Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical

Application for Merchant Mariner Credential (MMC), Merchant Mariner Certificate Evaluation Report, Small Vessel Sea Service Form, DOT/USCG Periodic Drug Testing Form, Merchant Mariner Evaluation of Fi

OMB: 1625-0040

IC ID: 43932

Information Collection (IC) Details

View Information Collection (IC)

Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical
 
No Modified
 
Required to Obtain or Retain Benefits
 
46 CFR 10.105(b)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CG-719B Application for Merchant Mariner Credential (MMC) CG-719B CG vendor version_12Mar14.pdf http://www.uscg.mil/forms Yes Yes Fillable Printable
Instruction 1625-0040_Instruction_r0_23Jan2014.docx Yes Yes Printable Only
Form and Instruction CG-719K (01/14) Application for Merchant Mariner Medical Certificate CG-719K CG vendor version_13Mar14.pdf http://www.uscg.mil/forms Yes Yes Fillable Printable
Form and Instruction CG-719K/E (01/14) Application for Merchant Mariner Medical Certificate for Entry Level Ratings CG-719KE CG vendor version_12Mar14.pdf http://www.uscg.mil/forms Yes Yes Fillable Printable
Form and Instruction CG-719P (01/14) DOT/USCG Periodic Drug Testing Form CG-719P CG vendor version_14Feb14.pdf http://www.uscg.mil/forms Yes Yes Fillable Printable
Form and Instruction CG-719S (01/14) Small Vessel Sea Service Form CG-719S CG vendor version_11Feb14.pdf http://www.uscg.mil/forms Yes Yes Fillable Printable
Form and Instruction CG-719C (01/14) Disclosure Statement for Narcotics, DWI/DUI, AND/OR Other Convictions CG-719C CG vendor version_14Feb14.pdf http://www.uscg.mil/forms Yes Yes Fillable Printable

Transportation Water Transportation

 

259,606 0
   
Private Sector Businesses or other for-profits
 
   10 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 56,500 0 0 0 0 56,500
Annual IC Time Burden (Hours) 47,444 0 0 3,186 0 44,258
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

© 2024 OMB.report | Privacy Policy