Coast Guard Auxiliary Safety Survey

District Five, Coast Guard Auxiliary Safety Survey

Documents and Forms

Document Name Document Type
Form CG-16798 (11/13) Coast Guard Auxiliary Safety Survey Form
1625-NEW_Inst_r1_2014.docx Instruction
CG-16798 (11/13) District Five Auxiliary Safety Survey USCG AUX Survey Draft8-03202013.doc surveys.uscg.mil/Community/se.ashx?s=6F20F77460608CE6 Form

Information Collection (IC) Details

IC Title:	Coast Guard Auxiliary Safety Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CG-16798 (11/13)	District Five Auxiliary Safety Survey	USCG AUX Survey Draft8-03202013.doc	https://surveys.uscg.mil/Community/se.ashx?s=6F20F77460608CE6	Yes	Yes	Fillable Fileable
Instruction			1625-NEW_Inst_r1_2014.docx		Yes	No	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title: Privacy Act of 1974; Department of Homeland Security United States Coast Guard - 024 Auxiliary Database	FR Citation: 76 FR 28795

Number of Respondents: 3,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	3,200	3,200
Annual IC Time Burden (Hours)	533	533
Annual IC Cost Burden (Dollars)	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.