ASSIGNMENT LIST (ICS 204)

1. Incident Name:	2. Operational Period: Date From: Date To: Time From: Time To:	3. Branch: 1 Division: 1 Group: 1 Staging Area: 1
4. Operations Personnel: Name Contact Number(s) Operations Section Chief: Branch Director: Division/Group Supervisor:
5. Resources Assigned:	# of Persons	Contact (e.g., phone, pager, radio frequency, etc.)	Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
Resource Identifier	Leader
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: