CG-3752 Application for US Vessel Inspection

86DEPARTMENT OF
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U.S. COAST GUARD
CG-3752 (Rev. -)

FORM APPROVED

APPLICATION FOR INSPECTION OF U.S. VESSEL20%12
Date:
Expiration

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The Coast Guard estimates that the average burden for this report is 15 mins. You may submit any comments concerning the accuracy of this
burden estimate or any suggestion reducing the burden to: Commandant (G-MOC), U.S. Coast Guard, Washington, DC 20593-0001 or Office of
Management and Budget, Paperwork Reduction Project (15-000):DVKLQJWRQ'&.
Address to reply to:
TO:

Officer in Charge, Marine Inspection

Marine Inspection Zone
The undersigned applies to have the
Motorboat

Steam Vessel

Barge

Motor Vessel

TELEPHONE NUMBER:
DATE:

Other ( Indicate)
Official or Award No.

named
inspected under the laws of the United States; to be employed as a
Cargo Vessel

Tank Vessel

MODU

Passenger Vessel (No. of Passengers

)

Other (Indicate)

on the following route: (Waters, Geographical limits)

Liquid cargo in bulk

will

will not be carried as follows:

Flammable or Combustible (Indicate grade)
Chemicals (Indicate)
Length of vessel
Hull material:

ft.
Steel

Other (Indicate)

Vessel will be at (Port, Pier, etc.)
The current Certificate of Inspection expires on

.

Inspection is desired on

.

Cargo Ship Safety Construction Certificate to be issued by
Vessel

is

ABS

USCG.

is not to be classed.

If classed, indicate Classification Society:
I CERTIFY that previous application for this inspection

ABS

Other (Indicate)
has

has not been made. I further certify that I have instructed

the master to present the vessel ready in all respects for the above requested inspection on the date specified. I understand that if this inspection is
to be conducted at foreign port or place the vessel owners will be billed for the costs incurred in accordance with 46 USC 385b-1.

(Signature)

(Title)
PREVIOUS EDITION IS OBSOLETE

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