start date (month/day/year).
• Enter the start time (using the 24-hour clock).
To Date/Time • Enter the end date (month/day/year).
• Enter the end time (using the 24-hour clock).
Block Block Title Instructions
Number
APPROVAL & ROUTING INFORMATION
*12 Prepared By REQUIRED BLOCK.
When an incident management organization is in place, this would be the
Situation Unit Leader or Planning Section Chief at the incident. On other
incidents, it could be a dispatcher in the local emergency communications
center, or another staff person or manager.
Print Name Print the name of the person preparing the form.
ICS Position The ICS title of the person preparing the form (e.g., "Situation Unit Leader").
Date/Time Prepared Enter the date (month/day/year) and time (using the 24-hour clock)the form
was prepared. Enter the time zone if appropriate.
*13 Date/Time Submitted REQUIRED.
Enter the submission date (month/day/year) and time (using the 24-hour
clock).
Time Zone Enter the time zone from which the ICS 209 was submitted (e.g., EDT,
PST).
*14 Approved By REQUIRED.
When an incident management organization is in place, this would be the
Planning Section Chief or Incident Commander at the incident. On other
incidents, it could be the jurisdiction's dispatch center manager,
organizational administrator, or other manager.
Print Name Print the name of the person approving the form.
ICS Position The position of the person signing the ICS 209 should be entered (e.g.,
"Incident Commander").
Signature Signature of the person approving the ICS 209, typically the Incident
Commander. The original signed ICS 209 should be maintained with other
incident documents.
*15 Primary Location, REQUIRED BLOCK.
Organization, or Agency Enter the appropriate primary location or office the ICS 209 was sent to
Sent To apart from the incident. This most likely is the entity or office that ordered
the incident management organization that is managing the incident. This
may be a dispatch center or a MACS element such as an emergency
operations center. If a dispatch center or other emergency center prepared
the ICS 209 for the incident, indicate where it was submitted initially.
INCIDENT LOCATION INFORMATION
• Much of the "Incident Location Information" in Blocks 16-26 is optional, but completing as many fields as possible
increases accuracy, and improves interoperability and information sharing between disparate systems.
• As with all ICS 209 information, accuracy is essential because the information may be widely distributed and used in
a variety of systems. Location and/or geospatial data may be used for maps, reports, and analysis by multiple
parties outside the incident.
• Be certain to follow accepted protocols, conventions, or standards where appropriate when submitting location
information, and clearly label all location information.
• Incident location information is usually based on the point of origin of the incident, and the majority of the area
where the incident jurisdiction is.
*16 State REQUIRED BLOCK WHEN APPLICABLE.
• Enter the State where the incident originated.
• If other States or jurisdictions are involved, enter them in Block 25 or
Block 44.
Block Block Title Instructions
Number
*17 County/ Parish / REQUIRED BLOCK WHEN APPLICABLE.
Borough • Enter the county, parish, or borough where the incident originated.
• If other counties or jurisdictions are involved, enter them in Block 25 or
Block 47.
*18 City REQUIRED BLOCK WHEN APPLICABLE.
• Enter the city where the incident originated.
• If other cities or jurisdictions are involved, enter them in Block 25 or Block
47.
19 Unit or Other Enter the unit, sub-unit, unit identification (ID) number or code (if used), or
other information about where the incident originated. This may be a local
identifier that indicates primary incident jurisdiction or responsibility(e.g.,
police, fire, public works, etc.)or another type of organization. Enter
specifics in Block 25.
*20 Incident Jurisdiction REQUIRED BLOCK WHEN APPLICABLE.
Enter the jurisdiction where the incident originated (the entry may be
general, such as Federal, city, or State, or may specifically identify agency
names such as Warren County, U.S. Coast Guard, Panama City, NYPD).
21 Incident Location • When relevant, indicate the ownership of the area where the incident
Ownership (if different originated, especially if it is different than the agency having jurisdiction.
than jurisdiction) • This may include situations where jurisdictions contract for emergency
services, or where it is relevant to include ownership by private entities,
such as a large industrial site.
22 22. Longitude (indicate • Enter the longitude and latitude where the incident originated, if available
format): and normally used by the authority having jurisdiction for the incident.
• Clearly label the data, as longitude and latitude can be derived from
Latitude (indicate various sources. For example, if degrees, minutes, and seconds are
format): used, label as "33 degrees, 45 minutes, 01 seconds."
23 US National Grid • Enter the US National Grid (USNG) reference where the incident
Reference originated, if available and commonly used by the agencies/jurisdictions
with primary responsibility for the incident.
• Clearly label the data.
24 Legal Description • Enter the legal description where the incident originated, if available and
(township, section, range) commonly used by the agencies/jurisdictions with primary responsibility
for the incident.
• Clearly label the data (e.g., N 1/2 SE 1/4, SW 1/4, S24, T32N, R18E).
*25 Short Location or Area REQUIRED BLOCK.
Description (list all • List all affected areas as described in instructions for Blocks 16-24
affected areas or a above, OR summarize a general location, OR list a reference point for
reference point) the incident (e.g., "the southern third of Florida," "in ocean 20 miles west
of Catalina Island, CA," or"within a 5 mile radius of Walden, CO").
• This information is important for readers unfamiliar with the area (or with
other location identification systems)to be able to quickly identify the
general location of the incident on a map.
• Other location information may also be listed here if needed or relevant
for incident support(e.g., base meridian).
26 UTM Coordinates Indicate Universal Transverse Mercator reference coordinates if used by the
discipline or jurisdiction.
Block Block Title Instructions
Number
27 Note any electronic • Indicate whether and how geospatial data is included or attached.
geospatial data included • Utilize common and open geospatial data standards.
or attached (indicate data • WARNING: Do not attach or send extremely large data files with the ICS
format, content, and 209. Incident geospatial data that is distributed with the ICS 209 should
collection time information be simple incident geospatial basics, such as the incident perimeter,
and labels) origin, etc. Data file sizes should be small enough to be easily
transmitted through dial-up connections or other limited communications
capabilities when ICS 209 information is transmitted electronically.
• NOTE: Clearly indicate data content. For example, data may be about
an incident perimeter(such as a shape file), the incident origin (a point),
a point and radius (such as an evacuation zone), or a line or lines (such
as a pipeline).
• NOTE: Indicate the data format(e.g., .shp, .kml, .kmz, or .gml file) and
any relevant information about projection, etc.
• NOTE: Include a hyperlink or other access information if incident map
data is posted online or on an FTP (file transfer protocol) site to facilitate
downloading and minimize information requests.
• NOTE: Include a point of contact for getting geospatial incident
information, if included in the ICS 209 or available and supporting the
incident.
INCIDENT SUMMARY
*28 Significant Events for REQUIRED BLOCK.
the Time Period • Describe significant events that occurred during the period being
Reported (summarize reported in Block 6. Examples include:
significant progress made, o Road closures.
evacuations, incident o Evacuations.
growth, etc.) o Progress made and accomplishments.
o Incident command transitions.
o Repopulation of formerly evacuated areas and specifics.
o Containment.
• Refer to other blocks in the ICS 209 when relevant for additional
information (e.g., "Details on evacuations may be found in Block 33"), or
in Remarks, Block 47.
• Be specific and detailed in reference to events. For example, references
to road closures should include road number and duration of closure (or
include further detail in Block 33). Use specific metrics if needed, such
as the number of people or animals evacuated, or the amount of a
material spilled and/or recovered.
• This block may be used for a single-paragraph synopsis of overall
incident status.
29 Primary Materials or • When relevant, enter the appropriate primary materials, fuels, or other
Hazards Involved hazards involved in the incident that are leaking, burning, infecting, or
(hazardous chemicals, otherwise influencing the incident.
fuel types, infectious • Examples include hazardous chemicals, wildland fuel models,
agents, radiation, etc.) biohazards, explosive materials, oil, gas, structural collapse, avalanche
activity, criminal activity, etc.
Other Enter any miscellaneous issues which impacted Critical Infrastructure and
Key Resources.
Block Block Title Instructions
Number
30 Damage Assessment • Include a short summary of damage or use/access restrictions/
Information (summarize limitations caused by the incident for the reporting period, and
damage and/or restriction cumulatively.
of use or availability to • Include if needed any information on the facility status, such as
residential or commercial operational status, if it is evacuated, etc. when needed.
property, natural • Include any critical infrastructure or key resources damaged/destroyed/
resources, critical impacted by the incident, the kind of infrastructure, and the extent of
infrastructure and key damage and/or impact and any known cascading impacts.
resources, etc.) • Refer to more specific or detailed damage assessment forms and
packages when they are used and/or relevant.
A. Structural Summary Complete this table as needed based on the definitions for 30B—F below.
Note in table or in text block if numbers entered are estimates or are
confirmed. Summaries may also include impact to Shoreline and Wildlife,
etc.
B. #Threatened (72 hrs) Enter the number of structures potentially threatened by the incident within
the next 72 hours, based on currently available information.
C. # Damaged Enter the number of structures damaged by the incident.
D. # Destroyed Enter the number of structures destroyed beyond repair by the incident.
E. Single Residences Enter the number of single dwellings/homes/units impacted in Columns
30B—D. Note any specifics in the text block if needed, such as type of
residence (apartments, condominiums, single-family homes, etc.).
F. Nonresidential Enter the number of buildings or units impacted in Columns 30B—D. This
Commercial Properties includes any primary structure used for nonresidential purposes, excluding
Other Minor Structures (Block 30G). Note any specifics regarding building
or unit types in the text block.
Other Minor Structures Enter any miscellaneous structures impacted in Columns 30B—D not
covered in 30E—F above, including any minor structures such as booths,
sheds, or outbuildings.
Other Enter any miscellaneous issues which impacted Critical Infrastructure and
Key Resources.
Block Block Title Instructions
Number
ADDITIONAL INCIDENT DECISION SUPPORT INFORMATION (PAGE 2)
*31 Public Status Summary • This section is for summary information regarding incident-related
injuries, illness, and fatalities for civilians (or members of the public); see
31C—N below.
• Explain or describe the nature of any reported injuries, illness, or other
activities in Life, Safety, and Health Status/Threat Remarks (Block 33).
• Illnesses include those that may be caused through a biological event
such as an epidemic or an exposure to toxic or radiological substances.
• NOTE: Do not estimate any fatality information.
• NOTE: Please use caution when reporting information in this section that
may be on the periphery of the incident or change frequently. This
information should be reported as accurately as possible as a snapshot
in time, as much of the information is subject to frequent change.
• NOTE: Do not complete this block if the incident covered by the ICS 209
is not directly responsible for these actions (such as evacuations,
sheltering, immunizations, etc.) even if they are related to the incident.
o Only the authority having jurisdiction should submit reports for these
actions, to mitigate multiple/conflicting reports.
o For example, if managing evacuation shelters is part of the incident
operation itself, do include these numbers in Block 31J with any notes
in Block 33.
• NOTE: When providing an estimated value, denote in parenthesis: "est."
Handling Sensitive Information
• Release of information in this section should be carefully coordinated
within the incident management organization to ensure synchronization
with public information and investigative/intelligence actions.
• Thoroughly review the "Distribution" section in the introductory ICS 209
instructions for details on handling sensitive information. Use caution
when providing information in any situation involving fatalities, and verify
that appropriate notifications have been made prior to release of this
information. Electronic transmission of any ICS 209 may make
information available to many people and networks at once.
• Information regarding fatalities should be cleared with the Incident
Commander and/or an organizational administrator prior to submission of
the ICS 209.
A. #This Reporting Enter the total number of individuals impacted in each category for this
Period reporting period (since the previous ICS 209 was submitted).
B. Total #to Date • Enter the total number of individuals impacted in each category for the
entire duration of the incident.
• This is a cumulative total number that should be adjusted each reporting
period.
C. Indicate Number of • For lines 31 D—M below, enter the number of civilians affected for each
Civilians (Public) Below category.
• Indicate if numbers are estimates, for those blocks where this is an
option.
• Civilians are those members of the public who are affected by the
incident, but who are not included as part of the response effort through
Unified Command partnerships and those organizations and agencies
assisting and cooperating with response efforts.
D. Fatalities • Enter the number of confirmed civilian/public fatalities.
• See information in introductory instructions ("Distribution")and in Block
31 instructions regarding sensitive handling of fatality information.
Block Block Title Instructions
Number
E. With Injuries/Illness Enter the number of civilian/public injuries or illnesses directly related to the
incident. Injury or illness is defined by the incident or jurisdiction(s).
*31 F. Trapped/In Need of Enter the number of civilians who are trapped or in need of rescue due to
(continued) Rescue the incident.
G. Missing (note if Enter the number of civilians who are missing due to the incident. Indicate if
estimated) an estimate is used.
H. Evacuated (note if Enter the number of civilians who are evacuated due to the incident. These
estimated) are likely to be best estimates, but indicate if they are estimated.
I. Sheltering-in-Place Enter the number of civilians who are sheltering in place due to the incident.
(note if estimated) Indicate if estimates are used.
J. In Temporary Shelters Enter the number of civilians who are in temporary shelters as a direct result
(note if estimated) of the incident, noting if the number is an estimate.
K. Have Received Mass Enter the number of civilians who have received mass immunizations due to
Immunizations the incident and/or as part of incident operations. Do not estimate.
L. Require Mass Enter the number of civilians who require mass immunizations due to the
Immunizations (note if incident and/or as part of incident operations. Indicate if it is an estimate.
estimated)
M. In Quarantine Enter the number of civilians who are in quarantine due to the incident
and/or as part of incident operations. Do not estimate.
N. Total#Civilians Enter sum totals for Columns 31A and 31B for Rows 31D—M.
(Public)Affected
*32 Responder Status • This section is for summary information regarding incident-related
Summary injuries, illness, and fatalities for responders; see 32C—N.
