Information Collection

Application And Report Of Physical, First Aid, And Ship Sanitation Examination, And Application And Report Of Color Vision

IC 140876 under ICR 198305-2115-001 · OMB 2115-0524.

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Document Name	Document Type

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IC Title:

APPLICATION AND REPORT OF PHYSICAL, FIRST AID, AND SHIP SANITATION EXAMINATION, AND APPLICATION AND REPORT OF COLOR VISION

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CG-954				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25,610

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	25,610	25,610
Annual IC Time Burden (Hours)	18,982	18,982
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.