October 24, 2016

ASSIGNMENT LIST
ICS 204
1. INCIDENT/ EVENT NAME 2. OPERATIONAL PERIOD 3. Branch:
From (Date and Time): Group:
To (Date and Time): Division:
Staging Area:
4. OPERATIONS PERSONNEL
Position  Name Contact Number(s)
Operations Section Chief
Branch Director
Staging Area Manager
Division /Group Supervisor
Air/Water Tactical Group Supervisor
5. RESOURCES ASSIGNED FOR THIS PERIOD
Name of Trans. Drop off point and Pick-up time Remarks
Contact No. of Needed?
Resource Identifier Leader time at area of from area of
Numbers Personnel
Yes No assignment assignment

6. SPECIFIC WORK ASSIGNMENT

7. SPECIAL INSTRUCTIONS/ SAFETY MEASURES

8. COMMUNICATIONS SUMMARY
Function System Channel Frequency Others (cellphone, satphone, etc.

9. Prepared by RESL Name and Signature: Date Prepared: Time Prepared:

 October 24, 2016

ICS 204: ASSIGNMENT LIST

PURPOSE: The ICS 204 informs the Division and Group supervisors of incident assignments. Once the
Command and General Staff agree to the assignments, the assignment information is given to the
appropriate Divisions and groups.

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..

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.

HOW TO FILL-UP THE FORM:

BLOCK NO. BLOCK TITLE INSTRUCTIONS

1 Incident/Event Name Enter the name assigned to the incident/event
2 Operational Period Enter the start date (mm-dd-yyyy) and time (24 hour format)
and end date and time for the operational period to which
the form applies.
3 Branch This block is for use in a large IAP for reference only. Enter
Group the appropriate alphanumeric abbreviation as appropriate.
Division Eg. Branch 1, Division A, etc.
Staging Area
4 Operations Personnel Enter the names, agencies/offices, and contact numbers of
the OSC and the applicable Branch Director (s) and
Division/Group Supervisor (s).

Note that there may be two or more divisions or groups

during an operational period. Use additional 204s as
needed.
5 Resources assigned Enter information about resources assigned for this
for this Period operational period
Resource Identification Enter the breakdown of resources assigned for the
Branch/Division/Group/Staging Area.

Indicate the resource identification and specify if you are

going to use single resource, strike team or task force for
each.

If strike team or task force, enter in the succeeding blocks

the breakdown of resources composing the said strike team
or task force.

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.
 October 24, 2016

Note: The name of leader for every single resource, strike

team or task force indicated in this form shall be entered.
Contact Details Enter the contact details of the leader.

Note: The contact details of leader for every single

resource, strike team or task force indicated in this form
shall be entered.
No. of Personnel Enter the number of personnel for the unit or resource.
Trans. Needed? Indicate “Y” for yes or “N” for no if the resources requires to
be transported
Drop off point and time Enter special notes or directions specific to this resource. If
at area of assignment required, add remarks to indicate: (1) specific location/time
where the resources should be drop off/picked up; (2)
special equipment and supplies that will be used or needed;
(3) whether or not the resource received briefings; (4)
transportation needs; or (5) other information.
Pick-up time from area Enter special notes or directions specific to this resource. If
of assignment required, add remarks to indicate: (1) specific location/time
where the resources should be picked up
Remarks Enter other important details about the resource.
6 Specific Work Enter statement of tactical objectives to be achieved within
Assignment the operational period by the personnel assigned to this
Division or Group. Also indicate the specific locations where
they will perform their assignment.

Note: The information for this block can be referred from

the Operational Planning Worksheet (ICS 215)
7 Special Instructions/ Enter a statement noting any safety precautions to be
Safety Measures exercised or other important information.

Note: The information for this block can be referred from

the Operational Planning Worksheet (ICS 215)
8 Communications Enter specific communications information (including
Summary emergency numbers) for this Branch/Division/Group. If
radios are being used, enter function (command, tactical,
support, etc.,) frequency, system, and channel from the
Incident Radio Communications Plan (ICS 205). In light of
potential IAP distribution, use sensitivity when including
cellphone numbers. Add a secondary contact (phone
number or radio)if needed
9 Prepared by RESL Enter complete name of the RESL, signature, date (mm-dd-
yyyy), and time (24 hour format) the form was prepared and
completed.

The form is prepared usually by the RESL. In the absence

of RESL, it shall be prepared by the PSC or OSC.
 October 24, 2016

ASSIGNMENT LIST
ICS 204
1. INCIDENT/ EVENT NAME 2. OPERATIONAL PERIOD 3. Branch:
Rizal Earthquake From (Date and Time): 09-17-20xx, 1000H Group:
To (Date and Time): 09-17-20xx, 2200H Division: A
Staging Area:
4. OPERATIONS PERSONNEL
Position  Name Contact Number(s)
Operations Section Chief Dingdong Dingdang 12345
Branch Director
Staging Area Manager
Division /Group Supervisor Kim Che 67890
Air/Water Tactical Group Supervisor
5. RESOURCES ASSIGNED FOR THIS PERIOD
Name of Trans. Drop off point and Pick-up time Remarks
Contact No. of Needed?
Resource Identifier Leader time at area of from area of
Numbers Personnel
Yes No assignment assignment
Ridge School Ridge School
1111111 1
Task Force Jin Kasama / 1100H 2200H
Ridge School Ridge School
2222222 5
 PO1 Albert Whisker / 1100H 2200H
Ridge School Ridge School
3333333 5
 PO2 Jill Valentina / 1100H 2200H
Ridge School Ridge School
4444444 7 /
 SAR1 Cloud Strive 1100H 2200H
Ridge School Ridge School
5555555 7 /
 SAR2 Johnny Cagie 1100H 2200H
 AMB1 Forest Lawlaw 6666666 5 /

6. SPECIFIC WORK ASSIGNMENT

PO – secure the perimeter, maintain law and order

SAR – conduct search and rescue operations in Ridge School
AMB - provide appropriate medical assistance to rescued victims

7. SPECIAL INSTRUCTIONS/ SAFETY MEASURES

 Wear PPEs, stay hydrated, work using buddy-buddy system , be careful of livewires

8. COMMUNICATIONS SUMMARY
Function System Channel Frequency Others (cellphone, satphone, etc.
Command Mun. Rizal 1 145.500MHz 123456
Tac 2 Mun. Rizal 3 145.700MHz 345678

Name and Signature:

Date Prepared: Time Prepared:
9. Prepared by RESL Vice
09-16-20xx 1500H
Vice Danda