Information Collection

U.S. Coast Guard CGES Scholarship Program Application

IC 209208 under ICR 201710-1625-001 · OMB 1625-0119.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0119 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CG 5867_Inst_r0_2016.docx	Instruction
CG-5687 (07/17) Coast Guard Exchange System Scholarship Program Applicat CG5687 (Rev July2017).pdf	Form

IC Title:

U.S. Coast Guard CGES Scholarship Program Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CG 5867_Inst_r0_2016.docx		Yes	Yes	Printable Only
Form	CG-5687 (07/17)	Coast Guard Exchange System Scholarship Program Application	CG5687 (Rev July2017).pdf		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records

Title: DHS/USCG-018 Exchange System and Morale Well-Being and Recreation

FR Citation: 73 FR 77736

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	30	0	30
Annual IC Time Burden (Hours)	120	0	120
Annual IC Cost Burden (Dollars)	15	15	0

Documents for IC

table that charts IC Documents
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.