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Written report of marine casualty
Marine Casualty Information & Periodic Chemical Drug and Alcohol Testing of Commercial Vessel Personnel
OMB: 1625-0001
IC ID: 20438
OMB.report
DHS/USCG
OMB 1625-0001
ICR 201601-1625-008
IC 20438
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0001 can be found here:
2022-07-19 - Extension without change of a currently approved collection
2019-03-28 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form DRAFT_CG-2692
Written report of marine casualty
Form
1625-0001_Inst_r5_2016-inv.doc
Instruction
DRAFT_CG-2692 Report of Marine Casualty, Commercial Diving Casualty, o
CG-2692_2015_draft.pdf
www.uscg.mil/forms
Form
DRAFT_CG-0692A Barge Addendum
CG-2692A_2015_draft.pdf
www.uscg.mil/forms
Form
DRAFT_CG-2692B Report of Mandatory Chemical Testing Following a Serious
CG-2692B_2015_draft.pdf
www.uscg.mil/forms
Form
DRAFT_CG-2692C Personnel Casualty Addendum
CG-2692C_2015_draft.pdf
www.uscg.mil/forms
Form
DRAFT_CG-2692D Involved Persons and Witness Addendum
CG-2692D_2015_draft.pdf
www.uscg.mil/forms
Form
Information Collection (IC) Details
View Information Collection (IC)
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 4.05-10
46 CFR 4.05-12
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
DRAFT_CG-2692
Report of Marine Casualty, Commercial Diving Casualty, or OCS-related Casualty
CG-2692_2015_draft.pdf
http://www.uscg.mil/forms
Yes
Yes
Fillable Printable
Form
DRAFT_CG-0692A
Barge Addendum
CG-2692A_2015_draft.pdf
http://www.uscg.mil/forms
Yes
Yes
Fillable Printable
Form
DRAFT_CG-2692B
Report of Mandatory Chemical Testing Following a Serious Marine Incident Involving Vessels in Commercial Service
CG-2692B_2015_draft.pdf
http://www.uscg.mil/forms
Yes
Yes
Fillable Printable
Instruction
1625-0001_Inst_r5_2016-inv.doc
Yes
Yes
Printable Only
Form
DRAFT_CG-2692C
Personnel Casualty Addendum
CG-2692C_2015_draft.pdf
http://www.uscg.mil/forms
Yes
Yes
Fillable Printable
Form
DRAFT_CG-2692D
Involved Persons and Witness Addendum
CG-2692D_2015_draft.pdf
http://www.uscg.mil/forms
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
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:
5,967
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
40 %
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
5,967
0
0
1,175
4,792
0
Annual IC Time Burden (Hours)
11,937
0
0
2,353
9,584
0
Annual IC Cost Burden (Dollars)
0
0
0
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.