• Illnesses include those that may be related to a biological event such as
an epidemic or an exposure to toxic or radiological substances directly in
relation to the incident.
• Explain or describe the nature of any reported injuries, illness, or other
activities in Block 33.
• NOTE: Do not estimate any fatality information or responder status
information.
• NOTE: Please use caution when reporting information in this section that
may be on the periphery of the incident or change frequently. This
information should be reported as accurately as possible as a snapshot
in time, as much of the information is subject to frequent change.
• NOTE: Do not complete this block if the incident covered by the ICS 209
is not directly responsible for these actions (such as evacuations,
sheltering, immunizations, etc.) even if they are related to the incident.
Only the authority having jurisdiction should submit reports for these
actions, to mitigate multiple/conflicting reports.
Handling Sensitive Information
• Release of information in this section should be carefully coordinated
within the incident management organization to ensure synchronization
with public information and investigative/intelligence actions.
• Thoroughly review the "Distribution" section in the introductory ICS 209
instructions for details on handling sensitive information. Use caution
when providing information in any situation involving fatalities, and verify
that appropriate notifications have been made prior to release of this
information. Electronic transmission of any ICS 209 may make
information available to many people and networks at once.
• Information regarding fatalities should be cleared with the Incident
Commander and/or an organizational administrator prior to submission of
the ICS 209.
Block Block Title Instructions
Number
*32 A. #This Reporting Enter the total number of responders impacted in each category for this
(continued) Period reporting period (since the previous ICS 209 was submitted).
B. Total #to Date • Enter the total number of individuals impacted in each category for the
entire duration of the incident.
• This is a cumulative total number that should be adjusted each reporting
period.
C. Indicate Number of • For lines 32D—M below, enter the number of responders relevant for
Responders Below each category.
• Responders are those personnel included as part of Unified Command
partnerships and those organizations and agencies assisting and
cooperating with response efforts.
D. Fatalities • Enter the number of confirmed responder fatalities.
• See information in introductory instructions ("Distribution") and for Block
32 regarding sensitive handling of fatality information.
E. With Injuries/Illness • Enter the number of incident responders with serious injuries or illnesses
due to the incident.
• For responders, serious injuries or illness are typically those in which the
person is unable to continue to perform in his or her incident assignment,
but the authority having jurisdiction may have additional guidelines on
reporting requirements in this area.
F. Trapped/In Need Of Enter the number of incident responders who are in trapped or in need of
Rescue rescue due to the incident.
G. Missing Enter the number of incident responders who are missing due to incident
conditions.
H. (BLANK; use however is appropriate.)
I. Sheltering in Place Enter the number of responders who are sheltering in place due to the
incident. Once responders become the victims, this needs to be noted in
Block 33 or Block 47 and handled accordingly.
J. (BLANK; use however is appropriate.)
L. Require Immunizations Enter the number of responders who require immunizations due to the
incident and/or as part of incident operations.
M. In Quarantine Enter the number of responders who are in quarantine as a direct result of
the incident and/or related to incident operations.
N. Total# Responders Enter sum totals for Columns 32A and 32B for Rows 32D—M.
Affected
33 Life, Safety, and Health • Enter any details needed for Blocks 31, 32, and 34. Enter any specific
Status/Threat Remarks comments regarding illness, injuries, fatalities, and threat management
for this incident, such as whether estimates were used for numbers given
in Block 31.
• This information should be reported as accurately as possible as a
snapshot in time, as much of the information is subject to frequent
change.
• Evacuation information can be very sensitive to local residents and
officials. Be accurate in the assessment.
• Clearly note primary responsibility and contacts for any activities or
information in Blocks 31, 32, and 34 that may be caused by the incident,
but that are being managed and/or reported by other parties.
• Provide additional explanation or information as relevant in Blocks 28,
36, 38, 40, 41, or in Remarks (Block 47).
Block Block Title Instructions
Number
*34 Life, Safety, and Health Note any details in Life, Safety, and Health Status/Threat Remarks (Block
Threat Management 33), and provide additional explanation or information as relevant in Blocks
28, 36, 38, 40, 41, or in Remarks (Block 47). Additional pages may be
necessary for notes.
A. Check if Active Check any applicable blocks in 34C—P based on currently available
information regarding incident activity and potential.
B. Notes Note any specific details, or include in Block 33.
C. No Likely Threat Check if there is no likely threat to life, health, and safety.
D. Potential Future Threat Check if there is a potential future threat to life, health, and safety.
E. Mass Notifications In • Check if there are any mass notifications in progress regarding
Progress emergency situations, evacuations, shelter in place, or other public safety
advisories related to this incident.
• These may include use of threat and alert systems such as the
Emergency Alert System or a "reverse 911" system.
• Please indicate the areas where mass notifications have been completed
(e.g., "mass notifications to ZIP codes 50201, 50014, 50010, 50011," or
"notified all residents within a 5-mile radius of Gatlinburg").
F. Mass Notifications Check if actions referred to in Block 34E above have been completed.
Completed
G. No Evacuation(s) Check if evacuations are not anticipated in the near future based on current
Imminent information.
H. Planning for Check if evacuation planning is underway in relation to this incident.
Evacuation
I. Planning for Shelter-in- Check if planning is underway for shelter-in-place activities related to this
Place incident.
J. Evacuation(s) in Check if there are active evacuations in progress in relation to this incident.
Progress
K. Shelter-In-Place in Check if there are active shelter-in-place actions in progress in relation to
Progress this incident.
L. Repopulation in Check if there is an active repopulation in progress related to this incident.
Progress
M. Mass Immunization in Check if there is an active mass immunization in progress related to this
Progress incident.
N. Mass Immunization Check if a mass immunization effort has been completed in relation to this
Complete incident.
O. Quarantine in Progress Check if there is an active quarantine in progress related to this incident.
P. Area Restriction in Check if there are any restrictions in effect, such as road or area closures,
Effect especially those noted in Block 28.
Block Block Title Instructions
Number
35 Weather Concerns • Complete a short synopsis/discussion on significant weather factors that
(synopsis of current and could cause concerns for the incident when relevant.
predicted weather; • Include current and/or predicted weather factors, and the timeframe for
discuss related factors predictions.
that may cause concern) • Include relevant factors such as:
o Wind speed (label units, such as mph).
o Wind direction (clarify and label where wind is coming from and going
to in plain language—e.g., "from NNW," "from E," or"from SW").
o Temperature (label units, such as F).
o Relative humidity(label %).
o Watches.
o Warnings.
o Tides.
o Currents.
• Any other weather information relative to the incident, such as flooding,
hurricanes, etc.
36 Projected Incident • Provide an estimate (when it is possible to do so)of the direction/scope
Activity, Potential, in which the incident is expected to spread, migrate, or expand during the
Movement, Escalation, next indicated operational period, or other factors that may cause activity
or Spread and influencing changes.
factors during the next • Discuss incident potential relative to values at risk, or values to be
operational period and in protected (such as human life), and the potential changes to those as the
12-, 24-, 48-, and 72-hour incident changes.
timeframes • Include an estimate of the acreage or area that will likely be affected.
12 hours • If known, provide the above information in 12-, 24-, 48- and 72-hour
24 hours timeframes, and any activity anticipated after 72 hours.
48 hours
72 hours
Anticipated after 72
hours
37 Strategic Objectives Briefly discuss the desired outcome for the incident based on currently
(define planned end-state available information. Note any high-level objectives and any possible
for incident) strategic benefits as well (especially for planned events).
Block Block Title Instructions
Number
ADDITIONAL INCIDENT DECISION SUPPORT INFORMATION (continued) (PAGE 3)
38 Current Incident Threat Summarize major or significant threats due to incident activity based on
Summary and Risk currently available information. Include a breakdown of threats in terms of
Information in 12-, 24-, 12-, 24-, 48-, and 72-hour timeframes.
48-, and 72-hour
timeframes and beyond.
Summarize primary
incident threats to life,
property, communities
and community stability,
residences, health care
facilities, other critical
infrastructure and key
resources, commercial
facilities, natural and
environmental resources,
cultural resources, and
continuity of operations
and/or business. Identify
corresponding incident-
related potential economic
or cascading impacts.
12 hours
24 hours
48 hours
72 hours
Anticipated after 72
hours
Block Block Title Instructions
Number
39 Critical Resource Needs • List the specific critical resources and numbers needed, in order of
in 12-, 24-, 48-, and 72- priority. Be specific as to the need.
hour timeframes and • Use plain language and common terminology for resources, and indicate
beyond to meet critical resource category, kind, and type (if available or known)to facilitate
incident objectives. List incident support.
resource category, kind, • If critical resources are listed in this block, there should be corresponding
and/or type, and amount orders placed for them through appropriate resource ordering channels.
needed, in priority order: • Provide critical resource needs in 12-, 24-, 48-and 72-hour increments.
12 hours List the most critical resources needed for each timeframe, if needs have
24 hours been identified for each timeframe. Listing critical resources by the time
they are needed gives incident support personnel a "heads up"for short-
48 hours range planning, and assists the ordering process to ensure these
72 hours resources will be in place when they are needed.
Anticipated after 72 • More than one resource need may be listed for each timeframe. For
hours example, a list could include:
O 24 hrs: 3 Type 2 firefighting helicopters, 2 Type I Disaster Medical
Assistance Teams
O 48 hrs: Mobile Communications Unit(Law/Fire)
o After 72 hrs: 1 Type 2 Incident Management Team
• Documentation in the ICS 209 can help the incident obtain critical
regional or national resources through outside support mechanisms
including multiagency coordination systems and mutual aid.
o Information provided in other blocks on the ICS 209 can help to
support the need for resources, including Blocks 28, 29, 31-38, and
40-42.
o Additional comments in the Remarks section (Block 47) can also help
explain what the incident is requesting and why it is critical (for
example, "Type 2 Incident Management Team is needed in three
days to transition command when the current Type 2 Team times
out").
• Do not use this block for noncritical resources.
40 Strategic Discussion: • Wording should be consistent with Block 39 to justify critical resource
Explain the relation of needs, which should relate to planned actions in the Incident Action Plan.
overall strategy, • Give a short assessment of the likelihood of meeting the incident
constraints, and current management targets, given the current management strategy and
available information to: currently known constraints.
1) critical resource needs • Identify when the chosen management strategy will succeed given the
identified above, current constraints. Adjust the anticipated incident management
2)the Incident Action Plan completion target in Block 43 as needed based on this discussion.
and management • Explain major problems and concerns as indicated.
objectives and targets,
3) anticipated results.
Explain major problems
and concerns such as
operational challenges,
incident management
problems, and social,
political, economic, or
environmental concerns
or impacts.
Block Block Title Instructions
Number
41 Planned Actions for • Provide a short summary of actions planned for the next operational
Next Operational Period period.
• Examples:
o "The current Incident Management Team will transition out to a
replacement IMT."
o "Continue to review operational/engineering plan to facilitate removal
of the partially collapsed west bridge supports."
o "Continue refining mapping of the recovery operations and damaged
assets using GPS."
o "Initiate removal of unauthorized food vendors."
42 Projected Final Incident • Enter an estimate of the total area likely to be involved or affected over
Size/Area (use unit label the course of the incident.
-e.g., "sq mi") • Label the estimate of the total area or population involved, affected, or
impacted with the relevant units such as acres, hectares, square miles,
etc.
• Note that total area involved may not be limited to geographic area (see
previous discussions regarding incident definition, scope, operations, and
objectives). Projected final size may involve a population rather than a
geographic area.
43 Anticipated Incident • Enter the date (month/day/year) at which time it is expected that incident
Management objectives will be met. This is often explained similar to incident
Completion Date containment or control, or the time at which the incident is expected to be
closed or when significant incident support will be discontinued.
• Avoid leaving this block blank if possible, as this is important information
for managers.
44 Projected Significant Enter the date (month/day/year)when initiation of significant resource
Resource demobilization is anticipated.
Demobilization Start
Date
45 Estimated Incident • Enter the estimated total incident costs to date for the entire incident
Costs to Date based on currently available information.
• Incident costs include estimates of all costs for the response, including all
management and support activities per discipline, agency, or
organizational guidance and policy.
• This does not include damage assessment figures, as they are impacts
from the incident and not response costs.
• If costs decrease, explain in Remarks (Block 47).
• If additional space is required, please add as an attachment.
46 Projected Final Incident • Enter an estimate of the total costs for the incident once all costs have
Cost Estimate been processed based on current spending and projected incident
potential, per discipline, agency, or organizational guidance and policy.
This is often an estimate of daily costs combined with incident potential
information.
• This does not include damage assessment figures, as they are impacts
from the incident and not response costs.
• If additional space is required, please add as an attachment.
Block Block Title Instructions
Number
47 Remarks (or continuation • Use this block to expand on information that has been entered in
of any blocks above—list previous blocks, or to include other pertinent information that has not
block number in notation) been previously addressed.
• List the block number for any information continued from a previous
block.
• Additional information may include more detailed weather information,
specifics on injuries or fatalities, threats to critical infrastructure or other
resources, more detailed evacuation site locations and number of
evacuated, information or details regarding incident cause, etc.
• For Complexes that include multiple incidents, list all sub-incidents
included in the Complex.
• List jurisdictional or ownership breakdowns if needed when an incident is
in more than one jurisdiction and/or ownership area. Breakdown may be:
o By size (e.g., 35 acres in City of Gatlinburg, 250 acres in Great Smoky
Mountains), and/or
o By geography(e.g., incident area on the west side of the river is in
jurisdiction of City of Minneapolis; area on east side of river is City of
St. Paul jurisdiction; river is joint jurisdiction with USACE).
• Explain any reasons for incident size reductions or adjustments (e.g.,
reduction in acreage due to more accurate mapping).
