January 26, 2020

INCIDENT CHECK-IN LIST

ICS 211
1. INCIDENT/EVENT NAME 2. START DATE AND TIME 3. CHECK-IN LOCATION (Please check)
Date:
Time:
□Base □ Camp □Staging Area □ ICP □Others
4. CHECK-IN INFORMATION
Name of With
Resource Identifier Departure Details
Order/ Check-In Agency / Total Manifest? Data
Name of Contact Incident Other
Request Date and Kind Type Single Office / No. of Sent to
Leader Details Point
Date and Method Assignment Qualifications
No. Time Resourc ST TF Home Pers. of Yes No RESL
Base Time of Travel
e Origin
Kristian
September Mark Septembe
092068171 r 15, 20xx
15, 20xx IMT √ RIZAL Moises L. 10 Rizal Land √ ICP
1000H 62 1000H
Bugnose
n
September Septembe ICP
Joe S. 097754861
15, 20xx PT1 √ PNP 4 Rizal r 15, 20xx Land √
1010H Lim 58

September ICP
Ping W. 091584784 Septembe
15, 20xx PT2 √ PNP 4 Rizal Land √
1015H Lacson 57 r 15, 20xx

September √ Zacarias Septembe ICP

15, 20xx 091665665
001 1100H PT3 PNP M. 4 Cavite r 15, 20xx Land √
65
Mathias
September √ ICP
15, 20xx Devon L. 091665665 Septembe
002 1100H PT4 PNP 4 Laguna Land √
Lim 66 r 15, 20xx

September √ Septembe ICP

15, 20xx Ace A. 091242453
1105H PS1 PNP 1 Cavite r 15, 20xx Land √
Smith 25
September √ Septembe Land ICP
15, 20xx AMB RHU Paul O. 094578911 3 Rizal
r 15, 20xx
√
1110H 1 RIZAL Simon 71
September √ RIZAL Septembe Land ICP
15, 20xx r 15, 20xx
1110H AMB DISTRICT Ben P. 097512487 3 Rizal √
2 HOSPITA Son 55
L
Use additional sheets as needed
Page __1_ of __5__ 5. Prepared by (_____) Name and Signature: Date Prepared: Time Prepared: 1330H
SEPTEMBER 15, 20XX
 January 26, 2020

INCIDENT CHECK-IN LIST

ICS 211
1. INCIDENT/EVENT NAME 2. START DATE AND TIME 3. CHECK-IN LOCATION (Please check)
Date:
Time:
□Base □ Camp □Staging Area □ ICP □Others
4. CHECK-IN INFORMATION
Name of With
Resource Identifier Departure Details
Order/ Check-In Agency / Total Manifest? Data
Name of Contact Incident Other
Request Date and Kind Type Single Office / No. of Sent to
Leader Details Point
Date and Method Assignment Qualifications
No. Time Resourc ST TF Home Pers. of Yes No RESL
Base Time of Travel
e Origin
September √ ICP
September
15, 20xx Mang R. 097785411
1130H DT1 DPWH 1 Manila 15, 20xx Land √
Tomas 25
September √ September Land ICP
15, 20xx EMV Cardo B. 091522547 15, 20xx
1133H 1 DPWH 1 Manila √
Dalisay 87
September √ September Land ICP
15, 20xx Buko V. 097812355 15, 20xx
1140H FL1 DPWH 1 Manila √
Pie 46
September √ September Land ICP
15, 20xx VOL - Agnes H. 097781475 15, 20xx
1145H 1 RIZAL 10 RIZAL √
Hill 51
September √ September Land ICP
15, 20xx VOL- Lily X. 091888842 15, 20xx
1148H RIZAL 10 RIZAL √
2 Aguas 44
September √ September Land ICP
003
15, 20xx
FF-1
BFP Enrile F. 098845425 5 RIZAL
15, 20xx
√
1150H RIZAL Yu 89
September √ September Land ICP
15, 20xx SAR- Mar T. 091712358 LAGU 15, 20xx
004 1157H OCD 10 √
1 Roxas 61 NA

