Form: Oregon_Declaration_Emergency_Initial.html,Oregon_Declaration_Emergency_Viewer.html To: Cc: Subject: OR Declaration - - Msg: Status: To: Governor, State of Oregon Through: Director, Office Oregon Emergency Management From: 1. County: 2. Incident Type: 3. Beginning Date/Time of Incident: 4. Incident is: IF ENDED, Date/Time: 5. Problem and Type of Assistance Needed: -------------------------------------- 6. Initial Assessment of Damage - # of Injuries - # of Deaths: -------------------------------------- 7. Actions Pending or Taken by County or Local Governments: -------------------------------------- 8. Request Date/Time - Form Filled Out: 9. Name of Authorizing Official (s): ------------------------ Express Sending Station: Senders Express Version: Senders Template Version: