Narrative of Revisions
The purpose of the Narrative of Revisions is to clearly indicate revisions to a collection since the previous approval
Application for Merchant Mariner Credential (MMC), Application for Merchant Mariner Medical Certificate, Application for Merchant Mariner Medical Certificate for Entry Level Ratings, Small Vessel Sea Service Form, DOT/USCG Periodic Drug Testing Form, Disclosure Statement for Narcotics, DWI/DUI, and/or Other Convictions, Merchant Mariner Medical Certificate, Recognition of Foreign Certificate
OMB Control No.: 1625-0040
Current Expiration Date: 01/31/2016
Collection Instruments: CG-719B, CG-719K, CG-719K/E, CG-719S, CG-719P, CG-719C, CG-4610, CG-4610A, and CG-4610B
The changes to this collection are mainly comprised of improvements to the flow and quality of content, user functionality, and to aid the Coast Guard in processing applications. The CG-719C was added to this collection as an optional form for respondents.
There was a negligible impact on the burden estimate of each form.
The Collection Title is being revised to:
Application for Merchant Mariner Credential (MMC), Application for Merchant Mariner Medical Certificate, Application for Merchant Mariner Medical Certificate for Entry Level Ratings, Small Vessel Sea Service Form, DOT/USCG Periodic Drug Testing Form, Disclosure Statement for Narcotics, DWI/DUI, and/or Other Convictions, Merchant Mariner Medical Certificate, Recognition of Foreign Certificate
The CG-719C was added to this collection. A respondent must provide written disclosure of all convictions not previously disclosed to the Coast Guard on an application. The CG-719C will provide respondents an instrument in which they may disclose this information to the Coast Guard. The use of the CG-719C is optional.
The following revisions were made to the CG-719B:
The most substantive change to the CG-719B was the merging of lines 3 and 4 in Section III, and the revision of its content. The Coast Guard determined that the language on the CG-719B that expired on 6/30/2013 was more appropriate than the language on the current CG-719B. Changed to read:
“CONVICTIONS AND DRUG USE (NOT PREVIOUSLY DISCLOSED): If you answer Yes to ANY of the below questions complete form CG-719C or its equivalent for each question marked "Yes"
Have you ever been a user of/or addicted to a dangerous drug, including marijuana, within the last 10 years? [ ] Yes [ ] No
Have you ever been convicted of violating a dangerous drug law of the United States, District of Columbia, or any state, or territory of the United States? [ ] Yes [ ] No
Have you ever been convicted by any court-including military court - for an offense other than a minor traffic violation? [ ] Yes [ ] No
Have you ever been convicted of a traffic infraction arising in connection with a fatal traffic accident, reckless driving or racing on the highway or operating a motor vehicle while under the influence of, or impaired by, alcohol or a controlled substance? [ ] Yes [ ] No
Have you ever had your driver's license revoked or suspended for refusing to submit to an alcohol or drug test? [ ] Yes [ ] No
f.) Have you had a drug test with a result other than negative within the last 10-years? [ ] Yes [ ] No”
Made content improvements to the instructions section and relocated the instructions to the front of the form.
Revised the Privacy Act statement following a review by Coast Guard legal.
Text boxes throughout the CG-719B were redesigned to provide optimal image preprocessing for optical character recognition. All text boxes remain labeled with horizontal boxes below. This change improves usability while providing a means to convert data from the form to the electronic medium.
Revised data fields (e.g., date of birth, address boxes, names, phone numbers, etc.) to ensure format consistency throughout the forms in this collection.
Section II, combined “Increase in Scope” with “Raise of Grade or New Endorsement” endorsement category and added an endorsement category for “Certificate of Registry”. Added “United States Registered Pilot” in the “Description of Endorsement(s) Desired”.
Section II, removed “FOR RENEWAL TRANSACTIONS ONLY” and “If I am not approved for this…” checkboxes.
Section III, section title renamed “Safety and Suitability”.
Section III, 1, added “…under Coast Guard Policy Letter 11-15. I understand that a name based safety and suitability check could significantly delay the processing of my Merchant Mariner Credential Application.”
Section III, relocated “Mariner Outreach System (MOS)” to Section IV.
Section IV, 4, removed “Medical” as an option.
Section IV, 5, revised to read:
“My signature below attests that:
All information on this application is true and correct to the best of my knowledge.
I understand an application determined to be fraudulent may result in the denial of my application for one year from the date of submission, even if the fraudulent information was not by itself cause for denial or prosecution.
If registered as a U.S. Registered Pilot, I will obey all applicable regulations of the Secretary of Homeland Security, the U.S. Coast Guard and of any other Federal
Agency; and that I will be continuously available for service when required on those waters of the Great Lakes for which registered.
I consent to a check of the National Driver Registry related to my driving history, including motor vehicle convictions involving alcohol or controlled substances; and any traffic violations in connection with a fatal traffic accident, reckless driving, or racing.
