Date and time
The date and time at the top of the form.
GSA3696
Command Center Personnel/Occupant Emergency Team Coordinators Present for Evacuation
- Agency
- GSA
- Revision
- Rev. 10/2009
- Fillable fields
- 42
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3696: Command Center/Occupant Emergency Team Coordinators Present for Evacuation
GSA Form 3696, Command Center Personnel/Occupant Emergency Team Coordinators Present for Evacuation, is a one-page General Services Administration form, Rev. 10/2009. It records which command center personnel and occupant emergency team coordinators were present for an evacuation, and how each floor reported in to the command center.
The top of the form has the date and time and a line for each of nine roles: Designated Official, Security Office, OEM Representative, Floor Team Coordinator, Medical Coordinator, Contract Security Advisor, FPO in Charge, Building Manager Representative and Radio/Phone Talker. Below it, a checklist of floors as they report in to the command center has columns for floor, check-in, who, and physically disabled accountable. The bottom has the official timer's printed name, the organization and the total evacuation time. The form prints no instructions.
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What's on GSA Form 3696
Command center roles
A boxed list of nine roles, from the Designated Official to the Radio/Phone Talker, each with a line to fill in.
Checklist of floors
Rows for Basement (BASE 1), Ground (GROUND 1) and the 1st to 7th floors, as they report in to the command center.
Check-in, who and accountability columns
For each floor: the check-in, who reported, and a physically disabled accountable column.
Official timer and total time
The official timer's printed name, the organization and the total evacuation time.
How to complete GSA Form 3696
- 1
Enter the date and time
Fill in the date and time lines at the top of the form.
- 2
Name each role present
Enter a name on the line for each of the nine roles listed in the box.
- 3
Record each floor as it reports in
For each floor from the basement to the 7th, enter the check-in and who reported to the command center.
- 4
Note physically disabled accountability
Fill in the physically disabled accountable column for each floor row.
- 5
Record the timer and total time
Print the official timer's name, then enter the organization and the total evacuation time.
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What the form says
Where it goes
The form prints no instructions, routing or filing address. GSA's page lists no authority or regulation for it.
Related evacuation report
GSA Form 3697, the Evacuation Report/Survey, is the form its own header says is to be completed by all wardens and monitors after an evacuation.
Related forms
Who appears on GSA Form 3696?
The form prints no instructions and does not say who completes it. These are the entries it names.
Official sources and the blank
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Questions about Form GSA3696
Who fills out GSA Form 3696?
The form prints no instructions and does not say who completes it. It has a line for the official timer's printed name and organization.
Which roles does the form list?
Designated Official, Security Office, OEM Representative, Floor Team Coordinator, Medical Coordinator, Contract Security Advisor, FPO in Charge, Building Manager Representative and Radio/Phone Talker.
Which floors does the checklist cover?
Basement (BASE 1), Ground (GROUND 1) and the 1st through 7th floors, each with check-in, who and physically disabled accountable columns.
Where is GSA Form 3696 sent?
The form prints no routing or filing address, and GSA's page lists no authority or regulation for it.