ARES/RACES MESSAGE FORM

EOC MESSAGE FORM
PacFORMS adaption of SCCo ICS Form 213 (Ver. 2.1.3)
By Phil Henderson, KF6ZSQ
(This form works with Outpost/OpDirect for Automatic ASCII text save)
For Instructions using this form
This Form has been filled in using file Message CERT DA Summary Report.txt

2.) When Receiving Msg.:
Senders's msg. #

Msg. #

RED Areas Required

3.) When Sending Msg.:
Receiving msg. #

1a.) Date: (MM/DD/YY)	4.) Situation Severity (Select One) EMERGENCY (e.g., Life Threat) URGENT (e.g., Property Threat) OTHER (All Others)	5.) Msg. Handling Order (Select One) IMMEDIATE (As Soon as Possible) PRIORITY (Less Than One Hour) ROUTINE (More Than One Hour)	6.) Message Request You to: TAKE ACTION (Check one) Yes No REPLY (Check one) Yes, by No FOR YOUR INFO. (No action required)
1b.) Time: (24 hour clock) 0001 to 2400 2:00 PM = (2+12)=1400 Hrs.

To:	7.) ICS Position: (required)	From:	8.) ICS Position: (required)
	9a.) Location: (required)		9b.) Location: (required)
	Name: (optional)		Name: (optional)
	Telephone #: (optional)		Telephone #: (optional)

10.) SUBJECT:

11.) REFERENCE (e.g., Number of earlier msg.):

12.) Message (what, when, where needed; how long; contact name and phone number) KEEP MSG BRIEF
F= G= W= E= C= Bldg. L= M= H= I= D= T= M= A= N= %=

13.) Action Taken: (For use by Originator / Recipient) -> USE SEPARATE MESSAGE FORM IF SENDING REPLY!

CC: Management Operations Planning Logistics Finance

14.) Operator use Only

How Received or Sent (Check One this line and one below)
Telephone Dispatch Center
EOC Radio FAX Courier
Amateur Radio Other

Operator Call Sign:
Operator Name:

Date:	Time:

Outgoing (Sent):
Message Originator: Send the top copy (white) to Radio, yellow to PLANNING, retain the pink copy for originators file.
Radio: After sending, complete Action Taken info. in gray area, keep white for file in Radio.
Incoming (Received):
Radio: After receiving, complete Action Taken info. in gray area, route top copy (white) to the addressee, pink copy to PLANNING; retain yellow for file in Radio.
Addressee; Take approriate action.

SCCo ICS FORM 213 (Ver. 2.1.3), 11/11/2007