Demobilization checkout




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DEMOBILIZATION CHECKOUT

1. Incident Name/Number

     


2. Date/Time

     


3. Demob. No.

     


4. Unit/Personnel Released

     


5. Transportation Type/No.

     


6. Actual Release Date/Time

     


7. Manifest?  Yes  No Number      

8. Destination

     


9. Notified:  Agency  Region  Area  Dispatch

Name:      

Date:      


10. Unit Leader Responsible for Collecting Performance Rating

     


11. Unit/Personnel

You and your resources have been released subject to sign off from the following:

Demob. Unit Leader check the appropriate box

Logistics Section

 Supply Unit

     

 Communications Unit

     

 Facilities Unit

     

 Ground Support Unit Leader

     

Planning Section

 Documentation Unit

     

Finance Section

 Time Unit

     

Other

      

     

      

     

12. Remarks

     


13. Prepared by (include Date and Time)

     





Instructions for completing the Demobilization Checkout (ICS form 221)

Prior to actual Demob Planning Section (Demob Unit) should check with the Command Staff (Liaison Officer) to determine any agency specific needs related to demob and release. If any, add to line Number 11.



Item No.

Item Title

Instructions

1.

Incident Name/No.

Enter Name and/or Number of Incident.

2.

Date & Time

Enter Date and Time prepared.

3.

Demob. No.

Enter Agency Request Number, Order Number, or Agency Demob Number if applicable.

4.

Unit/Personnel Released

Enter appropriate vehicle or Strike Team/Task Force ID Number(s) and Leader’s name or individual overhead or staff personnel being released.

5.

Transportation

Enter Method and vehicle ID number for transportation back to home unit. Enter N/A if own transportation is provided. Additional specific details should be included in Remarks, block # 12.

6.

Actual Release Date/Time

To be completed at conclusion of Demob at time of actual release from incident. Would normally be last item of form to be completed.

7.

Manifest

Mark appropriate box. If yes, enter manifest number. Some agencies require a manifest for air travel.

8.

Destination

Enter the location to which Unit or personnel have been released. i.e. Area, Region, Home Base, Airport, Mobilization Center, etc.

9.

Area/Agency/

Region Notified



Identify the Area, Agency, or Region notified and enter date and time of notification.

10.

Unit Leader Responsible for Collecting Performance Ratings

Self-explanatory. Not all agencies require these ratings.

11.

Resource Supervision

Demob Unit Leader will identify with a check in the box to the left of those units requiring check-out. Identified Unit Leaders are to initial to the right to indicate release.

Blank boxes are provided for any additional check, (unit requirements as needed), i.e. Safety Officer, Agency Rep., etc.



12.

Remarks

Any additional information pertaining to demob or release.

13.

Prepared by

Enter the name of the person who prepared this Demobilization Checkout, including the Date and Time.


ICS 221 NFES 1353


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