• This section can also be used to list any additional information about the
incident that may be needed by incident support mechanisms outside the
incident itself. This may be basic information needed through
multiagency coordination systems or public information systems (e.g., a
public information phone number for the incident, or the incident Web site
address).
• Attach additional pages if it is necessary to include additional comments
in the Remarks section.
INCIDENT RESOURCE COMMITMENT SUMMARY (PAGE 4)
• This last/fourth page of the ICS 209 can be copied and used if needed to accommodate additional resources,
agencies, or organizations. Write the actual page number on the pages as they are used.
• Include only resources that have been assigned to the incident and that have arrived and/or been checked in to the
incident. Do not include resources that have been ordered but have not yet arrived.
For summarizing:
• When there are large numbers of responders, it may be helpful to group agencies or organizations together. Use
the approach that works best for the multiagency coordination system applicable to the incident. For example,
o Group State, local, county, city, or Federal responders together under such headings, or
o Group resources from one jurisdiction together and list only individual jurisdictions (e.g., list the public works,
police, and fire department resources for a city under that city's name).
• On a large incident, it may also be helpful to group similar categories, kinds, or types of resources together for this
summary.
Block Block Title Instructions
Number
48 Agency or Organization • List the agencies or organizations contributing resources to the incident
as responders, through mutual aid agreements, etc.
• List agencies or organizations using clear language so readers who may
not be from the discipline or host jurisdiction can understand the
information.
• Agencies or organizations may be listed individually or in groups.
• When resources are grouped together, individual agencies or
organizations may be listed below in Block 53.
• Indicate in the rows under Block 49 how many resources are assigned to
the incident under each resource identified.
o These can listed with the number of resources on the top of the box,
and the number of personnel associated with the resources on the
bottom half of the box.
o For example:
• Resource: Type 2 Helicopters... 3/8 (indicates 3 aircraft, 8
personnel).
• Resource: Type 1 Decontamination Unit... 1/3 (indicates 1 unit, 3
personnel).
• Indicate in the rows under Block 51 the total number of personnel
assigned for each agency listed under Block 48, including both individual
overhead and those associated with other resources such as fire
engines, decontamination units, etc.
49 Resources (summarize • List resources using clear language when possible—so ICS 209 readers
resources by category, who may not be from the discipline or host jurisdiction can understand
kind, and/or type; show# the information.
of resources on top 1/2 of o Examples: Type 1 Fire Engines, Type 4 Helicopters
box, show#of personnel • Enter total numbers in columns for each resource by agency,
associated with resource organization, or grouping in the proper blocks.
on bottom 1/2 of box) o These can listed with the number of resources on the top of the box,
and the number of personnel associated with the resources on the
bottom half of the box.
o For example:
• Resource: Type 2 Helicopters... 3/8 (indicates 3 aircraft, 8
personnel).
• Resource: Type 1 Decontamination Unit... 1/3 (indicates 1 unit, 3
personnel).
• NOTE: One option is to group similar resources together when it is
sensible to do so for the summary.
o For example, do not list every type of fire engine— rather, it may be
advisable to list two generalized types of engines, such as "structure
fire engines" and "wildland fire engines" in separate columns with
totals for each.
• NOTE: It is not advisable to list individual overhead personnel
individually in the resource section, especially as this form is intended as
a summary. These personnel should be included in the Total Personnel
sums in Block 51.
50 Additional Personnel not List the number of additional individuals (or overhead) that are not assigned
assigned to a resource to a specific resource by agency or organization.
51 Total Personnel • Enter the total personnel for each agency, organization, or grouping in
(includes those the Total Personnel column.
associated with resources • WARNING: Do not simply add the numbers across!
—e.g., aircraft or engines • The number of Total Personnel for each row should include both:
—and individual o The total number of personnel assigned to each of the resources
overhead) listed in Block 49, and
o The total number of additional individual overhead personnel from
each agency, organization, or group listed in Block 50.
Block Block Title Instructions
Number
52 Total Resources Include the sum total of resources for each column, including the total for the
column under Blocks 49, 50, and 51. This should include the total number
of resources in Block 49, as personnel totals will be counted under Block 51.
53 Additional Cooperating • List all agencies and organizations that are not directly involved in the
and Assisting incident, but are providing support.
Organizations Not • Examples may include ambulance services, Red Cross, DHS, utility
Listed Above companies, etc.
• Do not repeat any resources counted in Blocks 48-52, unless
explanations are needed for groupings created under Block 48 (Agency
or Organization).
RESOURCE STATUS CHANGE (ICS 210)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Resource 4. New Status 5. From (Assignment 6. To (Assignment and 7. Time and Date of Change:
Number (Available, and Status): Status):
Assigned, O/S)
8. Comments:
9. Prepared by: Name: Position/Title: Signature:
ICS 210 I Date/Time:
ICS 210
Resource Status Change
Purpose. The Resource Status Change (ICS 210) is used by the Incident Communications Center Manager to record
status change information received on resources assigned to the incident. This information could be transmitted with a
General Message (ICS 213). The form could also be used by Operations as a worksheet to track entry, etc.
Preparation. The ICS 210 is completed by radio/telephone operators who receive status change information from
individual resources, Task Forces, Strike Teams, and Division/Group Supervisors. Status information could also be
reported by Staging Area and Helibase Managers and fixed-wing facilities.
Distribution. The ICS 210 is maintained by the Communications Unit and copied to Resources Unit and filed by
Documentation Unit.
Notes:
• The ICS 210 is essentially a message form that can be used to update Resource Status Cards or T-Cards (ICS 219)
for incident-level resource management.
• If additional pages are needed, use a blank ICS 210 and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour clock)
• Date and Time From and end date and time for the operational period to which the form applies.
• Date and Time To
3 Resource Number Enter the resource identification (ID) number(this may be a letter and
number combination) assigned by either the sending unit or the incident.
4 New Status (Available, Indicate the current status of the resource:
Assigned, Out of Service) • Available— Indicates resource is available for incident use immediately.
• Assigned— Indicates resource is checked in and assigned a work task
on the incident.
• Out of Service— Indicates resource is assigned to the incident but
unable to respond for mechanical, rest, or personnel reasons. If space
permits, indicate the estimated time of return (ETR). It may be useful to
indicate the reason a resource is out of service (e.g., "O/S— Mech" (for
mechanical issues), "O/S— Rest" (for off shift), or"O/S— Pers" (for
personnel issues).
5 From (Assignment and Indicate the current location of the resource (where it came from) and the
Status) status. When more than one Division, Staging Area, or Camp is used,
identify the specific location (e.g., Division A, Staging Area, Incident
Command Post, Western Camp).
6 To (Assignment and Status) Indicate the assigned incident location of the resource and status. When
more than one Division, Staging Area, or Camp is used, identify the
specific location.
7 Time and Date of Change Enter the time and location of the status change (24-hour clock). Enter the
date as well if relevant(e.g., out of service).
8 Comments Enter any special information provided by the resource or dispatch center.
This may include details about why a resource is out of service, or
individual identifying designators (IDs) of Strike Teams and Task Forces.
9 Prepared by Enter the name, ICS position/title, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour clock).
• Position/Title
• Signature
• Date/Time
INCIDENT CHECK-IN LIST (ICS 211)
1. Incident Name: 2. Incident Number: 3. Check-In Location (complete all that apply): 4. Start Date/Time:
Base Staging Area 11ICP ElHelibase Other Date:
Time:
Check-In Information (use reverse of form for remarks or comments)
5. List single resource .E w
a1 c
personnel (overhead) by 4 w E o o
agency and name, o w L •c > 0) c
OR list resources by the a) E a) o o a° a� I N 0
co o = N _ -a .—
following format: a a1 Z o c c E o Q 1 a o
E .r D L5 �. o
E co I- z a� a1 -t o a" a 0
) LL L H C a1 C co E >+ Q .+ L
U 0 D E ,_ r Y R 4- o C1 E o V a) d c 5 al 3
N c O i 10 V N O y L 2 0 d O 0 0
o m v1
m 0) C C >, a�i m O 0 a) J y o '~ csi as ri v cri cc m
co < 0 Y H � Z u) Qp hV ac Oid , Q , 0 .- r rre
ICS 211 17. Prepared by: Name: Position/Title: Signature: Date/Time:
ICS 211
Incident Check-In List
Purpose. Personnel and equipment arriving at the incident can check in at various incident locations. Check-in consists
of reporting specific information, which is recorded on the Check-In List(ICS 211). The ICS 211 serves several purposes,
as it: (1) records arrival times at the incident of all overhead personnel and equipment, (2) records the initial location of
personnel and equipment to facilitate subsequent assignments, and (3) supports demobilization by recording the home
base, method of travel, etc., for resources checked in.
Preparation. The ICS 211 is initiated at a number of incident locations including: Staging Areas, Base, and Incident
Command Post(ICP). Preparation may be completed by: (1)overhead at these locations, who record the information
and give it to the Resources Unit as soon as possible, (2)the Incident Communications Center Manager located in the
Communications Center, who records the information and gives it to the Resources Unit as soon as possible, (3) a
recorder from the Resources Unit during check-in to the ICP. As an option, the ICS 211 can be printed on colored paper
to match the designated Resource Status Card (ICS 219) colors. The purpose of this is to aid the process of completing a
large volume of ICS 219s. The ICS 219 colors are:
• 219-1: Header Card—Gray(used only as label cards for T-Card racks)
• 219-2: Crew/Team Card—Green
• 219-3: Engine Card— Rose
• 219-4: Helicopter Card— Blue
• 219-5: Personnel Card—White
• 219-6: Fixed-Wing Card —Orange
• 219-7: Equipment Card—Yellow
• 219-8: Miscellaneous Equipment/Task Force Card—Tan
• 219-10: Generic Card— Light Purple
Distribution. ICS 211s, which are completed by personnel at the various check-in locations, are provided to the
Resources Unit, Demobilization Unit, and Finance/Administration Section. The Resources Unit maintains a master list of
all equipment and personnel that have reported to the incident.
Notes:
• Also available as 8'/2 x 14 (legal size) or 11 x 17 chart.
• Use reverse side of form for remarks or comments.
• If additional pages are needed for any form page, use a blank ICS 211 and repaginate as needed.
• Contact information for sender and receiver can be added for communications purposes to confirm resource orders.
Refer to 213RR example (Appendix B)
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Incident Number Enter the number assigned to the incident.
3 Check-In Location Check appropriate box and enter the check-in location for the incident.
❑Base Indicate specific information regarding the locations under each
❑Staging Area checkbox. ICP is for Incident Command Post.
❑ ICP Other may include...
❑Helibase
❑Other
4 Start Date/Time Enter the date (month/day/year) and time (using the 24-hour clock)that
• Date the form was started.
• Time
Block Block Title Instructions
Number
Check-In Information Self explanatory.
5 List single resource Enter the following information for resources:
personnel (overhead) by OPTIONAL: Indicate if resource is a single resource versus part of Strike
agency and name, OR list Team or Task Force. Fields can be left blank if not necessary.
resources by the following
format
• State Use this section to list the home State for the resource.
• Agency Use this section to list agency name (or designator), and individual
names for all single resource personnel (e.g., ORC, ARL, NYPD).
• Category Use this section to list the resource category based on NIMS, discipline,
or jurisdiction guidance.
• Kind Use this section to list the resource kind based on NIMS, discipline, or
jurisdiction guidance.
• Type Use this section to list the resource type based on NIMS, discipline, or
jurisdiction guidance.
• Resource Name or Use this section to enter the resource name or unique identifier. If it is a
Identifier Strike Team or a Task Force, list the unique Strike Team or Task Force
identifier(if used) on a single line with the component resources of the
Strike Team or Task Force listed on the following lines. For example, for
an Engine Strike Team with the call sign "XLT459" show"XLT459" in this
box and then in the next five rows, list the unique identifier for the five
engines assigned to the Strike Team.
• ST or TF Use ST or TF to indicate whether the resource is part of a Strike Team or
Task Force. See above for additional instructions.
6 Order Request# The order request number will be assigned by the agency dispatching
resources or personnel to the incident. Use existing protocol as
appropriate for the jurisdiction and/or discipline, since several incident
numbers may be used for the same incident.
7 Date/Time Check-In Enter date (month/day/year) and time of check-in (24-hour clock)to the
incident.
8 Leader's Name • For equipment, enter the operator's name.
• Enter the Strike Team or Task Force leader's name.
• Leave blank for single resource personnel (overhead).
9 Total Number of Personnel Enter total number of personnel associated with the resource. Include
leaders.
10 Incident Contact Enter available contact information (e.g., radio frequency, cell phone
Information number, etc.)for the incident.
11 Home Unit or Agency Enter the home unit or agency to which the resource or individual is
normally assigned (may not be departure location).
12 Departure Point, Date and Enter the location from which the resource or individual departed for this
Time incident. Enter the departure time using the 24-hour clock.
13 Method of Travel Enter the means of travel the individual used to bring himself/herself to
the incident(e.g., bus, truck, engine, personal vehicle, etc.).
14 Incident Assignment Enter the incident assignment at time of dispatch.
15 Other Qualifications Enter additional duties (ICS positions) pertinent to the incident that the
resource/individual is qualified to perform. Note that resources should not
be reassigned on the incident without going through the established
ordering process. This data may be useful when resources are
demobilized and remobilized for another incident.
Block Block Title Instructions
Number
16 Data Provided to Enter the date and time that the information pertaining to that entry was
Resources Unit transmitted to the Resources Unit, and the initials of the person who
transmitted the information.
17 Prepared by Enter the name, ICS position/title, and signature of the person preparing
• Name the form. Enter date (month/day/year)and time prepared (24-hour clock).
