CG-3752 Application for Inspection of U.S. Vessel

U.S. DEPARTMENT OF
HOMELAND SECURITY
U.S. COAST GUARD
CG-3752 (Rev. 6-04)

APPLICATION FOR INSPECTION OF U.S. VESSEL

FORM APPROVED
OMB
NO. 1625-0002

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number.
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 (1625-0002), Washington, DC 20503.
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)

named

Official or Award No.

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

ft.
Steel

Hull material:

Other (Indicate)

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

.

Inspection is desired on

.
ABS

Cargo Ship Safety Construction Certificate to be issued by
Vessel

is

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PREVIOUS EDITION IS OBSOLETE

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