September √ September Land ICP

15, 20xx SAR- Edu G. 097512548 CAVIT 15, 20xx
005 1158H 2 OCD 10 √
Marzan 67 E

Use additional sheets as needed

Page __2__ of _5__ 5. Prepared by (_____) Name and Signature: Date Prepared: Time Prepared:
January 26, 2020
 January 26, 2020

INCIDENT CHECK-IN LIST

ICS 211
1. INCIDENT/EVENT NAME 2. START DATE AND TIME 3. CHECK-IN LOCATION (Please check)
Date:
Time:
□Base □ Camp □Staging Area □ ICP □Others
4. CHECK-IN INFORMATION
Name of With
Resource Identifier Departure Details
Order/ Check-In Agency / Total Manifest? Data
Name of Contact Incident Other
Request Date and Kind Type Single Office / No. of Sent to
Leader Details Point
Date and Method Assignment Qualifications
No. Time Resourc ST TF Home Pers. of Yes No RESL
Base Time of Travel
e Origin
September √ September Land ICP
006
15, 20xx
FF-2
BFP Susan S. 098845425 5
CAVIT 15, 20xx
√
1200H CAVITE Su 88 E

September √ September Land ICP

15, 20xx EMT- Frank I. 091523677 CAVIT 15, 20xx
007 1205H 1 CAVITE 7 √
Beef 45 E

September √ September Land ICP

15, 20xx BFP 098845425 LAGU 15, 20xx
008 1205H FF-3 Phil I. Pit 5 √
LAGUNA 87 NA

September √ Dolly September Land ICP

15, 20xx 097758989 MANIL 15, 20xx
009 1205H RT-1 DSWD Anne N. 10 √
86 A
Mo
September √ September Land ICP
15, 20xx EMT- Rose M. 097812355 MANIL 15, 20xx
010 1205H PRC 7 √
2 Thorn 44 A

September √ September Land ICP

15, 20xx EMT- Deon D. 091777771 NIBEL 15, 20xx
011 1205H 3 PDRRMO 7 √
Jones 17 HEIM

September √ Fernando September Land ICP

15, 20xx 097758989 15, 20xx
012 1205H RT-2 RIZAL S. 10 RIZAL √
87
Katigbak
September √ September Land ICP
013
15, 20xx
ET-1
DPWH Bill M. 092348841 3
CAVIT 15, 20xx
√
1207H CAVITE Gates 1 E

Use additional sheets as needed

Page __3__ of _5__ 5. Prepared by (_____) Name and Signature: Date Prepared: Time Prepared:
 January 26, 2020

INCIDENT CHECK-IN LIST

ICS 211
1. INCIDENT/EVENT 2. START DATE AND TIME 3. CHECK-IN LOCATION (Please check)
NAME Date:
Time:
□Base □ Camp □Staging Area □ ICP
□Others
4. CHECK-IN INFORMATION
Name With
Departure
Ord Resource Identifier of Tot Manif
Chec Details Data
er/ K Agen Name Conta al est?
k-In Incident Other Sent
Req i Ty Sing cy / of ct No. Po Met
Date Assign Qualifi to
ues n pe le Offic Lead Detail of int Date hod Y
and N ment cations RES
t d Res ST TF e/ er s Per of and of e
Time Ori Time Tra s
o L
No. ourc Home s.
e Base gin vel
Septe √ DPW Sept Lan ICP
mber E Dina 0929 M emb d
H AN
014 15, T- T. 4174 3 er √
20xx 2 MAN IL 15,
Uto 125 A
1210H ILA 20xx
Septe √ Mary Sept Lan ICP
mber A RHU 0956 CA emb d
M K.
015 15, CAVI 2348 3 VI er √
20xx B Garc TE 15,
-3 TE 855
1210H ia 20xx
Septe √ Bon NI
Sept Lan ICP
mber emb d
15,
A gbon 0928 BE er
M
016 20xx B PRC g Y. 4174 3 LH 15, √
EI
1213H -4 Lobr 123 M
20xx
edo
Septe R √ Rain Sept Lan ICP
mber E 0917 LA emb d
LAG A. G
017 15, T 5482 3 er √
20xx T- UNA Sant U 15,
244 NA
1215H 1 os 20xx
Septe
M √
Mike 0947 M
Sept Lan ICP
mber emb d
E DEP AN
018 15,
T- T. 2525 3 er √
20xx ED IL
15,
1216H
1 Das 871 A
20xx
Septe √ Fiera Sept Lan ICP
mber F BFP 0955 M emb d
G. AN
019 15, E MAN 5557 4 er √
20xx -1 Fion IL 15,
ILA 474 A
1217H a 20xx
Septe √ Pedr Sept Lan ICP
mber E 0915 RI emb d
M RIZA o A.
020 15, 2367 1 ZA er √
20xx V L Pind L 15,
-2 742
1218H uko 20xx
Septe R √
Sun 0922
Sept Lan ICP
mber E emb d
PLD PL
021 15, T B. 4875 3 er √
20xx T- T DT
15,
1218H 2
Lee 871 20xx
 January 26, 2020
Lan
Use additional sheets as needed d