• Position/Title
• Signature
• Date/Time
GENERAL MESSAGE (ICS 213)
1. Incident Name (Optional):
2. To (Name and Position):
3. From (Name and Position):
4. Subject: 5. Date: 6. Time
7. Message:
8. Approved by: Name: Signature: Position/Title:
9. Reply:
10. Replied by: Name: Position/Title: Signature:
ICS 213 I Date/Time:
ICS 213
General Message
Purpose. The General Message (ICS 213) is used by the incident dispatchers to record incoming messages that cannot
be orally transmitted to the intended recipients. The ICS 213 is also used by the Incident Command Post and other
incident personnel to transmit messages (e.g., resource order, incident name change, other ICS coordination issues, etc.)
to the Incident Communications Center for transmission via radio or telephone to the addressee. This form is used to
send any message or notification to incident personnel that requires hard-copy delivery.
Preparation. The ICS 213 may be initiated by incident dispatchers and any other personnel on an incident.
Distribution. Upon completion, the ICS 213 may be delivered to the addressee and/or delivered to the Incident
Communication Center for transmission.
Notes:
• The ICS 213 is a three-part form, typically using carbon paper. The sender will complete Part 1 of the form and send
Parts 2 and 3 to the recipient. The recipient will complete Part 2 and return Part 3 to the sender.
• A copy of the ICS 213 should be sent to and maintained within the Documentation Unit.
• Contact information for the sender and receiver can be added for communications purposes to confirm resource
orders. Refer to 213RR example (Appendix B)
Block Block Title Instructions
Number
1 Incident Name (Optional) Enter the name assigned to the incident. This block is optional.
2 To (Name and Position) Enter the name and position the General Message is intended for. For
all individuals, use at least the first initial and last name. For Unified
Command, include agency names.
3 From (Name and Position) Enter the name and position of the individual sending the General
Message. For all individuals, use at least the first initial and last name.
For Unified Command, include agency names.
4 Subject Enter the subject of the message.
5 Date Enter the date (month/day/year)of the message.
6 Time Enter the time (using the 24-hour clock)of the message.
7 Message Enter the content of the message. Try to be as concise as possible.
8 Approved by Enter the name, signature, and ICS position/title of the person
• Name approving the message.
• Signature
• Position/Title
9 Reply The intended recipient will enter a reply to the message and return it to
the originator.
10 Replied by Enter the name, ICS position/title, and signature of the person replying
• Name to the message. Enter date (month/day/year)and time prepared (24-
• Position/Title hour clock).
• Signature
• Date/Time
RESOURCE REQUEST MESSAGE (ICS 213 RR)
1. Incident Name: 2. Date/Time 3. Resource Request Number:
4. Order(Use additional forms when requesting different resource sources of supply.):
Qty. Kind Type Detailed Item Description: (Vital characteristics, brand, specs, Arrival Date and Time Cost
experience, size, etc.) Requested Estimated
L
0
U)
d
Nd
LPL
5. Requested Delivery/Reporting Location:
6. Suitable Substitutes and/or Suggested Sources:
7. Requested by Name/Position: 8. Priority:❑Urgent DRoutine OLow 9. Section Chief Approval:
10. Logistics Order Number: 11. Supplier Phone/Fax/Email:
12. Name of Supplier/POC:
13. Notes:
a)
0
J
14. Approval Signature of Auth Logistics Rep: 15. Date/Time:
16. Order placed by (check box):OSPUL OPROC
17. Reply/Comments from Finance:
C
L
18. Finance Section Signature: 19. Date/Time:
ICS 213 RR, Page 1
ACTIVITY LOG (ICS 214)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
3. Name: 4. ICS Position: 5. Home Agency (and Unit):
6. Resources Assigned:
Name ICS Position Home Agency(and Unit)
7. Activity Log:
Date/Time Notable Activities
•
•
•
8. Prepared by: Name: Position/Title: Signature:
ICS 214, Page 1 Date/Time:
ACTIVITY LOG (ICS 214)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
7. Activity Log (continuation):
Date/Time Notable Activities
8. Prepared by: Name: Position/Title: Signature:
ICS 214, Page 2 Date/Time:
ICS 214
Activity Log
Purpose. The Activity Log (ICS 214) records details of notable activities at any ICS level, including single resources,
equipment, Task Forces, etc. These logs provide basic incident activity documentation, and a reference for any after-
action report.
Preparation. An ICS 214 can be initiated and maintained by personnel in various ICS positions as it is needed or
appropriate. Personnel should document how relevant incident activities are occurring and progressing, or any notable
events or communications.
Distribution. Completed ICS 214s are submitted to supervisors, who forward them to the Documentation Unit. All
completed original forms must be given to the Documentation Unit, which maintains a file of all ICS 214s. It is
recommended that individuals retain a copy for their own records.
Notes:
• The ICS 214 can be printed as a two-sided form.
• Use additional copies as continuation sheets as needed, and indicate pagination as used.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour clock)
• Date and Time From and end date and time for the operational period to which the form
• Date and Time To applies.
3 Name Enter the title of the organizational unit or resource designator(e.g.,
Facilities Unit, Safety Officer, Strike Team).
4 ICS Position Enter the name and ICS position of the individual in charge of the Unit.
5 Home Agency (and Unit) Enter the home agency of the individual completing the ICS 214. Enter
a unit designator if utilized by the jurisdiction or discipline.
6 Resources Assigned Enter the following information for resources assigned:
• Name Use this section to enter the resource's name. For all individuals, use at
least the first initial and last name. Cell phone number for the individual
can be added as an option.
• ICS Position Use this section to enter the resource's ICS position (e.g., Finance
Section Chief).
• Home Agency(and Unit) Use this section to enter the resource's home agency and/or unit (e.g.,
Des Moines Public Works Department, Water Management Unit).
7 Activity Log • Enter the time (24-hour clock) and briefly describe individual notable
• Date/Time activities. Note the date as well if the operational period covers
• Notable Activities more than one day.
• Activities described may include notable occurrences or events such
as task assignments, task completions, injuries, difficulties
encountered, etc.
• This block can also be used to track personal work habits by adding
columns such as "Action Required," "Delegated To," "Status," etc.
8 Prepared by Enter the name, ICS position/title, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour
• Position/Title clock).
• Signature
• Date/Time
OPERATIONAL PLANNING WORKSHEET (ICS 215)
1. Incident Name: 2. Operational Period: Date From: Date To:
Time From: Time To:
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11. Total Resources 14. Prepared by:
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12. Total Resources Position/Title:
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Signature:
13. Total Resources
ICS 215 Need To Order Date/Time:
ICS 215
Operational Planning Worksheet
Purpose. The Operational Planning Worksheet(ICS 215) communicates the decisions made by the Operations Section
Chief during the Tactics Meeting concerning resource assignments and needs for the next operational period. The ICS
215 is used by the Resources Unit to complete the Assignment Lists (ICS 204) and by the Logistics Section Chief for
ordering resources for the incident.
Preparation. The ICS 215 is initiated by the Operations Section Chief and often involves logistics personnel, the
Resources Unit, and the Safety Officer. The form is shared with the rest of the Command and General Staffs during the
Planning Meeting. It may be useful in some disciplines or jurisdictions to prefill ICS 215 copies prior to incidents.
Distribution. When the Branch, Division, or Group work assignments and accompanying resource allocations are agreed
upon, the form is distributed to the Resources Unit to assist in the preparation of the ICS 204. The Logistics Section will
use a copy of this worksheet for preparing requests for resources required for the next operational period.
Notes:
• This worksheet can be made into a wall mount.
• Also available as 8%x 14 (legal size) and 11 x 17 chart.
• If additional pages are needed, use a blank ICS 215 and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year)and time (using the 24-hour clock)
• Date and Time From and end date and time for the operational period to which the form applies.
• Date and Time To
3 Branch Enter the Branch of the work assignment for the resources.
4 Division, Group, or Other Enter the Division, Group, or other location (e.g., Staging Area) of the work
assignment for the resources.
5 Work Assignment& Enter the specific work assignments given to each of the Divisions/Groups
Special Instructions and any special instructions, as required.
6 Resources Complete resource headings for category, kind, and type as appropriate for
the incident. The use of a slash indicates a single resource in the upper
portion of the slash and a Strike Team or Task Force in the bottom portion
of the slash.
• Required Enter, for the appropriate resources, the number of resources by type
(engine, squad car, Advanced Life Support ambulance, etc.) required to
perform the work assignment.
• Have Enter, for the appropriate resources, the number of resources by type
(engines, crew, etc.) available to perform the work assignment.
• Need Enter the number of resources needed by subtracting the number in the
"Have" row from the number in the "Required" row.
7 Overhead Position(s) List any supervisory and nonsupervisory ICS position(s) not directly
assigned to a previously identified resource (e.g., Division/Group
Supervisor, Assistant Safety Officer, Technical Specialist, etc.).
8 Special Equipment& List special equipment and supplies, including aviation support, used or
Supplies needed. This may be a useful place to monitor span of control.
9 Reporting Location Enter the specific location where the resources are to report (Staging Area,
location at incident, etc.).
10 Requested Arrival Time Enter the time (24-hour clock)that resources are requested to arrive at the
reporting location.
Block Block Title Instructions
Number
11 Total Resources Required Enter the total number of resources required by category/kind/type as
preferred (e.g., engine, squad car, ALS ambulance, etc.). A slash can be
used again to indicate total single resources in the upper portion of the
slash and total Strike Teams/Task Forces in the bottom portion of the
slash.
12 Total Resources Have on Enter the total number of resources on hand that are assigned to the
Hand incident for incident use. A slash can be used again to indicate total single
resources in the upper portion of the slash and total Strike Teams/Task
Forces in the bottom portion of the slash.
13 Total Resources Need To Enter the total number of resources needed. A slash can be used again to
Order indicate total single resources in the upper portion of the slash and total
Strike Teams/Task Forces in the bottom portion of the slash.
14 Prepared by Enter the name, ICS position, and signature of the person preparing the
• Name form. Enter date (month/day/year) and time prepared (24-hour clock).
• Position/Title
• Signature
• Date/Time
INCIDENT ACTION PLAN SAFETY ANALYSIS (ICS 215A)
1. Incident Name: 2. Incident Number:
3. Date/Time Prepared: 4. Operational Period: Date From: Date To:
Date: Time: Time From: Time To:
5. Incident Area 6. Hazards/Risks 7. Mitigations
8. Prepared by (Safety Officer): Name: Signature:
Prepared by (Operations Section Chief): Name: Signature:
ICS 215A Date/Time:
ICS 215A
Incident Action Plan Safety Analysis
Purpose. The purpose of the Incident Action Plan Safety Analysis (ICS 215A) is to aid the Safety Officer in completing an
operational risk assessment to prioritize hazards, safety, and health issues, and to develop appropriate controls. This
worksheet addresses communications challenges between planning and operations, and is best utilized in the planning
phase and for Operations Section briefings.
Preparation. The ICS 215A is typically prepared by the Safety Officer during the incident action planning cycle. When
the Operations Section Chief is preparing for the tactics meeting, the Safety Officer collaborates with the Operations
Section Chief to complete the Incident Action Plan Safety Analysis. This worksheet is closely linked to the Operational
Planning Worksheet (ICS 215). Incident areas or regions are listed along with associated hazards and risks. For those
assignments involving risks and hazards, mitigations or controls should be developed to safeguard responders, and
appropriate incident personnel should be briefed on the hazards, mitigations, and related measures. Use additional
sheets as needed.
Distribution. When the safety analysis is completed, the form is distributed to the Resources Unit to help prepare the
Operations Section briefing. All completed original forms must be given to the Documentation Unit.
Notes:
• This worksheet can be made into a wall mount, and can be part of the IAP.
• If additional pages are needed, use a blank ICS 215A and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Incident Number Enter the number assigned to the incident.
3 Date/Time Prepared Enter date (month/day/year)and time (using the 24-hour clock)
prepared.
4 Operational Period Enter the start date (month/day/year) and time (24-hour clock) and end
• Date and Time From date and time for the operational period to which the form applies.
• Date and Time To
5 Incident Area Enter the incident areas where personnel or resources are likely to
encounter risks. This may be specified as a Branch, Division, or
Group.
6 Hazards/Risks List the types of hazards and/or risks likely to be encountered by
personnel or resources at the incident area relevant to the work
assignment.
7 Mitigations List actions taken to reduce risk for each hazard indicated (e.g.,
specify personal protective equipment or use of a buddy system or
escape routes).
8 Prepared by (Safety Officer and Enter the name of both the Safety Officer and the Operations Section
Operations Section Chief) Chief, who should collaborate on form preparation. Enter date
• Name (month/day/year) and time (24-hour clock) reviewed.
• Signature
• Date/Time
Frequency Band Description
COMMUNICATIONS RESOURCE AVAILABILITY WORKSHEET
Pg Channel Channel Name/Trunked Mode
Eligible Users RX Freq N or W RX Tone/NAC TX Freq N or W Tx Tone/NAC Remarks
No Configuration Radio System Talkgroup A, D or M
The convention calls for frequency lists to show four digits after the decimal place,followed by either an "N" or a "W", depending on whether the frequency is
narrow or wide band. Mode refers to either"A" or"D" indicating analog or digital (e.g. Project 25)or"M" indicating mixed mode. All channels are shown
as if programmed in a control station, mobile or portable radio. Repeater and base stations must be programmed with the Rx and Tx reversed.
