INCIDENT CHECK-IN LIST (ICS 211-CG) 3. CHECK-IN LOCATION: 1. INCIDENT NAME: 2. INCIDENT NUMBER: 4. START DATE/TIME: BASE STAGING AREA ICP OTHER CHECK-IN INFORMATION (use reverse of form for remarks or comments) 6. 7. 8. 10. 11. 12. 14. 16. 5. LIST SINGLE RESOURCE PERSONNEL (OVERHEAD) BY AGENCY OF AND NAME OR LIST RESOURCES BY THE FOLLOWING FORMAT: – NO. ORDER DATE/TIME INCIDENT HOME (BASE) DEPARTURE INCIDENT DATA LEADER’S REQUEST CHECK-IN NAME CONTACT UNIT POINT, ASSIGNMENT SENT TO OTHER NUMBER INFORMATION OR AGENCY DATE/TIME (LOCATION) RESOURCES TRAVEL METHOD TOTAL RESOURCE OR ST/ UNIT STATE AGENCY CAT KIND TYPE PERSONNEL NAME IDENTIFIER TF QUALIFICATIONS 9. 13. 15. 17. PREPARED BY: ICS 211-CG PAGE _ of __ _________________________ _____________ _______________ Name: Position/Title: Signature: Date/Time:
1. INCIDENT NAME: 2. INCIDENT NUMBER: 3. CHECK-IN LOCATION: BASE STAGING AREA ICP OTHER 4. START DATE/TIME: CHECK-IN INFORMATION (use reverse of form for remarks or comments) 5. LIST SINGLE RESOURCE PERSONNEL (OVERHEAD) BY AGENCY AND NAME – OR LIST RESOURCES BY THE FOLLOWING FORMAT: 6. ORDER REQUEST NUMBER 7. DATE/TIME CHECK-IN 8. LEADER’S NAME 9. TOTAL NO. PERSONNEL 10. INCIDENT CONTACT INFORMATION 11. HOME (BASE) UNIT OR AGENCY 12. DEPARTURE POINT, DATE/TIME 13. METHOD OF TRAVEL 14. INCIDENT ASSIGNMENT (LOCATION) 15. OTHER QUALIFICATIONS 16. DATA SENT TO RESOURCES UNIT STATE AGENCY CAT KIND TYPE RESOURCE OR NAME IDENTIFIER ST/ TF ICS 211-CG PAGE _ of __ 17. PREPARED BY: Name: _________________________ Position/Title: _____________ Signature: Date/Time: _______________ INCIDENT CHECK-IN LIST (ICS 211-CG)
ICS211-CG_Check-In_List_w-inst-Rev4-15_2.docx