OCR Deployment Tracking System (DTS)

OCR Deployment Tracking System (DTS)

OMB - Pre-Deployment Checklist - Randall.xls

OCR Deployment Tracking System (DTS)

OMB: 0412-0580

Document [xlsx]
Download: xlsx | pdf

Overview

Cover
Section I-VI
Section VII-X
Inprocessing Checklist


Sheet 1: Cover

READINESS AND DEPLOYMENT CHECKLIST (OMB 0412-0580; Expiration Date: XX/XX/XXX)











1. DATE (YYYYMMDD) 2. NAME (Last, First, Middle) 3. ORGANIZATIONLA ID NUMBER














4. SERVICE AFFILIATION 5. COMPONENT 6. STATUS 7. E-MAIL ADDRESS





USAID Commerce ACTIVE PSC





DOS Treasury STAND-BY DH 8. CITIZENSHIP COUNTRY





DOJ DHS RESERVE





USDA 9. DEPLOYMENT COUNTRY





10. JOB TITLE











11.OVERALL STATUS OF EACH SECTION







a. Readiness Certification b. Personnel c. Finance d. Training d. Medical





YES NO YES NO YES NO YES NO YES NO





f. Training g. Security h. Medical i. Dental j. Vision





YES NO YES NO YES NO YES NO YES NO





SECTION I - DEPLOYMENT VALIDATION





Part B. Team Leader Acknowledgement: (Commanders may approve a non-deployable individual for deployment based on the certifying official's recommendation, criticality, and mission needs, unless otherwise indicated.) I Acknowledge the SRP Sites findings.










1. PRINTED NAME (TEAM LEADER) 2. GRADE 3. ADDRESS

















4. SIGNATURE 5. TITLE











6. PHONE NUMBER 7. E-MAIL ADDRESS
8. Date





















Sheet 2: Section I-VI

READINESS AND DEPLOYMENT CHECKLIST
NAME (Last, First Middle) SSN

READINESS CERTIFICATION DEPLOYMENT VALIDATION
SECTION II - PERSONNEL GO NO GO NA DATE (YYYYMMDD) GO NO GO NA DATE (YYYYMMDD)

1. Emergency Data Information/Locator Card







2. Insurance Verification/MEDEVAC Insurance Policy Curent (Verification)







3. DoS/USAID Badge







4. Passport requested or in possession, if required (carried by person)







5. Visa requested or in possession, if required (carried by person)








6. Citizenship/Natrualization Verification








7. Travel Authorization Orders








8. Airline Tickets








9. SF 50 (Stand-by personnel only)








10. Passport Photo in database








11. Service Agreement (Stand-by personnel only)








12a. Signature of Certifying Official 12b. Grade/Title 12c. Date (YYYYMMDD)
SECTION III - SUPPLY AND LOGISTICS
1. Personal clothing, basic issue or like quantities







2. Organizational clothing and equipment issued







3. Theater specific clothing issued







4. Theater specific equipment issued







5a. Signature of Certifying Official 5b. Grade/Title 5c. Date (YYYYMMDD)

Sheet 3: Section VII-X

READINESS AND DEPLOYMENT CHECKLIST
NAME (Last, First Middle) SSN
SECTION IV -TRAINING READINESS CERTIFICATION DEPLOYMENT VALIDATION
GO NO GO NA DATE (YYYYMMDD) GO NO GO NA DATE (YYYYMMDD)
1. Force Protection Training administered







2. OPSEC/SAEDA Briefing







3. Deployment Briefing to Family Members







4. Safety and Local laws for deployment area briefing







5. Media Awareness Training







6. Sector specific training requirements completed







7. Military Common Task Training







8a. SIGNATURE OF CERTIFYING OFFICIAL 8b. Grade/Title 8c.DATE (YYYYMMDD)
SECTION V- SECURITY
1. Security clearance meets requirement for duty position







2. Security clearance meets requirement for deployment mission







3. Security Clearance Provided to Gaining EMB.







4a. SIGNATURE OF CERTIFYING OFFICIAL 4b. Grade/Title 4c. DATE (YYYYMMDD)
SECTION VI- MEDICAL
1. Shot/Innoculations Current







2. Immunizations current







3. Current physical exam on hand (Class I)







4. Country specific immunizations required for deployment area.







5. Prescriptions, sufficient supply; minimum 90 day if Overseas)







6. Medical Tags/Bracelets








7a. SIGNATURE OF CERTIFYING OFFICIAL 7b. Grade/Title 7c. DATE (YYYYMMDD)

Sheet 4: Inprocessing Checklist

Civilian Response Corps (CRC) Inprocessing Checklist
Privacy Act Statement
Adminstrative Information
Name (Last, First M.I.) Organization ID Number Grade Hiring Mechanism
Date of Birth Age Height Weight Hair Color Eye Color Blood Type Religion
Home Address Phone Number (Work) Duty Title
Phone Number (Home)
Primary E-Mail Address
Phone Numner (Cell)
Section/Organization Address Alternate E-Mail Address
Emergency Information
Address A/ Phone Number
E-Mail Address Alternate E-Mail Address
Security Information
Security Clearence Date Initiated Expiration Date
Languages (Reading/Writing/Verbal) Equipment Sizes
a. c. Hat Size Boot Size Coat Size



b. d. Trouser Size Glove Size NBC Suit Size




NBC Glove Size NBC Boot Size Protective Mask Size














































Sector Expertise Foreign Country Experience
Sector Experience Country Duration (Mos.) Desciption


























Training
Orientation Training Date Annual Training


Military Training Date Civilian Training Date Language Training Date Skill Level (i.e. 1/1/1)
USAID 101
Weapons Familiarization
R & S Training
Arabic

Military 101
Convoy Live Fire
DG Training



CMM 102
NBC Training
Conflict Management Tng



State 101
First Aid
HAZMAT Training



Equal Opportuniy
Communication
EPA Training



IT Training
Land Navigation
Cultural Awareness
Sapnish



Drivers Training
Rule of Law
Japanese




WST Training


Chinese




H.E.A.T. Training








EST 2000








MOUT Training








Counter IED Training


























Medical
Physical Required Medical Items Allergies
Type Date Type Yes/No 1
Spectacles (2 Pair)
Shots/Immunization/Vaccinations Preotective Mask Inserts (2 Pair)
2
Type Yes/No Type Yes/No
Ear Plugs (Fitted)
Yellow Fever
Hepatitis B

Hear Aids
3
Influenza
Anthrax

Medical Warning Tags
Hepatitis A
Smallpox


















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AuthorAdministrator
Last Modified ByUSAID
File Modified2010-01-07
File Created2002-06-26

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