ICS 217A Excel 3/2007
SUPPORT VEHICLE/EQUIPMENT INVENTORY (ICS 218)
1. Incident Name: 2. Incident Number: 3. Date/Time Prepared: 4. Vehicle/Equipment Category:
Date: Time:
5. Vehicle/Equipment Information
Category/ Incident
Order Vehicle or Vehicle or Kind/Type, Vehicle or Agency Operator Vehicle Incident Release
Request Incident Equipment Equipment Capacity, or Equipment or Name or License or Incident Start Date Date and
Number ID No. Classification Make Size Features Owner Contact ID No. Assignment and Time Time
ICS 218 6. Prepared by: Name: Position/Title: Signature:
ICS 218
Support Vehicle/Equipment Inventory
Purpose. The Support Vehicle/Equipment Inventory(ICS 218) provides an inventory of all transportation and support
vehicles and equipment assigned to the incident. The information is used by the Ground Support Unit to maintain a
record of the types and locations of vehicles and equipment on the incident. The Resources Unit uses the information to
initiate and maintain status/resource information.
Preparation. The ICS 218 is prepared by Ground Support Unit personnel at intervals specified by the Ground Support
Unit Leader.
Distribution. Initial inventory information recorded on the form should be given to the Resources Unit. Subsequent
changes to the status or location of transportation and support vehicles and equipment should be provided to the
Resources Unit immediately.
Notes:
• If additional pages are needed, use a blank ICS 218 and repaginate as needed.
• Also available as 8%x 14 (legal size) and 11 x 17 chart.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Incident Number Enter the number assigned to the incident.
3 Date/Time Prepared Enter the date (month/day/year) and time (using the 24-hour clock)the form
is prepared.
4 Vehicle/Equipment Enter the specific vehicle or equipment category(e.g., buses, generators,
Category dozers, pickups/sedans, rental cars, etc.). Use a separate sheet for each
vehicle or equipment category.
5 Vehicle/Equipment Record the following information:
Information
Order Request Number Enter the order request number for the resource as used by the jurisdiction or
discipline, or the relevant EMAC order request number.
Incident Identification Enter any special incident identification numbers or agency radio identifier
Number assigned to the piece of equipment used only during the incident, if this
system if used (e.g., "Decontamination Unit 2,"or"Water Tender 14").
Vehicle or Equipment Enter the specific vehicle or equipment classification (e.g., bus, backhoe,
Classification Type 2 engine, etc.) as relevant.
Vehicle or Equipment Enter the vehicle or equipment manufacturer name (e.g., "GMC,"
Make "International").
Category/Kind/Type, Enter the vehicle or equipment category/kind/type, capacity, or size (e.g., 30-
Capacity, or Size person bus, 3/4-ton truck, 50 kW generator).
Vehicle or Equipment Indicate any vehicle or equipment features such as 2WD, 4WD, towing
Features capability, number of axles, heavy-duty tires, high clearance, automatic
vehicle locator(AVL), etc.
Agency or Owner Enter the name of the agency or owner of the vehicle or equipment.
Operator Name or Contact Enter the operator name and/or contact information (cell phone, radio
frequency, etc.).
Vehicle License or Enter the license plate number or another identification number(such as a
Identification Number serial or rig number) of the vehicle or equipment.
Incident Assignment Enter where the vehicle or equipment will be located at the incident and its
function (use abbreviations per discipline or jurisdiction).
Block Block Title Instructions
Number
5 Incident Start Date and Indicate start date (month/day/year) and time (using the 24-hour clock)for
(continued) Time driver or for equipment as may be relevant.
Incident Release Date and Enter the date (month/day/year) and time (using the 24-hour clock)the
Time vehicle or equipment is released from the incident.
6 Prepared by Enter the name, ICS position/title, and signature of the person preparing the
• Name form.
• Position/Title
• Signature
ICS 219
Resource Status Card (T-Card)
Purpose. Resource Status Cards (ICS 219) are also known as "T-Cards," and are used by the Resources Unit to record
status and location information on resources, transportation, and support vehicles and personnel. These cards provide a
visual display of the status and location of resources assigned to the incident.
Preparation. Information to be placed on the cards may be obtained from several sources including, but not limited to:
• Incident Briefing (ICS 201).
• Incident Check-In List(ICS 211).
• General Message (ICS 213).
• Agency-supplied information or electronic resource management systems.
Distribution. ICS 219s are displayed in resource status or"T-Card" racks where they can be easily viewed, retrieved,
updated, and rearranged. The Resources Unit typically maintains cards for resources assigned to an incident until
demobilization. At demobilization, all cards should be turned in to the Documentation Unit.
Notes. There are eight different status cards (see list below)and a header card, to be printed front-to-back on cardstock.
Each card is printed on a different color of cardstock and used for a different resource category/kind/type. The format and
content of information on each card varies depending upon the intended use of the card.
• 219-1: Header Card—Gray(used only as label cards for T-Card racks)
• 219-2: Crew/Team Card— Green
• 219-3: Engine Card— Rose
• 219-4: Helicopter Card— Blue
• 219-5: Personnel Card—White
• 219-6: Fixed-Wing Card—Orange
• 219-7: Equipment Card—Yellow
• 219-8: Miscellaneous Equipment/Task Force Card —Tan
• 219-10: Generic Card—Light Purple
Acronyms. Abbreviations utilized on the cards are listed below:
• AOV: Agency-owned vehicle
• ETA: Estimated time of arrival
• ETD: Estimated time of departure
• ETR: Estimated time of return
• 0/S Mech: Out-of-service for mechanical reasons
• 0/S Pers: Out-of-service for personnel reasons
• 0/S Rest: Out-of-service for rest/recuperation purposes/guidelines, or due to operating time limits/policies for pilots,
operators, drivers, equipment, or aircraft
• POV: Privately owned vehicle
[ [
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-1 HEADER CARD (GRAY) ICS 219-1 HEADER CARD (GRAY)
ICS 219-1: Header Card
Block Titl:- lnstructio
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front Back
Date/Time Checked In: Incident Location: Time:
Leader Name: Status:
❑Assigned 00/S Rest ❑O/S Pers
Primary Contact Information: [Available ❑O/S Mech ❑ETR:
Notes:
Crew/Team ID#(s)or Name(s):
Incident Location: Time:
Status:
Assigned ❑O/S Rest ❑O/S Pers
Manifest: Total Weight: ❑Available ❑O/S Mech ❑ETR:
EYes ❑No Notes:
Method of Travel to Incident:
❑AOV ❑POV us [Air [Other
Home Base:
Incident Location: Time:
Departure Point:
ETD: ETA:
Status:
Transportation Needs at Incident: I El
❑O/S Rest ❑0/S Pers
❑Vehicle ❑Bus [Air [Other nAvailable n0/S Mech nETR:
Notes:
Date/Time Ordered:
Remarks:
Incident Location: Time:
Status:
[Assigned IJ0/S Rest ❑0/S Pers
[Available ❑O/S Mech laTR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-2 CREW/TEAM (GREEN) ICS 219-2 CREW/TEAM (GREEN)
ICS 219-2: Crew/Team Card
lock Tit nstructions
ST/Unit Enter the State and/or unit identifier(3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available workday that the resource is allowed to work
# Pers Enter total number of personnel associated with the crew/team. Include leaders.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline, since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID# Use this section to enter the resource name or unique identifier(e.g., 13, Bluewater,
Utility 32).
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Leader Name Enter resource leader's name (use at least the first initial and last name).
Primary Contact Enter the primary contact information (e.g., cell phone number, radio, etc.)for the
Information leader.
If radios are being used, enter function (command, tactical, support, etc.), frequency,
system, and channel from the Incident Radio Communications Plan (ICS 205).
Phone and pager numbers should include the area code and any satellite phone
specifics.
Crew/Team ID#(s) or Provide the identifier number(s) or name(s)for this crew/team (e.g., Air Monitoring
Name(s) Team 2, Entry Team 3).
Manifest Use this section to enter whether or not the resource or personnel has a manifest. If
❑ Yes they do, indicate the manifest number.
❑ No
Total Weight Enter the total weight for the crew/team. This information is necessary when the
crew/team are transported by charter air.
Method of Travel to Check the box(es)for the appropriate method(s) of travel the individual used to bring
Incident himself/herself to the incident. AOV is "agency-owned vehicle." POV is "privately
❑ AOV owned vehicle."
❑ POV
❑ Bus
❑ Air
❑ Other
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the crew/team's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the crew/team's estimated time of arrival (using the 24-hour
clock) at the incident.
Transportation Needs at Check the box(es)for the appropriate method(s) of transportation at the incident.
Incident
❑ Vehicle
❑ Bus
❑ Air
❑ Other
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the crew/team was ordered to the
incident.
Remarks Enter any additional information pertaining to the crew/team.
BACK OF FORM
Incident Location Enter the location of the crew/team.
Time Enter the time (24-hour clock)the crew/team reported to this location.
Status Enter the crew/team's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech —Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the crew/team's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front Back
Date/Time Checked In: Incident Location: Time:
Leader Name: Status:
❑Assigned ❑O/S Rest ❑O/S Pers
Primary Contact Information: ❑Available ❑O/S Mech ❑ETR:
Notes:
Resource ID#(s)or Name(s):
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
❑Available ❑O/S Mech ❑ETR:
Notes:
Home Base:
Departure Point:
—
ETD: I ETA:
Incident Location: Time:
Date/Time Ordered:
Remarks:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
lAvailable ❑O/S Mech DTR:
Notes:
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
❑Available ❑O/S Mech ❑ETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-3 ENGINE (ROSE) ICS 219-3 ENGINE (ROSE)
ICS 219-3: Engine Card
lock Title nstructions
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available workday that the resource is allowed to work
# Pers Enter total number of personnel associated with the resource. Include leaders.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID# Use this section to enter the resource name or unique identifier(e.g., 13, Bluewater,
Utility 32).
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Leader Name Enter resource leader's name (use at least the first initial and last name).
Primary Contact Enter the primary contact information (e.g., cell phone number, radio, etc.)for the
Information leader.
If radios are being used, enter function (command, tactical, support, etc.), frequency,
system, and channel from the Incident Radio Communications Plan (ICS 205).
Phone and pager numbers should include the area code & any satellite phone specifics.
Resource ID #(s) or Provide the identifier number(s) or name(s)for the resource(s).
Name(s)
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the resource's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the resource's estimated time of arrival (using the 24-hour
clock) at the incident.
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the resource was ordered to the
incident.
Remarks Enter any additional information pertaining to the resource.
BACK OF FORM
Incident Location Enter the location of the resource.
ITime Enter the time (24-hour clock)the resource reported to this location.
Status Enter the resource's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech —Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the resource's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front Back
Date/Time Checked In: Incident Location: Time:
Pilot Name: Status:
Assigned ❑O/S Rest ❑O/S Pers
Home Base: ❑Available ❑O/S Mech IJ ETR:
Departure Point: Notes:
ETD: I ETA:
Destination Point:
Date/Time Ordered:
Remarks: Incident Location: Time:
Status:
❑Assigned ❑0/S Rest ❑O/S Pers
Available ❑0/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
assigned ❑O/S Rest n0/S Pers
nAvailable ❑O/S Mech ❑ETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-4 HELICOPTER(BLUE) ICS 219-4 HELICOPTER (BLUE)
ICS 219-4: Helicopter Card
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available workday that the resource is allowed to work.
I # Pers Enter total number of personnel associated with the resource. Include the pilot.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID # Use this section to enter the resource name or unique identifier.
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Pilot Name: Enter pilot's name (use at least the first initial and last name).
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the resource's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the resource's estimated time of arrival (using the 24-hour
clock) at the destination point.
Destination Point Use this section to enter the location at the incident where the resource has been
requested to report.
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the resource was ordered to the
incident.
Remarks Enter any additional information pertaining to the resource.
BACK OF FORM
Incident Location Enter the location of the resource.
Time Enter the time (24-hour clock)the resource reported to this location.
Status Enter the resource's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech—Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the resource's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: Name: Position/Title: ST/Unit: Name: Position/Title:
Front Back
Date/Time Checked In: Incident Location: Time:
Name: Status:
Assigned ❑O/S Rest nO/S Pers
Primary Contact Information: ❑Available ❑O/S Mech ❑ETR:
Notes:
Manifest: Total Weight:
❑Yes ❑No
Incident Location: Time:
Method of Travel to Incident:
❑AOV❑POV ❑Bus❑Air❑Other
Status:
Home Base: Assigned ❑O/S Rest ❑O/S Pers
Departure Point: ❑Available ❑O/S Mech ❑ETR:
Notes:
ETD: I ETA:
Transportation Needs at Incident:
❑Vehicle ❑Bus ❑Air ❑Other
Date/Time Ordered: Incident Location: Time:
Remarks:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-5 PERSONNEL (WHITE ICS 219-5 PERSONNEL (WHITE
CARD) CARD)
ICS 219-5: Personnel Card
lock Tit Instructions
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
Name Enter the individual's first initial and last name.
Position/Title Enter the individual's ICS position/title.
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Name Enter the individual's full name.
Primary Contact Enter the primary contact information (e.g., cell phone number, radio, etc.)for the
Information leader.
If radios are being used, enter function (command, tactical, support, etc.), frequency,
system, and channel from the Incident Radio Communications Plan (ICS 205).
Phone and pager numbers should include the area code and any satellite phone
specifics.
Manifest Use this section to enter whether or not the resource or personnel has a manifest. If
❑ Yes they do, indicate the manifest number.
❑ No
Total Weight Enter the total weight for the crew. This information is necessary when the crew are
transported by charter air.
Method of Travel to Check the box(es)for the appropriate method(s) of travel the individual used to bring
Incident himself/herself to the incident. AOV is "agency-owned vehicle." POV is "privately
❑ AOV owned vehicle."
❑ POV
❑ Bus
❑ Air
❑ Other
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the crew's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the crew's estimated time of arrival (using the 24-hour clock) at
the incident.
Transportation Needs at Check the box(es)for the appropriate method(s) of transportation at the incident.
Incident
❑ Vehicle
❑ Bus
❑ Air
❑ Other
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the crew was ordered to the
incident.
