ࡱ; %(&Root Entry F{)CompObjbWordDocumentlObjectPool毾毾 4@  A? !"#$@QBCDEFGHIJKLMNOPRSTUVSummaryInformation(  FMicrosoft Word 6.0 Document MSWordDocWord.Document.6;  Oh+'0$ h   @d D/"s!?"sH/="?> ND:\WINWORD\NORMAL.DOTDEMOBILIZATION CHECKOUTState & Private Forestry - R2State & Private Forestry - R2@!d|@oR)@u)d @`Microsoft Word 6.046ORMTEXT 4. Unit/Personnel Released  FORMTEXT 5. Transportation Type/No.  FORMTEXT 6. ܥe- meGl;<<XXXXXd^X0^^^^4(_F^k]n_Jaaaaafbtb<dddd.eef)lT}lefXb aabbfbXXan_bbbbXaXadhXvX6XXXXbdb bDEMOBILIZATION CHECKOUT1. Incident Name/Number  FORMTEXT 2. Date/Time  FORMTEXT 3. Demob. No.  FORMTEXT 4. Unit/Personnel Released  FORMTEXT 5. Transportation Type/No.  FORMTEXT 6. Actual Release Date/Time  FORMTEXT 7. Manifest?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Number  FORMTEXT  8. Destination9. Notified:  FORMCHECKBOX  Agency  FORMCHECKBOX  Region  FORMCHECKBOX  Area  FORMCHECKBOX  Dispatch Name:  FORMTEXT  Date:  FORMTEXT 10. Unit Leader Responsible for Collecting Performance Rating  FORMTEXT 11. Unit/PersonnelYou and your resources have been released subject to sign off from the following: Demob. Unit Leader check the appropriate boxLogistics Section FORMCHECKBOX  Supply Unit FORMTEXT  FORMCHECKBOX  Communications Unit FORMTEXT  FORMCHECKBOX  Facilities Unit FORMTEXT  FORMCHECKBOX  Ground Support Unit Leader FORMTEXT Planning Section FORMCHECKBOX  Documentation Unit FORMTEXT Finance Section FORMCHECKBOX  Time Unit FORMTEXT Other FORMCHECKBOX   FORMTEXT  FORMTEXT  FORMCHECKBOX   FORMTEXT   FORMTEXT 12. Remarks  FORMTEXT  13. Prepared by (include Date and Time)  FORMTEXT  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 NumberItem TitleInstructions1.Incident Name/No.Enter Name and/or Number of Incident.2.Date & TimeEnter Date and Time prepared.3.Demob. No.Enter Agency Request Number, Order Number, or Agency Demob Number if applicable.4.Unit/Personnel ReleasedEnter appropriate vehicle or Strike Team/Task Force ID Number(s) and Leaders name or individual overhead or staff personnel being released.5.TransportationEnter 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/TimeTo be completed at conclusion of Demob at time of actual release from incident. Would normally be last item of form to be completed.7.ManifestMark appropriate box. If yes, enter manifest number. Some agencies require a manifest for air travel.8.DestinationEnter the location to which Unit or personnel have been released. i.e. Area, Region, Home Base, Airport, Mobilization Center, etc.9.Area/Agency/ Region NotifiedIdentify the Area, Agency, or Region notified and enter date and time of notification.10.Unit Leader Responsible for Collecting Performance RatingsSelf-explanatory. Not all agencies require these ratings.11.Resource SupervisionDemob 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. 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Incident Name/Number  FORMTEXT 2. Date/Time  FORMTEXT 3. Demob. No.  FORMTEXT 4. Unit/Personnel Released  FORMTEXT 5. Transportation Type/No.  FORMTEXT 6. Actual Release Date/Time  FORMTEXT 7. Manifest?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Number  FORMTEXT  8. Destination9. Notified:  FORMCHECKBOX  Agency  FORMCHECKBOX  Region  FORMCHECKBOX  Area  FORMCHECKBOX  Dispatch Name:  FORMTEXT  Date:  FORMTEXT 10. Unit Leader Responsible for Collecting Performance Rating  FORMTEXT 11. Unit/PersonnelYou and your resources have been released subject to sign off from the following: Demob. Unit Leader check the appropriate boxLogistics Section FORMCHECKBOX  Supply Unit FORMTEXT  FORMCHECKBOX  Communications Unit FORMTEXT  FORMCHECKBOX  Facilities Unit FORMTEXT  FORMCHECKBOX  Ground Support Unit Leader FORMTEXT Planning Section FORMCHECKBOX  Documentation Unit FORMTEXT Finance Section FORMCHECKBOX  Time Unit FORMTEXT Other FORMCHECKBOX   FORMTEXT  FORMTEXT  FORMCHECKBOX   FORMTEXT   FORMTEXT 12. Remarks  FORMTEXT  13. Prepared by (include Date and Time)  FORMTEXT  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 NumberItem TitleInstructions1.Incident Name/No.Enter Name and/or Number of Incident.2.Date & TimeEnter Date and Time prepared.3.Demob. No.Enter Agency Request Number, Order Number, or Agency Demob Number if applicable.4.Unit/Personnel ReleasedEnter appropriate vehicle or Strike Team/Task Force ID Number(s) and Leaders name or individual overhead or staff personnel being released.5.TransportationEnter 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/TimeTo be completed at conclusion of Demob at time of actual release from incident. Would normally be last item of form to be completed.7.ManifestMark appropriate box. If yes, enter manifest number. Some agencies require a manifest for air travel.8.DestinationEnter the location to which Unit or personnel have been released. i.e. Area, Region, Home Base, Airport, Mobilization Center, etc.9.Area/Agency/ Region NotifiedIdentify the Area, Agency, or Region notified and enter date and time of notification.10.Unit Leader Responsible for Collecting Performance RatingsSelf-explanatory. Not all agencies require these ratings.11.Resource SupervisionDemob 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 checMMMM)))))) VVVVfV))**@ %t)  x(**@ dt)     ((**@ bu)  :x( 45678^stuvw)))) JJJJJ JJJJgJ))**@ Mt)  **@ Mt)     x(x(**@ Ot)     (() ))))))))))))jd)_)ZZ0\`0p@ P !$`'0*-/2p5@8;=@CPF I**@ k)     ((**@@W} 7,     ((    # 5 [ \ _ k  d e ))){ 77{ 77 * Z0*x(x(*(Z0*  x*(Z0*Ze h    | } "2 JKOW (x * Z0*x(x("  0123EFG>BB)HL}MwTxT5(($`' !% !(2Z\`0p@ P !$`'0*-/2p5@8;=@CPF IK @ Normal ]a c$@$ Heading 4h^c @ Heading 5U @ Heading 6^ @ Heading 7V @ Heading 8V @ Heading 9 V"A@"Default Paragraph Font @ Footer ! @ Header !$&@$Footnote Referencece@" Footnote Text V:eCheck1V:eCheck2V:eCheck1V:eCheck1V:eCheck1V:eCV:eCheck2V:eCheck1V:eCheck1V:eCheck1V:eCheck1W:eCheck10V:eCheck9V:eCheck8V:eCheck7V:eCheck3V:eCheck4 V:eCheck5V:eCheck6 ggg ggg))))) MMMM))))) VVVV))))) JJJJ JJJJ)))))))))))))))){ 7{ 7PMQMVMWM\M]MbMgMhMmMrMwM|M}MPvTwTxTuuD TC]cGuDSC]cGuDpSC]cGuD]cuDSC]cGheck1W:eCheck10V:eCheck9FV:eCheck8V:eCheck7k4V:eCheck3V:eCheck4V:eCheck5orV:eCheck6 FORMTEXT   FORMTEXT  ICW:7Text170 P:xk, (unit requirements as needed), i.e. Safety Officer, Agency Rep., etc.12.RemarksAny additional information pertaining to demob or release.13.Prepared byEnter the name of the person who prepared this Demobilization Checkout, including the Date and Time. 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