Submission of continuous discharge book, revised merchant mariner application, physical report new sea service, chemical testing and entry level physical forms.

ICR 200111-2115-009

OMB: 2115-0514

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
2115-0514 200111-2115-009
Historical Active 199808-2115-002
DOT/USCG
Submission of continuous discharge book, revised merchant mariner application, physical report new sea service, chemical testing and entry level physical forms.
Revision of a currently approved collection   No
Regular
Approved without change 01/02/2002
Retrieve Notice of Action (NOA) 11/20/2001
  Inventory as of this Action Requested Previously Approved
01/31/2005 01/31/2005 01/31/2002
48,029 0 1
21,358 0 83,327
0 0 0

In accordance with Title 46, Code of Federal Register, Parts 10 & 12, the Collection of information is necessary to determine competency. Character and physcial qualifications for issuance of mandated coast guard licenses and/or merchant mariner documents.

None
None


No

1
IC Title Form No. Form Name
Submission of continuous discharge book, revised merchant mariner application, physical report new sea service, chemical testing and entry level physical forms. CG-719A, CG-719B, CG-719K, CG-719S, CG-719P, CG-719K/E

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 48,029 1 0 48,028 0 0
Annual Time Burden (Hours) 21,358 83,327 0 -61,969 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/20/2001


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