Remarks Enter any additional information pertaining to the crew.
BACK OF FORM
Incident Location Enter the location of the crew.
Time Enter the time (24-hour clock)the crew reported to this location.
Status Enter the crew's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech —Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the crew's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front I Back
Date/Time Checked-In: Incident Location: Time:
Pilot Name: Status:
❑Assigned ❑O/S Rest ❑J/S Pers
Home Base: ❑Available ❑O/S Mech ❑ETR:
Departure Point: Notes:
ETD: I ETA:
Destination Point:
Date/Time Ordered:
Manufacturer: I Incident Location: Time:
Remarks:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
❑Available ❑O/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
❑Available ❑O/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
(Available ❑O/S Mech ❑ETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-6 FIXED-WING (ORANGE) ICS 219-6 FIXED-WING (ORANGE)
ICS 219-6: Fixed-Wing Card
lock Title nstructions
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available workday that the resource is allowed to work.
# Pers Enter total number of personnel associated with the resource. Include the pilot.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID# Use this section to enter the resource name or unique identifier.
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Pilot Name: Enter pilot's name (use at least the first initial and last name).
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the resource's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the resource's estimated time of arrival (using the 24-hour
clock) at the destination point.
Destination Point Use this section to enter the location at the incident where the resource has been
requested to report.
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the resource was ordered to the
incident.
Manufacturer Enter the manufacturer of the aircraft.
Remarks Enter any additional information pertaining to the resource.
BACK OF FORM
Incident Location Enter the location of the resource.
Time Enter the time (24-hour clock)the resource reported to this location.
I Status Enter the resource's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech —Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the resource's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front Back
Date/Time Checked In: Incident Location: Time:
Leader Name: Status:
Assigned ❑O/S Rest ❑D/S Pers
Primary Contact Information: Available nO/S Mech FrTR:
Notes:
Resource ID#(s)or Name(s):
Incident Location: Time:
Status:
assigned ❑O/S Rest ❑O/S Pers
available ❑O/S Mech ETR:
Notes:
Home Base:
Departure Point:
ETD: ETA:
Incident Location: Time:
Date/Time Ordered:
Remarks:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-7 EQUIPMENT (YELLOW) ICS 219-7 EQUIPMENT (YELLOW)
ICS 219-7: Equipment Card
lock Title Instructions
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available workday that the resource is allowed to work.
# Pers Enter total number of personnel associated with the resource. Include leaders.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID# Use this section to enter the resource name or unique identifier(e.g., 13, Bluewater,
Utility 32).
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Leader Name Enter resource leader's name (use at least the first initial and last name).
Primary Contact Enter the primary contact information (e.g., cell phone number, radio, etc.)for the
Information leader.
If radios are being used, enter function (command, tactical, support, etc.), frequency,
system, and channel from the Incident Radio Communications Plan (ICS 205).
Phone and pager numbers should include the area code & any satellite phone specifics.
Resource ID #(s) or Provide the identifier number(s) or name(s)for this resource.
Name(s)
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the resource's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the resource's estimated time of arrival (using the 24-hour
clock) at the incident.
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the resource was ordered to the
incident.
Remarks Enter any additional information pertaining to the resource.
BACK OF FORM
Incident Location Enter the location of the resource.
ITime Enter the time (24-hour clock)the resource reported to this location.
Status Enter the resource's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ O/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech —Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the resource's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front Back _
Date/Time Checked In: Incident Location: Time:
Leader Name: Status:
assigned ❑O/S Rest ❑O/S Pers
Primary Contact Information: ❑Available ❑O/S Mech ❑ETR:
Notes:
Resource ID#(s)or Name(s):
Incident Location: Time:
Status:
Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Home Base:
Departure Point:
ETD: I ETA:
Incident Location: Time:
Date/Time Ordered:
Remarks:
Status:
Assigned ❑O/S Rest ❑O/S Pers
Available ❑O/S Mech ❑ETR:
Notes:
Incident Location: Time:
Status:
assigned ❑O/S Rest LO/S Pers
Available ❑O/S Mech nETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-8 MISCELLANEOUS ICS 219-8 MISCELLANEOUS
EQUIPMENT/TASK FORCE (TAN) EQUIPMENT/TASK FORCE (TAN)
ICS 219-8: Miscellaneous Equipment/Task Force Card
lock Tit
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available work day that the resource is allowed to work.
# Pers Enter total number of personnel associated with the resource. Include leaders.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID# Use this section to enter the resource name or unique identifier(e.g., 13, Bluewater,
Utility 32).
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Leader Name Enter resource leader's name (use at least the first initial and last name).
Primary Contact Enter the primary contact information (e.g., cell phone number, radio, etc.)for the
Information leader.
If radios are being used, enter function (command, tactical, support, etc.), frequency,
system, and channel from the Incident Radio Communications Plan (ICS 205).
Phone and pager numbers should include the area code & any satellite phone specifics.
Resource ID #(s) or Provide the identifier number or name for this resource.
Name(s)
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the resource's estimated time of departure (using the 24-hour I
clock)from their home base.
ETA Use this section to enter the resource's estimated time of arrival (using the 24-hour
clock) at the incident.
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the resource was ordered to the
incident.
Remarks Enter any additional information pertaining to the resource.
BACK OF FORM
Incident Location Enter the location of the resource.
Time Enter the time (24-hour clock)the resource reported to this location.
Status Enter the resource's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech—Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the resource's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
ST/Unit: LDW: #Pers: Order#: ST/Unit: LDW: #Pers: Order#:
Agency Cat/Kind/Type Name/ID# Agency Cat/Kind/Type Name/ID#
Front Back
Date/Time Checked In: Incident Location: Time:
Leader Name: Status:
❑Assigned ❑O/S Rest ❑O/S Pers
Primary Contact Information: ❑Available ❑0/S Mech ❑ETR:
Notes:
Resource ID#(s)or Name(s):
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
❑Available ❑O/S Mech aTR:
Notes:
Home Base:
Departure Point:
ETD: I ETA:
Incident Location: Time:
Date/Time Ordered:
Remarks:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
nAvailable nO/S Mech nETR:
Notes:
Incident Location: Time:
Status:
❑Assigned ❑O/S Rest ❑O/S Pers
❑Available ❑O/S Mech ❑ETR:
Notes:
Prepared by: Prepared by:
Date/Time: Date/Time:
ICS 219-10 GENERIC (LIGHT ICS 219-10 GENERIC (LIGHT
PURPLE) PURPLE)
ICS 219-10: Generic Card
lock Tit Instructions
ST/Unit Enter the State and or unit identifier (3-5 letters) used by the authority having
jurisdiction.
LDW(Last Day Worked) Indicate the last available workday that the resource is allowed to work.
# Pers Enter total number of personnel associated with the resource. Include leaders.
Order# The order request number will be assigned by the agency dispatching resources or
personnel to the incident. Use existing protocol as appropriate for the jurisdiction
and/or discipline since several incident numbers may be used for the same incident.
Agency Use this section to list agency name or designator(e.g., ORC, ARL, NYPD).
Cat/Kind/Type Enter the category/kind/type based on NIMS, discipline, or jurisdiction guidance.
Name/ID# Use this section to enter the resource name or unique identifier(e.g., 13, Bluewater,
Utility 32).
Date/Time Checked In Enter date (month/day/year) and time of check-in (24-hour clock)to the incident.
Leader Name Enter resource leader's name (use at least the first initial and last name).
Primary Contact Enter the primary contact information (e.g., cell phone number, radio, etc.)for the
Information leader.
If radios are being used, enter function (command, tactical, support, etc.), frequency,
system, and channel from the Incident Radio Communications Plan (ICS 205).
Phone and pager numbers should include the area code & any satellite phone specifics.
Resource ID #(s) or Provide the identifier number(s) or name(s)for this resource.
Name(s)
Home Base Enter the home base to which the resource or individual is normally assigned (may not
be departure location).
Departure Point Enter the location from which the resource or individual departed for this incident.
ETD Use this section to enter the resource's estimated time of departure (using the 24-hour
clock)from their home base.
ETA Use this section to enter the resource's estimated time of arrival (using the 24-hour
clock) at the incident.
Date/Time Ordered Enter date (month/day/year) and time (24-hour clock)the resource was ordered to the
incident.
Remarks Enter any additional information pertaining to the resource.
BACK OF FORM
Incident Location Enter the location of the resource.
ITime Enter the time (24-hour clock)the resource reported to this location.
Status Enter the resource's current status:
❑ Assigned • Assigned —Assigned to the incident
❑ 0/S Rest • 0/S Rest—Out-of-service for rest/recuperation purposes/guidelines, or due to
❑ 0/S Pers operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
❑ Available • 0/S Pers—Out-of-service for personnel reasons
❑ 0/S Mech • Available—Available to be assigned to the incident
❑ ETR: • 0/S Mech —Out-of-service for mechanical reasons
• ETR— Estimated time of return
Notes Enter any additional information pertaining to the resource's current location or status.
Prepared by Enter the name of the person preparing the form. Enter the date (month/day/year) and
Date/Time time prepared (using the 24-hour clock).
AIR OPERATIONS SUMMARY (ICS 220)
1. Incident Name: 2. Operational Period: 3. Sunrise: Sunset:
Date From: Date To:
Time From: Time To:
4. Remarks (safety notes, hazards, air operations special 5. Ready Alert Aircraft: 6. Temporary Flight Restriction Number:
equipment, etc.): Medivac: Altitude:
New Incident: Center Point:
8. Frequencies: AM FM 9. Fixed-Wing (category/kind/type,
make/model, N#, base):
Air/Air Fixed-Wing Air Tactical Group Supervisor Aircraft:
Air/Air Rotary-Wing—
7. Personnel: Name: Phone Number: Flight Following
Air Operations Branch Air/Ground
Director
Air Support Group Command Other Fixed-Wing Aircraft:
Supervisor
Air Tactical Group Deck Coordinator
Supervisor
Helicopter Coordinator Take-Off& Landing
Coordinator
Helibase Manager Air Guard
10. Helicopters (use additional sheets as necessary):
FAA N# Category/Kind/Type Make/Model Base I Available Start Remarks
11. Prepared by: Name: Position/Title: Signature:
ICS 220, Page 1 I Date/Time:
AIR OPERATIONS SUMMARY (ICS 220)
1. Incident Name: 2. Operational Period: 3. Sunrise: Sunset:
Date From: Date To:
Time From: Time To:
12. Task/Mission/Assignment(category/kind/type and function includes: air tactical, reconnaissance, personnel transport, search and rescue, etc.):
Category/Kind/Type Name of Personnel or Cargo (if applicable) Mission
and Function or Instructions for Tactical Aircraft Start Fly From Fly To
11. Prepared by: Name: Position/Title: Signature:
ICS 220, Page 2 Date/Time:
ICS 220
Air Operations Summary
Purpose. The Air Operations Summary(ICS 220) provides the Air Operations Branch with the number, type, location,
and specific assignments of helicopters and air resources.
Preparation. The ICS 220 is completed by the Operations Section Chief or the Air Operations Branch Director during
each Planning Meeting. General air resources assignment information is obtained from the Operational Planning
Worksheet (ICS 215), which also is completed during each Planning Meeting. Specific designators of the air resources
assigned to the incident are provided by the Air and Fixed-Wing Support Groups. If aviation assets would be utilized for
rescue or are referenced on the Medical Plan (ICS 206), coordinate with the Medical Unit Leader and indicate on the ICS
206.
Distribution. After the ICS 220 is completed by Air Operations personnel, the form is given to the Air Support Group
Supervisor and Fixed-Wing Coordinator personnel. These personnel complete the form by indicating the designators of
the helicopters and fixed-wing aircraft assigned missions during the specified operational period. This information is
provided to Air Operations personnel who, in turn, give the information to the Resources Unit.
Notes:
• If additional pages are needed for any form page, use a blank ICS 220 and repaginate as needed.
Block Block Title Instructions
Number
1 Incident Name Enter the name assigned to the incident.
2 Operational Period Enter the start date (month/day/year) and time (using the 24-hour
• Date and Time From clock) and end date and time for the operational period to which the
• Date and Time To form applies.
3 Sunrise/Sunset Enter the sunrise and sunset times.
4 Remarks (safety notes, Enter special instructions or information, including safety notes,
hazards, air operations special hazards, and priorities for Air Operations personnel.
equipment, etc.)
5 Ready Alert Aircraft Identify ready alert aircraft that will be used as Medivac for incident
• Medivac assigned personnel and indicate on the Medical Plan (ICS 206).
• New Incident Identify aircraft to be used for new incidents within the area or new
incident(s)within an incident.
6 Temporary Flight Restriction Enter Temporary Flight Restriction Number, altitude (from the center
Number point), and center point (latitude and longitude). This number is
• Altitude provided by the Federal Aviation Administration (FAA) or is the order
• Center Point request number for the Temporary Flight Restriction.
7 Personnel Enter the name and phone number of the individuals in Air Operations.
• Name
• Phone Number
Air Operations Branch Director
Air Support Group Supervisor
Air Tactical Group Supervisor
Helicopter Coordinator
Helibase Manager
Block Block Title • u •
Number
•
8 Frequencies Enter primary air/air, air/ground (if applicable), command, deck
• AM coordinator, take-off and landing coordinator, and other radio
• FM frequencies to be used during the incident.
Air/Air Fixed-Wing
Air/Air Rotary-Wing— Flight Flight following is typically done by Air Operations.
Following
Air/Ground
Command
Deck Coordinator
Take-Off& Landing Coordinator
Air Guard
9 Fixed-Wing (category/kind/type, Enter the category/kind/type based on NIMS, discipline, or jurisdiction
make/model, N#, base) guidance, make/model, N#, and base of air assets allocated to the
incident.
