Information Collection

United States Coast Guard Prospect Questionnaire with Instructions

IC 229233 under ICR 201711-1625-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CGRC-1130 (01/17) United States Coast Guard Prospect Questionnaire with Instructions	Form and Instruction
1625-new_Inst_r1_2016.docx	Instruction
CGRC-1130 (01/17) United States Coast Guard Prospect Questionnaire /Instru CG-1130, Prospect Questionnaire Unencrypted_20170217.pdf cgrats.uscg.mil/ContactRecruiter/index.html	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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
Form and Instruction	CGRC-1130 (01/17)	United States Coast Guard Prospect Questionnaire /Instructions	CG-1130, Prospect Questionnaire Unencrypted_20170217.pdf	https://cgrats.uscg.mil/ContactRecruiter/index.html	Yes	Yes	Fillable Printable
Instruction			1625-new_Inst_r1_2016.docx		Yes	Yes	Printable Only

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records

Title: DHS/USCG--014, Military Pay and Personnel

FR Citation: 76 FR 66933

Number of Respondents: 50,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	50,000	50,000
Annual IC Time Burden (Hours)	25,000	25,000
Annual IC Cost Burden (Dollars)	0	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.