Demobilization Check-Out (ICS 221)

1. Incident Name:	2. Incident Number:
3. Planned Release Date/Time: Date: Time:	4. Resource or Personnel Released:	5. Order Request Number:
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:
8. Travel Information:	Room Overnight: Yes No
Estimated Time of Departure:	Actual Release Date/Time:
Destination:	Estimated Time of Arrival:
Travel Method:	Contact Information While Traveling:
Manifest: Yes No Number:	Area/Agency/Region Notified:
9. Reassignment Information: Yes No
Incident Name:	Incident Number:
Location:	Order Request Number:
10. Prepared by: Name: Position/Title: Signature:
ICS 221	Date/Time: