CG-4918 Campaign Update Report

DEPARTMENT OF HOMELAND SECURITY

U.S. Coast Guard
CAMPAIGN UPDATE REPORT

OMB NO. 1625-0010
Exp. Date 03/31/2012
Mail to: Commandant (CG-54223), USCG, 2100 Second Street, SW STOP 7581, Washington, DC 20593-7581

1. NAME OF COMPANY CONDUCTING DEFECT NOTIFICATION CAMPAIGN

CAMPAIGN NUMBER

REPORT NUMBER

2. NUMBER OF UNITS WHICH MIGHT CONTAIN THE PROBLEM
(See item 10.a. of the Defect/Noncompliance Report )
3. NUMBER OF FIRST PURCHASERS NOTIFIED ABOUT THE PROBLEM
(See item 10.b. of the Defect/Noncompliance Report )
4. NUMBER OF DEALERS/DISTRIBUTORS NOTIFIED
(See item 10.c. of the Defect/Noncompliance Report )
5. NUMBER OF UNITS CORRECTED OR REPAIRED
(See item 10.d. of the Defect/Noncompliance Report )
6. NUMBER OF UNITS INSPECTED WHICH DID NOT HAVE THE PROBLEM
(See item 10.e. of the Defect/Noncompliance Report )
7. NUMBER OF OWNERS WHO REFUSED THE OFFER TO REPAIR OR CORRECT
(See item 10.f. of the Defect/Noncompliance Report )
Your files must contain written evidence of each owner's refusal
8. SHOULD THE COAST GUARD CONSIDER TERMINATION OF THIS CAMPAIGN?
NO

YES (If yes, please state reasons)

THIS FORM IS AUTHORIZED BY 46 U.S.C. CHAPTER 43 AND 33 CFR 179 FOR THE COLLECTION OF INFORMATION
CONCERNING THE PRODUCTS INVOLVED IN THIS DEFECT NOTIFICATION AND RECALL CAMPAIGN. THE
INFORMATION PROVIDED ON THIS FORM WILL BECOME A PART OF THE OFFICIAL U.S.COAST GUARD FILE
COVERING THIS CAMPAIGN AND WILL BE USED IN EVALUATING THE DILIGENCE WITH WHICH YOUR
COMPANY CONDUCTS THIS CAMPAIGN. FAILURE TO SUBMIT THIS REPORT FORM WITHIN SPECIFIED
TIME CONSTRAINTS CAN RESULT IN A CIVIL PENALTY OF $1100.
SIGNATURE AND TITLE OF PREPARER:

DATE:

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 30 minutes. You may submit any comments concerning the accuracy of this burden
estimate or any suggestions for reducing the burden to: Commandant (CG-54223), U.S. Coast Guard, 2100 Second Street, SW STOP 7581, Washington, DC
20593-7581 or Office of Management and Budget, Paperwork Reduction Project (1625-0010), Washington, DC 20503.

SPACE FOR ADDITIONAL INFORMATION:

PREVIOUS EDITIONS ARE OBSOLETE
CG-4918 (11/11)

THE COAST GUARD MUST
RECEIVE THIS REPORT ON
OR BEFORE:

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