Page
5. Prepared by Time Prepared: Lan
__4__ of Name and Signature: Date Prepared: d
_5__ (_____)
 January 26, 2020

INCIDENT CHECK-IN LIST

ICS 211
1. INCIDENT/EVENT NAME 2. START DATE AND TIME 3. CHECK-IN LOCATION (Please check)
Date:
Time:
□Base □ Camp □Staging Area □ ICP □Others
4. CHECK-IN INFORMATION
Name of With
Resource Identifier Departure Details
Order/ Check-In Agency / Total Manifest? Data
Name of Contact Incident Other
Request Date and Kind Type Single Office / No. of Sent to
Leader Details Point
Date and Method Assignment Qualifications
No. Time Resourc ST TF Home Pers. of Yes No RESL
Base Time of Travel
e Origin
September √ September Land ICP
15, 20xx Bong L. 099999987 NIBEL 15, 20xx
022 1220H SV-1 PGLU 1 √
Go 87 HEIM

September √ September Land ICP

15, 20xx Mat U. 099999987 NIBEL 15, 20xx
023 1220H SV-2 PGLU 1 √
Rog 88 HEIM

September √ September Land ICP

15, 20xx MET- 094725258 15, 20xx
024 1221H DEPED Gori L. Ya 3 RIZAL √
2 72

Use additional sheets as needed

Page __5__ of __5_ 5. Prepared by (_____) Name and Signature: Date Prepared: Time Prepared:
 January 26, 2020

ICS 211: INCIDENT CHECK-IN LIST

PURPOSE: The ICS 211 records arrival times at the incident of all resources, records the initial location of resources to facilitate subsequent
assignments and supports demobilization by recording the home method of travel for resources checked in.

PREPARATION: The ICS 211 is initiated at a number of locations including staging areas, bases, camps and Incident Command Post to be
accomplished by the leader/authorized representative/overhead of the resources. Preparations may be completed by the overhead at these
locations or a check-in recorder from the Resources Unit. All accomplished 211s must be given to the Resource Unit Leader (RESL) as soon as
possible.

DISTRIBUTION: The ICS 211s, once accomplished at various locations, are provided to the Resources Unit, Demobilization Unit and
Finance/Administration Unit. The Resources Unit maintains a master list of all equipment and personnel that have reported to the incident/event.

HOW TO FILL-UP THE FORM:

BLOCK NO. BLOCK TITLE INSTRUCTIONS

1 Incident/Event Name Enter the name assigned to the incident/event
2 Start Date and Time Enter the starting date (month-dd-yyyy) and time (24 hour format) for the check-in.
3 Check-in Location Check to indicate the location for the check-in.
4 Check-in Information Enter the following check-in information.
Order/Request No. Enter the Order/Request No. for the resource (only if applicable)
Check-in Enter the date (month -dd-yyyy) and time (24 hour format) of check-in of the resource
Kind Enter the kind of resource. Kind refers to broad categories of resources (e.g. crews, bulldozers,
engines, SAR teams)
Type Enter the type of resource. Type describes performance capability (e.g. T1 - highest capability, T2 -
next to T1)
Resource Identifier Determine whether the resource is:
 Single resource – individual personnel, single pieces of equipment (with or without operator), or
a crew of individuals, with an identified work supervisor.
 Strike Team – group of resources of the same kind and type with common communications
 Task Force – combination of mixed resources from with common communications

NOTE: The resource identifier shall be designated by the check-in recorder.

