Adequacy Certification for Reception Facilities and Advance Notice - 33 CFR Part 158

Adequacy Certification for Reception Facilities and Advance Notice - - 33 CFR Part 158

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0045 can be found here:

Documents and Forms

Document Name Document Type
Form CG-5401 Adequacy Certification for Reception Facilities and Advance Notice - - 33 CFR Part 158 Form
CG-5401 Certificate of Adequacy for Reception Facilty CG-5401.pdf This is a certificate that USCG personnel issue in the performance of their duties. Form
CG-5401A Application for Certificate of Adequacy for Reception Fa CG-5401A.pdf www.uscg.mil/forms/cg.asp?files=280&id= Form and Instruction
CG-5401B Application for Certificate of Adequacy for Reception Fa CG-5401B.pdf www.uscg.mil/forms/cg.asp?files=280&id= Form and Instruction
CG-5401C Application for Certifiate of Adequacy for Reception Fac CG-5401C.pdf www.uscg.mil/forms/cg.asp?files=280&id= Form and Instruction

Information Collection (IC) Details

IC Title:	Adequacy Certification for Reception Facilities and Advance Notice - - 33 CFR Part 158	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 33 CFR 158.140

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CG-5401	Certificate of Adequacy for Reception Facilty	CG-5401.pdf	This is a certificate that USCG personnel issue in the performance of their duties.	No		Paper Only
Form and Instruction	CG-5401A	Application for Certificate of Adequacy for Reception Facilities	CG-5401A.pdf	http://www.uscg.mil/forms/cg.asp?files=280&id=	Yes	Yes	Fillable Printable
Form and Instruction	CG-5401B	Application for Certificate of Adequacy for Reception Facilities FORM B	CG-5401B.pdf	http://www.uscg.mil/forms/cg.asp?files=280&id=	Yes	Yes	Fillable Printable
Form and Instruction	CG-5401C	Application for Certifiate of Adequacy for Reception Facilities FORM C	CG-5401C.pdf	http://www.uscg.mil/forms/cg.asp?files=280&id=	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 85	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	122	-4,060	4,182
Annual IC Time Burden (Hours)	227	-831	1,058
Annual IC Cost Burden (Dollars)	0	0	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.