Coast Guard Boating Accident Report Form (CG-3865)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0003 can be found here:

Documents and Forms

Document Name Document Type
Form CG-3865 Coast Guard Boating Accident Report Form (CG-3865) Form
CG-3865 Boating Accident Report CG-3865.pdf www.uscg.mil/forms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Coast Guard Boating Accident Report Form (CG-3865)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 33 CFR 173 33 CFR 174 33 CFR 173.55

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CG-3865	Boating Accident Report	CG-3865.pdf	http://www.uscg.mil/forms	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,000	0	5,000
Annual IC Time Burden (Hours)	2,500	0	2,500
Annual IC Cost Burden (Dollars)	2,050	2,050	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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