Air Tactical Group Supervisor
Aircraft
Other Fixed-Wing Aircraft
10 Helicopters Enter the following information about the helicopter resources
allocated to the incident.
FAA N# Enter the FAA N#.
Category/Kind/Type Enter the helicopter category/kind/type based on NIMS, discipline, or
jurisdiction guidance.
Make/Model Enter the make and model of the helicopter.
Base Enter the base where the helicopter is located.
Available Enter the time the aircraft is available.
Start Enter the time the aircraft becomes operational.
Remarks
11 Prepared by Enter the name, ICS position, and signature of the person preparing
• Name the form. Enter date (month/day/year) and time prepared (24-hour
• Position/Title clock).
• Signature
• Date/Time
12 Task/Mission/Assignment Enter the specific assignment(e.g., water or retardant drops, logistical
(category/kind/type and function support, or availability status for a specific purpose, support backup,
includes: air tactical, recon, Medivac, etc.). If applicable, enter the primary air/air and
reconnaissance, personnel air/ground radio frequency to be used. Mission assignments may be
transport, search and rescue, listed by priority.
etc.)
Category/Kind/Type and
Function
Name of Personnel or Cargo (if
applicable) or Instructions for
Tactical Aircraft
Mission Start
Fly From Enter the incident location or air base the aircraft is flying from.
Fly To Enter the incident location or air base the aircraft is flying to.
DEMOBILIZATION CHECK-OUT (ICS 221)
1. Incident Name: 2. Incident Number:
3. Planned Release Date/Time: 4. Resource or Personnel Released: 5. Order Request Number:
Date: Time:
6. Resource or Personnel:
You and your resources are in the process of being released. Resources are not released until the checked boxes
below have been signed off by the appropriate overhead and the Demobilization Unit Leader(or Planning Section
representative).
LOGISTICS SECTION
Unit/Manager Remarks Name Signature
❑ Supply Unit
n Communications Unit
❑ _Facilities Unit
❑ Ground Support Unit
❑ Security Manager
FINANCE/ADMINISTRATION SECTION
Unit/Leader Remarks Name Signature
❑ Time Unit
111
OTHER SECTION/STAFF
Unit/Other Remarks Name Signature
PLANNING SECTION
Unit/Leader Remarks Name Signature
n Documentation Leader
❑ Demobilization Leader
7. Remarks:
8. Travel Information: Room Overnight: ❑Yes ❑No
Estimated Time of Departure: Actual Release Date/Time:
Destination: Estimated Time of Arrival:
Travel Method: Contact Information While Traveling:
Manifest: ❑Yes No Area/Agency/Region Notified:
Number:
9. Reassignment Information: ❑Yes FNo
Incident Name: Incident Number:
Location: Order Request Number:
10. Prepared by: Name: Position/Title: Signature:
ICS 221 Date/Time:
ICS 221
Demobilization Check-Out
Purpose. The Demobilization Check-Out (ICS 221) ensures that resources checking out of the incident have completed
all 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. The
Demobilization Unit Leader completes the top portion of the form and checks the appropriate boxes in Block 6 that may
need attention after the Resources Unit Leader has given written notification that the resource is no longer needed. The
individual resource will have the appropriate overhead personnel sign off on any checked box(es) in Block 6 prior to
release from the incident.
Distribution. After completion, the ICS 221 is returned to the Demobilization Unit Leader or the Planning Section. All
completed original forms must be given to the Documentation Unit. Personnel may request to retain a copy of the ICS 221.
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.
Block Block Title Instructions
Number
1 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) of
the planned release from the incident.
4 Resource or Personnel Enter name of the individual or resource being released.
Released
5 Order Request Number Enter order request number(or agency demobilization number) of the
individual or resource being released.
6 Resource or Personnel Resources are not released until the checked boxes below have been
You and your resources are in signed off by the appropriate overhead. Blank boxes are provided for
the process of being released. any additional unit requirements as needed (e.g., Safety Officer,
Resources are not released until Agency Representative, etc.).
the checked boxes below have
been signed off by the
appropriate overhead and the
Demobilization Unit Leader (or
Planning Section
representative).
• Unit/Leader/Manager/Other
• Remarks
• Name
• Signature
Logistics Section The Demobilization Unit Leader will enter an "X" in the box to the left of
❑ Supply Unit those Units requiring the resource to check out.
❑ Communications Unit Identified Unit Leaders or other overhead are to sign the appropriate
❑ Facilities Unit line to indicate release.
❑ Ground Support Unit
❑ Security Manager
Block Block Title Instructions
Number
6 Finance/Administration The Demobilization Unit Leader will enter an "X" in the box to the left of
(continued) Section those Units requiring the resource to check out.
❑ Time Unit Identified Unit Leaders or other overhead are to sign the appropriate line
to indicate release.
Other Section/Staff The Demobilization Unit Leader will enter an "X" in the box to the left of
❑ those Units requiring the resource to check out.
Identified Unit Leaders or other overhead are to sign the appropriate line
to indicate release.
Planning Section The Demobilization Unit Leader will enter an "X" in the box to the left of
❑ Documentation Leader those Units requiring the resource to check out.
❑ Demobilization Leader Identified Unit Leaders or other overhead are to sign the appropriate line
to indicate release.
7 Remarks Enter any additional information pertaining to demobilization or release
(e.g., transportation needed, destination, etc.). This section may also be
used to indicate if a performance rating has been completed as required
by the discipline or jurisdiction.
8 Travel Information Enter the following travel information:
Room Overnight Use this section to enter whether or not the resource or personnel will be
staying in a hotel overnight prior to returning home base and/or unit.
Estimated Time of Departure Use this section to enter the resource's or personnel's estimated time of
departure (using the 24-hour clock).
Actual Release Date/Time Use this section to enter the resource's or personnel's actual release date
(month/day/year) and time (using the 24-hour clock).
Destination Use this section to enter the resource's or personnel's destination.
Estimated Time of Arrival Use this section to enter the resource's or personnel's estimated time of
arrival (using the 24-hour clock) at the destination.
Travel Method Use this section to enter the resource's or personnel's travel method (e.g.,
POV, air, etc.).
Contact Information While Use this section to enter the resource's or personnel's contact information
Traveling while traveling (e.g., cell phone, radio frequency, etc.).
Manifest ❑Yes ❑ No Use this section to enter whether or not the resource or personnel has a
Number manifest. If they do, indicate the manifest number.
Area/Agency/Region Notified Use this section to enter the area, agency, and/or region that was notified
of the resource's travel. List the name (first initial and last name) of the
individual notified and the date (month/day/year) he or she was notified.
9 Reassignment Information Enter whether or not the resource or personnel was reassigned to another
❑Yes ❑ No incident. If the resource or personnel was reassigned, complete the
section below.
Incident Name Use this section to enter the name of the new incident to which the
resource was reassigned.
Incident Number Use this section to enter the number of the new incident to which the
resource was reassigned.
Location Use this section to enter the location (city and State)of the new incident to
which the resource was reassigned.
Order Request Number Use this section to enter the new order request number assigned to the
resource or personnel.
Block Block Title Instructio
Number
10 Prepared by Enter the name, ICS position, and signature of the person preparing the
• Name form. Enter date (month/day/year) and time prepared (using the 24-hour
• Position/Title clock).
• Signature
• Date/Time
INCIDENT PERSONNEL PERFORMANCE RATING (ICS 225)
THIS RATING IS TO BE USED ONLY FOR DETERMINING AN INDIVIDUAL'S PERFORMANCE ON AN INCIDENT/EVENT
1. Name: 2. Incident Name: 3. Incident Number:
4. Home Unit Name and Address: 5. Incident Agency and Address:
6. Position Held on Incident: 7. Date(s)of Assignment: 8. Incident Complexity Level: 9. Incident Definition:
From: To: 01 02 03 04 ❑5
10. Evaluation
Rating Factors N/A 1-Unacceptable 2 3-Met Standards 4 5-Exceeded Expectations
11. Knowledge of the Job/ Questionable competence and Competent and credible authority on Superior expertise;advice and actions
Professional Competence: credibility.Operational or specialty specialty or operational issues. showed great breadth and depth of
Ability to acquire,apply,and expertise inadequate or lacking in Acquired and applied excellent knowledge.Remarkable grasp of
share technical and key areas.Made little effort to grow operational or specialty expertise for complex issues,concepts,and
administrative knowledge and professionally.Used knowledge as assigned duties.Showed professional situations.Rapidly developed
skills associated with power against others or bluffed growth through education,training,and professional growth beyond
description duties.(Includes rather than acknowledging professional reading.Shared expectations.Vigorously conveyed
operationalc ofaspects such as ignorance.Effectiveness reduced knowledge and information with others knowledge,directly resulting in increased
marine seamanship, due to limited knowledge of own clearly and simply.Understood own workplace productivity.Insightful
mrmnes safety,SAR,etc.,as organizational role and customer organizational role and customer knowledge of own role,customer needs,
aiappropriate.) needs. needs. and value of work.
El El 11 11 0 El
12.Ability To Obtain Routine tasks accomplished with Got the job done in all routine situations Maintained optimal balance among
Performance/Results: difficulty.Results often late or of and in many unusual ones.Work was quality,quantity,and timeliness of work.
Quality,quantity,timeliness, poor quality.Work had a negative timely and of high quality;required Quality of own and subordinates'work
and impact of work. impact on department or unit. same of subordinates.Results had a surpassed expectations.Results had a
Maintained the status quo despite positive impact on IMT.Continuously significant positive impact on the IMT.
opportunities to improve. improved services and organizational Established clearly effective systems of
effectiveness. continuous improvement.
El El 0 0 ❑
13. Planning/ Got caught by the unexpected; Consistently prepared.Set high but Exceptional preparation.Always looked
Preparedness: appeared to be controlled by events. realistic goals.Used sound criteria to beyond immediate events or problems.
Ability to anticipate,determine Set vague or unrealistic goals.Used set priorities and deadlines.Used Skillfully balanced competing demands.
goals,identify relevant unreasonable criteria to set priorities quality tools and processes to develop Developed strategies with contingency
set and and deadlines.Rarely had plan of action plans.Identified key information. plans.Assessed all aspects of problems,
deadlines,information,ande prioritieso a action.Failed to focus on relevant Kept supervisors and stakeholders including underlying issues and impact.
shared vision of the Incident information. informed.
Management Team(IMT). 0 El ❑ ❑ 0 0
14. Using Resources: Concentrated on unproductive Effectively managed a variety of Unusually skilled at bringing scarce
Ability to manage time, activities or often overlooked critical activities with available resources. resources to bear on the most critical of
materials,information,money, demands.Failed to use people Delegated,empowered,and followed competing demands.Optimized
and people(i.e.,all IMT productively.Did not follow up. up.Skilled time manager,budgeted productivity through effective delegation,
components as well as Mismanaged information,money,or own and subordinates'time empowerment,and follow-up control.
external publics). time.Used ineffective tools or left productively.Ensured subordinates had Found ways to systematically reduce
subordinates without means to adequate tools,materials,time,and cost,eliminate waste,and improve
accomplish tasks.Employed direction.Cost conscious,sought ways efficiency.
wasteful methods. to cut waste.
❑ 0 0 ❑ 0 ❑
15.Adaptability/Attitude: Unable to gauge effectiveness of Receptive to change,new information, Rapidly assessed and confidently
Ability to maintain a positive work,recognize political realities,or and technology.Effectively used adjusted to changing conditions,political
attitude and modify work make adjustments when needed. benchmarks to improve performance realities,new information,and
methods and priorities in Maintained a poor outlook. and service.Monitored progress and technology.Very skilled at using and
response to new information, Overlooked or screened out new changed course as required. responding to measurement indicators.
changing conditions,political information.Ineffective in Maintained a positive approach. Championed organizational
realities,or unexpected ambiguous,complex,or pressured Effectively dealt with pressure and improvements.Effectively dealt with
obstacles. situations. ambiguity.Facilitated smooth extremely complex situations.Turned
transitions.Adjusted direction to pressure and ambiguity into constructive
accommodate political realities. forces for change.
❑ ❑ ❑ ❑ ❑ ❑
16.Communication Skills: Unable to effectively articulate ideas Effectively expressed ideas and facts in Clearly articulated and promoted ideas
Ability to speak effectively and and facts;lacked preparation, individual and group situations; before a wide range of audiences;
listen to understand.Ability to confidence,or logic.Used nonverbal actions consistent with accomplished speaker in both formal and
express facts and ideas inappropriate language or rambled. spoken message.Communicated to extemporaneous situations.Adept at
clearly and convincingly. Nervous or distracting mannerisms people at all levels to ensure presenting complex or sensitive issues.
detracted from message.Failed to understanding.Listened carefully for Active listener;remarkable ability to listen
listen carefully or was too intended message as well as spoken with open mind and identify key issues.
argumentative.Written material words.Written material clear,concise, Clearly and persuasively expressed
frequently unclear,verbose,or and logically organized.Proofread complex or controversial material,
poorly organized.Seldom proofread. conscientiously. directly contributing to stated objectives.
0 ❑ 0 ❑ ❑ 0
INCIDENT PERSONNEL PERFORMANCE RATING (ICS 225)
1. Name: 2. Incident Name: 3. Incident Number:
10. Evaluation
Rating Factors N/A 1 —Unacceptable 2 3—Met Standards 4 5—Exceeded Expectations
17.Ability To Work on a Used teams ineffectively or at wrong Skillfully used teams to increase unit Insightful use of teams raised unit
Team: times.Conflicts mismanaged or effectiveness,quality,and service. productivity beyond expectations.
to manage,lead and often left unresolved,resulting in Resolved or managed group conflict, Inspired high level of esprit de corps,
Ability
prticipate in teams, decreased team effectiveness. enhanced cooperation,and involved even in difficult situations.Major
age cooperation,and Excluded team members from vital team members in decision process. contributor to team effort.Established
pacou
developesprit de corp . information.Stifled group Valued team participation.Effectively relationships and networks across a
discussions or did not contribute negotiated work across functional broad range of people and groups,
productively.Inhibited cross boundaries to enhance support of raising accomplishments of mutual goals
functional cooperation to the broader mutual goals. to a remarkable level.
detriment of unit or service goals.
