Information Collection

Written report of marine casualty

IC 20438 under ICR 201204-1625-004 · OMB 1625-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1625-0001_Inst_r1_2011.doc	Instruction
CG-2692 Report of Marine Accident, Injury or Death CG-2692_11-12_w-xx-exp_Final.pdf www.uscg.mil/forms	Form
CG-2692A Barge Addendum CG-2692A_11-12_w-xx-exp_Final.pdf www.uscg.mil/forms	Form
CG-2692B Report of Required Chemical Drug and Alcohol Testing Fol CG-2692B_11-12_w-xx-exp_Final.pdf www.uscg.mil/forms	Form

IC Title:

Written report of marine casualty

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 46 CFR Part 4 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			1625-0001_Inst_r1_2011.doc		Yes	Yes	Printable Only
Form	CG-2692B	Report of Required Chemical Drug and Alcohol Testing Following a Serious Marine Incident	CG-2692B_11-12_w-xx-exp_Final.pdf	http://www.uscg.mil/forms	Yes	Yes	Fillable Printable
Form	CG-2692	Report of Marine Accident, Injury or Death	CG-2692_11-12_w-xx-exp_Final.pdf	http://www.uscg.mil/forms	Yes	Yes	Fillable Printable
Form	CG-2692A	Barge Addendum	CG-2692A_11-12_w-xx-exp_Final.pdf	http://www.uscg.mil/forms	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records

Title: USCG (MISLE) System of Records

FR Citation: 74 FR 30305

Number of Respondents: 4,792

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 40 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,792	441	4,351
Annual IC Time Burden (Hours)	9,584	5,233	4,351
Annual IC Cost Burden (Dollars)	0	0	0

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.