Information Collection

Coast Guard Boating Accident Report Form (CG-3865)

IC 20444 under ICR 201201-1625-006 · OMB 1625-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0003 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1625-0003_Inst_r1_2012.doc	Instruction
1625-0003_BARD_screenshot_120403.pdf	Other-BARD Screenshot
CG-3865 Recreational Boating Accident Report CG-3865_1-11_BARD.pdf	Form

IC Title:

Coast Guard Boating Accident Report Form (CG-3865)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 33 CFR 174 33 CFR 173.55 33 CFR 173

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			1625-0003_Inst_r1_2012.doc	Yes	Yes	Printable Only
Form	CG-3865	Recreational Boating Accident Report	CG-3865_1-11_BARD.pdf	Yes	Yes	Fillable Printable
Other-BARD Screenshot			1625-0003_BARD_screenshot_120403.pdf	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,094	94	5,000
Annual IC Time Burden (Hours)	2,970	470	2,500
Annual IC Cost Burden (Dollars)	2,241	41	2,200

Documents for IC

table that charts IC Documents
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.