❑ ❑ ❑ 0 0 0
18.Consideration for Seldom recognized or responded to Cared for people.Recognized and Always accessible.Enhanced overall
Personnel/Team Welfare: needs of people;left outside responded to their needs;referred to quality of life.Actively contributed to
Ability to consider and respond resources untapped despite outside resources as appropriate. achieving balance among IMT
to others'personal needs, apparent need.Ignorance of Considered individuals'capabilities to requirements and professional and
capabilities,and individuals'capabilities increased maximize opportunities for success. personal responsibilities.Strong
achievements;support for and chance of failure.Seldom Consistently recognized and rewarded advocate for subordinates;ensured
application of worklife recognized or rewarded deserving deserving subordinates or other IMT appropriate and timely recognition,both
concepts and skills. subordinates or other IMT members. members. formal and informal.
❑ ❑ ❑ ❑ ❑ ❑
19.Directing Others: Showed difficulty in directing or A leader who earned others'support An inspirational leader who motivated
Ability to influence or direct influencing others.Low or unclear and commitment.Set high work others to achieve results not normally
others in accomplishing tasks work standards reduced productivity. standards;clearly articulated job attainable.Won people over rather than
or missions. Failed to hold subordinates requirements,expectations,and imposing will.Clearly articulated vision;
accountable for shoddy work or measurement criteria;held empowered subordinates to set goals
irresponsible actions.Unwilling to subordinates accountable.When and objectives to accomplish tasks.
delegate authority to increase appropriate,delegated authority to Modified leadership style to best meet
efficiency of task accomplishment. those directly responsible for the task. challenging situations.
❑ ❑ 0 ❑ 0 0
20.Judgment/Decisions Decisions often displayed poor Demonstrated analytical thought and Combined keen analytical thought,an
Under Stress: analysis.Failed to make necessary common sense in making decisions. understanding of political processes,and
bility to make sound decisions,or jumped to conclusions Used facts,data,and experience,and insight to make appropriate decisions.
A
decisions and provide valid without considering facts, considered the impact of alternatives Focused on the key issues and the most
by using alternatives,and impact.Did not and political realities.Weighed risk, relevant information.Did the right thing
facts,experience,recommendations bypo using
effectively weigh risk,cost,and time cost,and time considerations.Made at the right time.Actions indicated
acumen,common sense,risk tical
considerations.Unconcerned with sound decisions promptly with the best awareness of impact of decisions on
assessment,and analytical political drivers on organization. available information. others.Not afraid to take reasonable
thought. risks to achieve positive results.
❑ ❑ ❑ ❑ ❑ ❑
21. Initiative Postponed needed action. Championed improvement through new Aggressively sought out additional
Ability to originate and act on Implemented or supported ideas,methods,and practices. responsibility.A self-learner.Made
new ideas,pursue improvements only when directed to Anticipated problems and took prompt worthwhile ideas and practices work
opportunities to learn and do so.Showed little interest in action to avoid or resolve them. when others might have given up.
develop,and seek career development.Feasible Pursued productivity gains and Extremely innovative.Optimized use of
responsibility without guidance improvements in methods,services, enhanced mission performance by new ideas and methods to improve work
and supervision. or products went unexplored. applying new ideas and methods. processes and decisionmaking.
❑ ❑ ❑ ❑ ❑ 0
22.Physical Ability for the Failed to meet minimum standards Committed to health and well-being of Remarkable vitality,enthusiasm,
Job: of sobriety.Tolerated or condoned self and subordinates.Enhanced alertness,and energy.Consistently
Ability to invest in the IMT's others'alcohol abuse.Seldom personal performance through activities contributed at high levels of activity.
future by caring for the considered subordinates'health and supporting physical and emotional well- Optimized personal performance through
physical health and emotional well-being.Unwilling or unable to being.Recognized and managed involvement in activities that supported
well-being of self and others. recognize and manage stress stress effectively. physical and emotional well-being.
despite apparent need. Monitored and helped others deal with
stress and enhance health and well-being.
❑ 0 O ❑ 0 ❑
23.Adherence to Safety: Failed to adequately identify and Ensured that safe operating procedures Demonstrated a significant commitment
Ability to invest in the IMT's protect personnel from safety were followed. toward safety of personnel.
future by caring for the safety hazards.
of self and others. 0 ❑ ❑ 0 0 0
24.Remarks:
25.Rated Individual(This rating has been discussed with me):
Signature: Date/Time:
26.Rated by: Name: Signature:
Home Unit: Position Held on This Incident:
ICS 225 I Date/Time:
ICS 225
Incident Personnel Performance Rating
Purpose. The Incident Personnel Performance Rating (ICS 225) gives supervisors the opportunity to evaluate
subordinates on incident assignments. THIS RATING IS TO BE USED ONLY FOR DETERMINING AN INDIVIDUAL'S
PERFORMANCE ON AN INCIDENT/EVENT.
Preparation. The ICS 225 is normally prepared by the supervisor for each subordinate, using the evaluation standard
given in the form. The ICS 225 will be reviewed with the subordinate, who will sign at the bottom. It will be delivered to the
Planning Section before the rater leaves the incident
Distribution. The ICS 225 is provided to the Planning Section Chief before the rater leaves the incident.
Notes:
• Use a blank ICS 225 for each individual.
• Additional pages can be added based on individual need.
Block
Number
1 Name Enter the name of the individual being rated.
2 Incident Name Enter the name assigned to the incident.
3 Incident Number Enter the number assigned to the incident.
4 Home Unit Address Enter the physical address of the home unit for the individual being
rated.
5 Incident Agency and Address Enter the name and address of the authority having jurisdiction for the
incident.
6 Position Held on Incident Enter the position held (e.g., Resources Unit Leader, Safety Officer,
etc.) by the individual being rated.
7 Date(s) of Assignment Enter the date(s) (month/day/year)the individual was assigned to the
• From incident.
• To
8 Incident Complexity Level Indicate the level of complexity for the incident.
❑ 1
❑ 2
❑ 3
❑ 4
❑ 5
9 Incident Definition Enter a general definition of the incident in this block. This may be a
general incident category or kind description, such as "tornado,"
"wildfire,", "bridge collapse,", "civil unrest," "parade," "vehicle fire,"
"mass casualty," etc.
10 Evaluation Enter"X" under the appropriate column indicating the individual's level
of performance for each duty listed.
N/A The duty did not apply to this incident.
1 —Unacceptable Does not meet minimum requirements of the individual element.
Deficiencies/Improvements needed must be identified in Remarks.
2— Needs Improvement Meets some or most of the requirements of the individual element.
IDENTIFY IMPROVEMENT NEEDED IN REMARKS.
3— Met Standards Satisfactory. Employee meets all requirements of the individual
element.
Block Block Title Instruction
Number
4— Fully Successful Employee meets all requirements and exceeds one or several of the
requirements of the individual element.
10 5— Exceeded Expectations Superior. Employee consistently exceeds the performance
requirements.
11 Knowledge of the Job/ Ability to acquire, apply, and share technical and administrative
Professional Competence: knowledge and skills associated with description of duties. (Includes
operational aspects such as marine safety, seamanship, airmanship,
SAR, etc., as appropriate.)
12 Ability To Obtain Quality, quantity, timeliness, and impact of work.
Performance/Results:
13 Planning/Preparedness: Ability to anticipate, determine goals, identify relevant information, set
priorities and deadlines, and create a shared vision of the Incident
Management Team (IMT).
14 Using Resources: Ability to manage time, materials, information, money, and people (i.e.,
all IMT components as well as external publics).
15 Adaptability/Attitude: Ability to maintain a positive attitude and modify work methods and
priorities in response to new information, changing conditions, political
realities, or unexpected obstacles.
16 Communication Skills: Ability to speak effectively and listen to understand. Ability to express
facts and ideas clearly and convincingly.
17 Ability To Work on a Team: Ability to manage, lead and participate in teams, encourage
cooperation, and develop esprit de corps.
18 Consideration for Ability to consider and respond to others' personal needs, capabilities,
Personnel/Team Welfare: and achievements; support for and application of worklife concepts
and skills.
19 Directing Others: Ability to influence or direct others in accomplishing tasks or missions.
20 Judgment/Decisions Under Ability to make sound decisions and provide valid recommendations by I
Stress: using facts, experience, political acumen, common sense, risk
assessment, and analytical thought.
21 Initiative Ability to originate and act on new ideas, pursue opportunities to learn
and develop, and seek responsibility without guidance and
supervision.
22 Physical Ability for the Job: Ability to invest in the IMT's future by caring for the physical health and
emotional well-being of self and others.
23 Adherence to Safety: Ability to invest in the IMT's future by caring for the safety of self and
others.
24 Remarks Enter specific information on why the individual received performance
levels.
25 Rated Individual (This rating Enter the signature of the individual being rated. Enter the date
has been discussed with me) (month/day/year) and the time (24-hour clock) signed.
• Signature
• Date/Time
26 Rated by Enter the name, signature, home unit, and position held on the incident
• Name of the person preparing the form and rating the individual. Enter the
Signature date (month/day/year) and the time (24-hour clock) prepared.
•• Home Unit
• Position Held on This
Incident
• Date/Time
1.Incident Name 2.Operational Period(Date/Time) DAILY MEETING SCHEDULE
From: To: ICS 230-CG
3.Meeting Schedule(Commonly-held meetings are included)
Date/Time Meeting Name Purpose Attendees Location
Unified Command Review/identify objectives
Objectives Meeting for the next operational Unified Command members UC Meeting Room
period.
Command and General UC Presents direction to UC,Command Staff, ICP Meeting Room
Staff meeting Command and General General Staff, DOCL,SITL
Staff
Develop primary and PSC,OPS,LSC, RESL, ICP Meeting Room
Tactics Meeting alternate strategies/to meet SITL,SOFR,DOCL,COML,
Incident Objectives for the THSP
next Operational Period.
Review status and finalize ICP Meeting Room
strategies/tactics and UC,Command Staff,
Planning Meeting assignments to meet General Staff,SITL,DOCL,
Incident Objectives for the THSP
next Operational Period and
get tacit approval of IAP.
Present IAP and IC/UC,Command Staff, ICP Meeting Room
assignments to the General Staff,Branch
Operations Briefing Supervisors/Leaders for Directors, Div./Grp Sups.,
the next Operational Period. Task Force/Strike Team
Leaders and Unit Leaders
4.Prepared by:(Situation Unit Leader) Date/Time
DAILY MEETING SCHEDULE ICS 230-CG(Rev.09/05)
1. Incident Name: INCIDENT OPEN ACTION TRACKER
ICS-233 CG
5. Briefed 6. Start 8. Target 9. Actual
2. No. 3. Item 4. For/POC POC (X) Date 7. Status Date Date
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9
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INCIDENT OPEN ACTION TRACKER Page 1 of 1 ICS 233-CG (Rev 1/07))
Purpose. Open Actions Tracker
1. Is used by the Incident Commander/Unified Command (IC/UC)to assign and track tasks/actions to IMT
personnel that do not rise to the level of being an Incident Objective.
2. Is duplicated and provided to Command and General Staff members, giving them the open
tasks/actions needing to be completed and a means to track the open tasks/actions they have been
assigned.
Note: This form may also be used by Command and General Staff for tracking tasks/actions within a
Section/Staff element.
Preparation. The Planning Section Chief(PSC) is responsible for maintaining the Open Actions Tracker
for the IC/UC and typically utilizes the Documentation Unit Leader(DOCL)to assist in this forms
development and updating. The PSC should ensure all Command and General Staff are prepared to
discuss their assigned tasks/actions during the Command and General Staff and Planning Meetings.
Distribution. When completed, the form is duplicated and copies are distributed to the Unified Command
and Command and General Staff. It is also posted on a status board located at the ICP. All completed
original forms MUST be given to the Documentation Unit.
Item# Item Title Instructions
1. Incident Name Enter the name assigned to the incident.
2. No. Enter number of task in sequential order(1, 2, 3, ...).
3. Item Enter short descriptive of the task/action to be completed. Tasks/Actions
are important to be completed but are not an Incident Objective which
are documented on the ICS-202 form.
4. For/POC Enter the Point of Contact (POC), the responsible person/section.
5. Briefed to POC Enter"X", when the task/action has been briefed to the POC/responsible
person. This is to ensure that tasks/actions identified outside of the
POC's presence (during Unified Command Meeting for example) are
briefed to and acknowledged by the identified POC.
6. Start Date Enter the date the task/action was initially assigned under"Start Date."
7. Status Enter status of item. For example; "Awaiting LE Gear", "Update
needed", "Awaiting Feedback". When the item is completed, the word
"completed" is entered and if working in MS Excel, the task is cut and
pasted into the worksheet labeled "COMPLETED."
8. Target Date Enter deadline task/action should be completed. In the Excel
Worksheet, there is a hidden formula that shows green, yellow and red
blocks. When the target date is one day away, the block turns yellow.
When it is overdue it turns red. When the block is yellow, it serves as a
reminder to the UC/POC that the target date is nearing and the POC
needs to complete the task or the target date needs to be updated.
9. Actual Date Enter actual date task/action completed.
NOTE: In order to ensure the red and yellow reminders work for new tasks, the user simply copies a task
line, inserts it into the worksheet and overtypes the new task information.