Form CG-4423 Application for Approval of Marine Event

OMB Approval 1625-0008
E xp ira tio n Da te :
DEPARTMENT OF HOMELAND SECURITY
U.S. COAST GUARD
CG-4423 (Rev. 9-06)

APPLICATION FOR APPROVAL OF MARINE EVENT

13. HAVE ANY OBJECTIONS BEEN RECEIVED FROM OTHER INTERESTED PARTIES?

INSTRUCTIONS

NO

1.
2.
3.
4.

DATE SUBMITTED

Submit this form in Triplicate. Please complete on a typewriter or print in black ink
(to permit reproduction).
This application must reach the D istrict Office at least 135 days prior to the event.
Attach a section of a chart or a scale drawing showing boundaries and/or courses and
markers contemplated.
Submit a copy of your entry requirements, and any special rules pertaining to equipment,
rigs or procedures.

1. NAME OF EVENT

2. DATE OF EVENT

3. LOCATION

4. TIME (from, to)

YES (Explain)

14. VESSELS PROVIDED BY SPONSORING ORGANIZATION FOR SAFETY PURPOSES (number and description)

15. DOES THE SPONSORING ORGANIZATION DEEM THEIR PATROL ADEQUATE FOR SAFETY PURPOSES?
YES

NO (Explain)

5. NAME AND ADDRESS OF SPONSORING ORGANIZATION (Include Zip Code)

16. IS A COAST GUARD OR COAST GUARD AUXILIARY PATROL REQUESTED FOR CONTROL OF SPECTATOR
AND/OR COMMERCIAL TRAFFIC?
(If YES, how many vessels do you reccomend, and why?)
NO
YES

6. NO. PARTICIPANTS

17. PERSON IN CHARGE

7. SIZES OF BOATS

8. TYPES OF BOATS

9. NO. SPECTATOR CRAFT

18. WHERE WILL "PERSON IN CHARGE" BE
DURING THE EVENT?

19. HOW CAN "PERSON IN CHARGE" BE CONTACTED DURING THE EVENT?

20. PERSON TO BE CONTACTED FOR FURTHER DETAILS (Name, address, Zip code)

10. DESCRIPTION OF EVENT
AREA CODE AND TELEPHONE NO.
The undersigned has full authority to represent the sponsoring organization
21. SIGNATURE

11. WILL THIS EVENT INTERFERE OR IMPEDE THE NATURAL FLOW OF TRAFFIC?
NO

22. TITLE

23. ADDRESS (Include Zip code)

YES (Explain)

AREA CODE AND TELEPHONE NO.
12. WHAT EXTRA OR UNUSUAL HAZARD (to participants or non-participants) WILL BE INTRODUCED
INTO THE REGATTA AREA?

PREVIOUS EDITIONS ARE OBSOLETE

24.

TO:

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number.
The Coast Guard estimates that the average burden for this report form is 20 minutes. You may submit any comments concerning the accuracy of this burden
estimate or any suggestions for reducing the burden to: Commandant (G-PWM-1), U.S. Coast Guard, 2100 2nd St., SW, Washington, DC 20593-0001 or Office of
Management and Budget, Paperwork Reduction Project (1625-0008), Washington, DC 20593.

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