INCIDENT CHECK-IN LIST (ICS 211) 1. Incident Name: 2. Incident Number: 3. Check-In Location (complete all that apply): () Base () Staging Area () ICP () Helibase () Other 4. Start Date/Time: Check ins Row 1: 5. State / Agency / Category / Kind / Type / Resource Name or Identifier / ST or TF 6. Order Request # 7. Date/Time Check-In 8. Leader's Name 9. Total Number of Personnel 10. Incident Contact Information 11. Home Unit or Agency 12. Departure Point, Date and Time 13. Method of Travel 14. Incident Assignment 15. Other Qualifications 16. Data Provided to Resources Unit 17. Prepared by: Name: Position/Title: Signature: Date/Time: