Form Ics 204 PDF Details

In the complex and dynamic environment of managing emergency incidents, the ICS 204 Assignment List serves as a critical document, ensuring clear communication and coordination among various units. This form is an essential component of the Incident Action Plan (IAP), which outlines specific assignments for Division and Group supervisors, making the execution of tasks more structured and traceable. The preparation of the ICS 204 involves the meticulous gathering of information from different sources, including the Incident Objectives (ICS 202) and the Operational Planning Worksheet (ICS 215), under the guidance of the Resources Unit. The Incident Commander's approval is requisite, showcasing the form’s significance in the incident management process. It details operational periods, personnel involved, resources assigned, specific work assignments, and special instructions, along with communication protocols necessary for the seamless execution of responsibilities. This form not only facilitates a streamlined approach to incident management by providing a clear assignment list to supervisors but also prioritizes safety and efficiency through its structured format for conveying essential operational details and instructions.

QuestionAnswer
Form NameForm Ics 204
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesTBD, repaginate, IA-SCC-413, dropoff

Form Preview Example

ASSIGNMENT LIST (ICS 204)

1.

Incident Name:

 

 

 

 

 

2. Operational Period:

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

Date From:

 

 

 

Date To:

 

Branch:

1

 

 

 

 

 

 

 

 

 

Time From:

 

 

 

Time To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

4.

Operations Personnel: Name

 

 

 

Contact Number(s)

 

Division:

 

 

Operations Section Chief:

 

 

 

 

 

 

 

Group:

1

 

 

 

Branch Director:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Staging Area: 1

 

Division/Group Supervisor:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Resources Assigned:

 

# of Persons

 

 

 

 

 

Reporting Location,

 

 

 

 

 

 

 

 

 

 

 

 

Contact (e.g., phone, pager, radio

 

Special Equipment and

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supplies, Remarks, Notes,

 

Resource Identifier

 

 

Leader

 

frequency, etc.)

 

Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Work Assignments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

Special Instructions:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

Communications (radio and/or phone contact numbers needed for this assignment):

 

 

 

 

 

 

Name/Function

 

 

 

 

 

 

 

Primary Contact: indicate cell, pager, or radio (frequency/system/channel)

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. Prepared by: Name:

 

Position/Title:

Signature:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ICS 204

 

 

IAP Page _____

Date/Time:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ICS 204

Assignment List

Purpose. The Assignment List(s) (ICS 204) informs Division and Group supervisors of incident assignments. Once the Command and General Staffs agree to the assignments, the assignment information is given to the appropriate Divisions and Groups.

Preparation. The ICS 204 is normally prepared by the Resources Unit, using guidance from the Incident Objectives (ICS 202), Operational Planning Worksheet (ICS 215), and the Operations Section Chief. It must be approved by the Incident Commander, but may be reviewed and initialed by the Planning Section Chief and Operations Section Chief as well.

Distribution. The ICS 204 is duplicated and attached to the ICS 202 and given to all recipients as part of the Incident Action Plan (IAP). In some cases, assignments may be communicated via radio/telephone/fax. All completed original forms must be given to the Documentation Unit.

Notes:

The ICS 204 details assignments at Division and Group levels and is part of the IAP.

Multiple pages/copies can be used if needed.

If additional pages are needed, use a blank ICS 204 and repaginate as needed.

 

Block

 

 

Block Title

 

 

Instructions

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

Incident Name

 

Enter the name assigned to the incident.

 

 

 

 

 

 

2

 

 

Operational Period

 

Enter the start date (month/day/year) and time (using the 24-hour

 

 

 

 

Date and Time From

 

clock) and end date and time for the operational period to which the

 

 

 

 

Date and Time To

 

form applies.

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

Branch

 

This block is for use in a large IAP for reference only.

 

 

 

 

Division

 

Write the alphanumeric abbreviation for the Branch, Division, Group,

 

 

 

 

Group

 

 

 

 

 

 

and Staging Area (e.g., “Branch 1,” “Division D,” “Group 1A”) in large

 

 

 

 

 

 

 

 

 

 

 

 

 

Staging Area

 

letters for easy referencing.

 

 

 

 

 

 

4

 

 

Operations Personnel

 

Enter the name and contact numbers of the Operations Section Chief,

 

 

 

 

Name, Contact Number(s)

 

applicable Branch Director(s), and Division/Group Supervisor(s).

 

 

 

 

 

Operations Section Chief

 

 

 

 

 

 

 

 

Branch Director

 

 

 

 

 

 

 

 

Division/Group Supervisor

 

 

 

 

 

 

 

 

 

5

 

 

Resources Assigned

 

Enter the following information about the resources assigned to the

 

 

 

 

 

 

 

 

 

Division or Group for this period:

 

 

 

 

 

 

 

 

 

 

 

 

Resource Identifier

 

The identifier is a unique way to identify a resource (e.g., ENG-13,

 

 

 

 

 

 

 

 

 

IA-SCC-413). If the resource has been ordered but no identification

 

 

 

 

 

 

 

 

 

has been received, use TBD (to be determined).

 

 

 

 

 

 

 

 

 

 

 

 

Leader

 

Enter resource leader’s name.

 

 

 

 

 

 

 

 

 

 

 

 

# of Persons

 

Enter total number of persons for the resource assigned, including the

 

 

 

 

 

 

 

 

 

leader.

 

 

 

 

 

 

 

 

 

 

 

Contact (e.g., phone, pager,

 

Enter primary means of contacting the leader or contact person (e.g.,

 

 

 

 

 

radio frequency, etc.)

 

radio, phone, pager, etc.). Be sure to include the area code when

 

 

 

 

 

 

 

 

 

listing a phone number.

 

 

 

 

 

 

 

5

 

 

Reporting Location, Special

 

Provide special notes or directions specific to this resource. If

 

(continued)

 

 

Equipment and Supplies,

 

required, add notes to indicate: (1) specific location/time where the

 

 

 

 

 

Remarks, Notes, Information

 

resource should report or be dropped off/picked up; (2) special

 

 

 

 

 

 

 

 

 

equipment and supplies that will be used or needed; (3) whether or not

 

 

 

 

 

 

 

 

 

the resource received briefings; (4) transportation needs; or (5) other

 

 

 

 

 

 

 

 

 

information.

 

 

 

 

 

 

 

 

 

 

 

 

Block

 

 

Block Title

 

 

Instructions

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

Work Assignments

 

Provide a statement of the tactical objectives to be achieved within the

 

 

 

 

 

 

 

 

operational period by personnel assigned to this Division or Group.

 

 

 

 

 

 

7

 

 

Special Instructions

 

Enter a statement noting any safety problems, specific precautions to

 

 

 

 

 

 

 

 

be exercised, dropoff or pickup points, or other important information.

 

 

 

 

 

 

8

 

 

Communications (radio and/or

 

Enter specific communications information (including emergency

 

 

 

 

phone contact numbers needed

 

numbers) for this Branch/Division/Group.

 

 

 

 

for this assignment)

 

If radios are being used, enter function (command, tactical, support,

 

 

 

 

Name/Function

 

 

 

 

 

 

etc.), frequency, system, and channel from the Incident Radio

 

 

 

 

Primary Contact: indicate

 

 

 

 

 

 

Communications Plan (ICS 205).

 

 

 

 

 

cell, pager, or radio

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(frequency/system/channel)

 

Phone and pager numbers should include the area code and any

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

satellite phone specifics.

 

 

 

 

 

 

 

 

In light of potential IAP distribution, use sensitivity when including cell

 

 

 

 

 

 

 

 

phone number.

 

 

 

 

 

 

 

 

Add a secondary contact (phone number or radio) if needed.

 

 

 

 

 

 

9

 

 

Prepared by

 

Enter the name, ICS position, and signature of the person preparing

 

 

 

 

Name

 

the form. Enter date (month/day/year) and time prepared (24-hour

 

 

 

 

Position/Title

 

clock).

 

 

 

 

 

 

 

 

 

 

 

Signature

 

 

 

 

 

 

 

Date/Time