CG-950 Application for Permit to Carry Excursion Party

U.S. DEPARTMENT OF
HOMELAND SECURITY
U.S. COAST GUARD
CG-950 Rev. (01-07)

APPLICATION FOR PERMIT TO CARRY
EXCURSION PARTY

FORM APPROVED
OMB NO: 1625-0057
Exp.Date: 10/31/2011

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 is 5 mins. You may submit any
comments concerning the accuracy of this burden estimate or any suggestion reducing the burden to: Commandant (CG-3PCV),
U.S. Coast Guard, Washington DC 20593-0001 or Office of Management and Budget, Paperwork Reduction Project (1625-0002),
Washington, DC 20503.

This application may be used as a substitute for a written application from the owner or
managing operator of the vessel for which the permit is requested.
Name of Vessel: ____________________________________

Official or Award No. _________________

Home Port: _________________________________________ Gross tons: _______________________
Requested No. of Passengers: __________________

Requested No. of Crew: _____________

Requested Dates Excursion Permit is Valid: ____________________________________________
Requested Route and Special Conditions:

Person Submitting Application: _____________________________________________________
Title: _____________________________________________________
Signature: _____________________________________________________
Date: _____________________________________________________
Contact number or e-mail address: _______________________________________________________

Upon submission of this form to the cognizant OCMI, a marine inspector will evaluate information contained on
this form. If, after inspection, permission is granted, it is given on Coast Guard form CG-949 (Permit To Carry
Excursion Party).
U.S. DEPT. OF HOMELAND SECURITY, USCG, CG-950 (Rev. 01-07)

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