I understand that by checking boxes 4a - 4d in Section IV, I authorize release of information to the third party indicated until issuance of a MMC or until Agency final action is made.
I do solemnly swear or affirm that I will faithfully and honestly, according to my best skill and judgment, and without concealment and reservation, perform all the duties required of me by the laws of the United States. I will faithfully and honestly carry out the lawful orders of my superior officers aboard a vessel.”
Figure 1, added regulatory cites within the “Attachments to include” column; replaced the “Increase in Scope” column with “USRP Endorsement” column and added a “Certificate of Registry” column; updated checkboxes throughout the table; and added language below the table to clarify requirements.
The following revisions were made to the CG-719K:
The most substantive change to the CG-719K was the removal of the “Third Party Release” and relocation of the “Applicant’s Certification” to the end of the form.
The Title of the form was changed to “Application for Merchant Mariner Medical Certificate”.
Made content improvements to the instructions section and relocated the instructions to the front of the form.
Revised the Privacy Act statement following a review by Coast Guard legal.
Text boxes throughout the CG-719K were redesigned to provide optimal image preprocessing for optical character recognition. All text boxes remain labeled with horizontal boxes below. This change improves usability while providing a means to convert data from the form to the electronic medium.
Revised data fields (e.g., date of birth, address boxes, names, phone numbers, etc.) to ensure format consistency throughout the forms in this collection.
Section I, added “Please indicate best method(s) of contact…” data boxes.
Section I, removed Occupation, Specify, Social Security No., and Age data fields.
Section I, changed “Sex” to “Gender”.
Section I, revised “Application Type: checkboxes.
Section I, added “I have a medical waiver:” checkbox.
Section II (a), removed 3 line items from the list of medical conditions and revised the language of several other conditions to improve clarity.
Section II (b) and III, improved the clarity of instructions.
Section IV, b., reformatted section and clarified question when a color vision test is failed.
Section V, reformatted section and increased “55dB” to “65dB”.
Section VI, reformatted 16 and 17, and added “(For BMI >40 refer to Section VII” below the “BMI” data box.
Section VII, revised language to improve clarity. Relocated the “Lists of Tasks…” to the instructions section of the form.
Section VIII, revised language to improve clarity.
Section IX, changed “identity verified:” to “identity provided”, changed “Competent” and “Not Competent” to “Fit for Duty” and “Not fit for Duty”. Added an address stamp box under “Medical Practitioner” section.
The following revisions were made to the CG-719K/E:
The most substantive change to the CG-719K/E was in Section IV, added:
“Demonstration of Physical Ability - To be completed by the Medical Practitioner
An applicant for an Entry Level Rating [ordinary seaman, wiper, or steward's department (food handler)] serving on vessels to which STCW applies is not required to complete a physical examination, but must provide a demonstration of physical ability as described in Section IV of the Instructions.
Place an X in the appropriate block below:
Applicant has the physical strength, agility, and flexibility to perform all of the items listed in the instruction table.
Applicant does NOT have the physical strength, agility, and flexibility to perform all of the items listed in the instruction table.”
In addition, added a “Comments” section.
The Title of the form was changes to “Application for Merchant Mariner Medical Certificate for Entry Level Ratings”.
Made content improvements to the instructions section and relocated the instructions to the front of the form.
Revised the Privacy Act statement following a review by Coast Guard legal.
Text boxes throughout the CG-719K were redesigned to provide optimal image preprocessing for optical character recognition. All text boxes remain labeled with horizontal boxes below. This change improves usability while providing a means to convert data from the form to the electronic medium.
Revised data fields (e.g., date of birth, address boxes, names, phone numbers, etc.) to ensure format consistency throughout the forms in this collection.
Section I, added “Please indicate best method(s) of contact…” data boxes.
Section I, removed Social Security Number and Age data fields.
Section I, changed “Sex” to “Gender” and added check boxes.
Section II, revised language to improve clarity.
The following revisions were made to the CG-719P:
Text boxes throughout the CG-719P were redesigned to provide optimal image preprocessing for optical character recognition. All text boxes remain labeled with horizontal boxes below. This change improves usability while providing a means to convert data from the form to the electronic medium.
Section I, added a “Reference Number (if applicable)” data box.
Section III, added “Please print” and removed “Name (Printed” box.
Page 2, under Requirements, corrected the spelling of Phencyclidine.
Revised the Privacy Act statement following a review by Coast Guard legal.
The following revisions were made to the CG-719S:
Text boxes throughout the CG-719S were redesigned to provide optimal image preprocessing for optical character recognition. All text boxes remain labeled with horizontal boxes below. This change improves usability while providing a means to convert data from the form to the electronic medium.
Revised the Privacy Act statement following a review by Coast Guard legal.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Narrative of Revisions |
| Author | tyrone.huff |
| File Modified | 0000-00-00 |
| File Created | 2021-01-26 |