OMB
.report
Search
Adequacy Certification for Reception Facilities and Advance Notice - 33 CFR Part 158
Adequacy Certification for Reception Facilities and Advance Notice - - 33 CFR Part 158
OMB: 1625-0045
IC ID: 20537
OMB.report
DHS/USCG
OMB 1625-0045
ICR 201110-1625-009
IC 20537
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0045 can be found here:
2024-10-24 - Revision of a currently approved collection
2021-11-10 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form CG-5401A
Adequacy Certification for Reception Facilities and Advance Notice - - 33 CFR Part 158
Form and Instruction
CG-5401A Application for Certificate of Adequacy for Reception Fa
CG5401arev1.pdf
www.uscg.mil/forms/cg.asp?files=280&id=
Form and Instruction
CG-5401B Application for Certificate of Adequacy for Reception Fa
CG5401brev1.pdf
www.uscg.mil/forms/cg.asp?files=280&id=
Form and Instruction
CG-5401C Application for Certifiate of Adequacy for Reception Fac
CG5401crev1.pdf
www.uscg.mil/forms/cg.asp?files=280&id=
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
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 and Instruction
CG-5401A
Application for Certificate of Adequacy for Reception Facilities
CG5401arev1.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
CG5401brev1.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
CG5401crev1.pdf
http://www.uscg.mil/forms/cg.asp?files=280&id=
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Water Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
86
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
98 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
100
0
0
-22
0
122
Annual IC Time Burden (Hours)
183
0
0
-44
0
227
Annual IC Cost Burden (Dollars)
0
0
0
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.