ICS-213RR: Resource Request

* Indicates required field

1. Incident Name *

2. Date/Time of Request *

3. Resource Request # (If known) *

4. ORDER (Use additional forms when requesting different resource sources of supply.)

QUANTITY *

KIND *

TYPE *

Detailed Item Description: (Vital characteristics, brand, specs, experience, size, etc.) *

5. Resource Status

Received By:

Date/Time:

Assigned To:

Released To:

Date/Time:

Cost:

6. Requested Delivery/Reporting Location: *

6a. Requested Reporting Date/Time *

County of Operation *

7. Suitable Substitutes and/or Suggested Sources: *

8. Requested by Name: *

First

Last

Position: *

Email *

Phone Number *

9. Priority:  Urgent  Routine  Low *

URGENT Routine Low

Have you place into eTeams? *

YES No No Access, Please Enter

PLACE ORDER