ICS Form 204 Template
ICS Form 204 Template
ASSIGNMENT LIST
ICS 204
1. INCIDENT/ EVENT NAME 2. OPERATIONAL PERIOD 3.
From (Date and Time): Branch:
To (Date and Time): Group:
Division:
Staging Area:
4. OPERATIONS PERSONNEL
Position Name Agency/Office Contact Number(s)
Operations Section Chief
Branch Director
Staging Area Manager
Division /Group Supervisor
PREPARATION: For major incidents, the ICS 204 is normally prepared by the Resource Unit Leader
(RESL) using the guidance of ICS 202, 215 and based on the directives of the Operations Section
Chief (OSC). It may also be initiated by the Planning Section Chief (PSC) and the OSC as well. The
Incident Commander (IC) approves the ICS 204.
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). All completed original forms must be given to the Documentation
Unit.
Notes:
The breakdown of resources for this block shall be
obtained from the Operational Planning Worksheet
(ICS 215).
Remember to maintain the maximum span of
control.
Name of Leader Enter the name of the leader assigned for the unit or
resource.
ASSIGNMENT LIST
ICS 204
1. INCIDENT/ EVENT NAME 2. OPERATIONAL PERIOD 3.
Rizal Earthquake From (Date and Time): 09-17-20xx, 1000H Branch:
To (Date and Time): 09-17-20xx, 2200H Group:
Division: A
Staging Area:
4. OPERATIONS PERSONNEL
Position Name Agency/Office Contact Number(s)
Operations Section Chief Dingdong Dingdang PNP 12345
Branch Director
Staging Area Manager
Division /Group Supervisor Kim Che Municipal DRRMO 67890