Ics Form 219-4 - Helicopter Card T-Card Blue Page 2
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2ICS 219-4: Helicopter Card
Block 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 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 to the incident
Assigned
• O/S Rest – Out-of-service for rest/recuperation purposes/guidelines, or due to
O/S Rest
operating time limits/policies for pilots, operators, drivers, equipment, or aircraft
O/S Pers
• O/S Pers – Out-of-service for personnel reasons
Available
• Available – Available to be assigned to the incident
O/S Mech
• O/S Mech – Out-of-service for mechanical reasons
ETR: _____
• 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
time prepared (using the 24-hour clock).
Date/Time
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