Application and Permit to Handle Hazardous Material (Management, Clerical, and Recordkeeping)

Application and Permit to Handle Hazardous Material

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0005 can be found here:

Documents and Forms

Document Name Document Type
Form CG-4260 Application and Permit to Handle Hazardous Material (Management, Clerical, and Recordkeeping) Form
1625-0005_Inst_r1_2014.doc Instruction
CG-4260 Application and Permit to Handle Hazardous Materials CG-4260_6-04.pdf www.uscg.mil/forms Form

Information Collection (IC) Details

IC Title:	Application and Permit to Handle Hazardous Material (Management, Clerical, and Recordkeeping)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 49 CFR 176.100 49 CFR 176.415 33 CFR 126.17

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CG-4260	Application and Permit to Handle Hazardous Materials	CG-4260_6-04.pdf	http://www.uscg.mil/forms	Yes	Yes	Fillable Printable
Instruction			1625-0005_Inst_r1_2014.doc		Yes	Yes	Printable Only

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 66	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	165	103	62
Annual IC Time Burden (Hours)	182	89	93
Annual IC Cost Burden (Dollars)	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.