Name of Agency / Enter the name of agency, office or home base of the resource.
 January 26, 2020

Office / Home Base

Name of Leader Enter the leader / authorized representative of the resource.
Contact Details Enter the contact details of the leader / authorized representative of the resource
Total Number of Enter the number of personnel
Personnel
Departure Details Enter the following information about the departure of the resource:
 Point of Origin – Enter the location from which the resource departed for this incident/event.
 Date and Time – Enter the date (month-dd-yyyy) and time (24 hour format) of departure
 Method of Travel – Enter the means of travel the individual used going to the incident/event site
(e.g., bus, truck, engine, personal vehicle, etc.).
With Manifest? Enter if there is an attached manifest containing the comprehensive list of resource breakdown.
Incident Assignment Enter the incident assignment of the resource at the time of dispatch.
Other Qualifications Enter additional duties pertinent to the incident/event that the resource is qualified to perform.
Data Sent to RESL Enter the date (month-dd-yyyy) and time (24 hour format the information pertaining to that entry was
transmitted to the RESL.
5 Prepared by (___) Enter complete name and signature of the person who prepared the specific page of the form, date
(month-dd-yyyy), and time (24 hour format) the form was prepared and completed.

Indicate the position in the (_____).

 January 26, 2020

CHECK-IN MANIFEST
1. NAME Of AGENCY / OFFICE / HOME BASE
2. NAME Of LEADER
3. CONTACT DETAILS
4. TOTAL NUMBER OF PERSONNEL: _____

Capabilities/
Name Age Gender Weight (kg) Contact Details Others
Specialization

Use additional sheet as necessary

5. TOTAL NUMBER OF VEHICLES: _____
LAND: _____
WATER: _____
AIR: _____

Name of Kind Type Plate Number Fuel Type Weight (kg) Contact Details Capabilities/
Others
Operator Specialization
 January 26, 2020

Use additional sheet as necessary

6. TOTAL NUMBER OF EQUIPMENT: _____

Name of Kind Type Source of Fuel Type Weight (kg) Contact Details Capabilities/
Others
Operator Power Specialization

Use additional sheet as necessary

7. OTHERS: _____

Use additional sheet as necessary

7. Prepared by (_____) Name and Signature: Date Prepared: Time Prepared:
 January 26, 2020

CHECK-IN MANIFEST

PURPOSE: The Check-in Manifest is used to obtain the breakdown of resources checked-in as indicated in ICS 211..

PREPARATION: The Check-in Manifest is accomplished by the head or authorized representative of the agency or office that will check-in to the
incident/ event.

DISTRIBUTION: The Check-in Manifest is submitted along with the ICS 211. The Resources Unit maintains a master list of all equipment and
personnel that have reported to the incident/event.

HOW TO FILL-UP THE FORM:

BLOCK NO. BLOCK TITLE INSTRUCTIONS

1 Name of Agency/ Office/ Enter the name of agency, office or home base of the resource.
Home Base
2 Name of Leader Enter the leader / authorized representative of the resource.
3 Contact Details Enter the contact details of the leader, to include land line number, mobile number and/or email
address.
4 Total Number of Enter the total number of personnel as part of the resource. Afterwards, provide breakdown of
Personnel the personnel by filling up the appropriate blocks.
5 Total Number of Vehicles Enter the total number of vehicles as part of the resource. Afterwards, provide breakdown of the
vehicles by filling up the appropriate blocks.
6 Total Number of Major Enter the total number of equipment as part of the resource. Afterwards, provide breakdown of
Equipment the major equipment by filling up the appropriate blocks.
7 Others Enter the total number of other resource other than personnel, vehicles and major equipment.
Afterwards, provide the appropriate breakdown.
8 Prepared by (___) Enter complete name and signature of the person who prepared the specific page of the form,
date (month-dd-yyyy), and time (24 hour format) the form was prepared and completed.

Indicate the position in the (_____).