Form Ics 221 - Demobilization Check-Out
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4DEMOBILIZATION 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
Communications Unit
Facilities Unit
Ground Support Unit
Security Manager
FINANCE/ADMINISTRATION SECTION
Unit/Leader
Remarks
Name
Signature
Time Unit
OTHER SECTION/STAFF
Unit/Other
Remarks
Name
Signature
PLANNING SECTION
Unit/Leader
Remarks
Name
Signature
Documentation Leader
Demobilization Leader
7. Remarks:
Room Overnight: Yes No
8. Travel Information:
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 No
Incident Name:
Incident Number:
Location:
Order Request Number:
10. Prepared by: Name:
Position/Title:
Signature:
ICS 221
Date/Time:
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