STATE OF TEXAS ASSISTANCE REQUEST (STAR)          Vers 9 

    
   Incident Name             Initial Request Date/Time    

  Requesting County      Request # 

  Is this RR Tied to Another Request?           Other Tracking Numbers     

Requested Item Description
Qty Unit Item Name Item Description Cost Demob?
 Justification - Purpose for Request?
 
 When is this Resource Needed?     Estimated Needed Time Frame of Item? 

Delivery Information - Way Point Information
Point of Contact Name Phone # (s) Facility Name Zip
Facility Address      City     State  
 Additional Instructions
 

Final Destination
Point of Contact Name Phone # (s) Facility Name Zip
     
 Facility Address    City      State 

 Additional Instructions
 


Requester Information
  Requested by Position  / Name
 Email Phone # (s)
  Updating Agency   FILL 1
POC Name / Position             Qty Filled  
Phone (s)      ETA  
Email            Est. Cost  
Provider Notes  

   
  Approver Name      Date & Time   
  Updating Agency   FILL 2
 
POC Name / Position               Qty Filled  
Phone (s)    ETA  
  Email             Est. Cost   
Provider Notes       

 
  Approver Name      Date & Time   
  Updating Agency   FILL 3

POC Name / Position         Qty Filled  
Phone (s)    ETA  
Email           Est. Cost   
Provider Notes      
 
  Approver Name                  Date & Time   
Additional Notes