Application and Permit to Handle Hazardous Material (Management, Clerical, and Recordkeeping)

Application and Permit to Handle Hazardous Material

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0005 can be found here:

Documents and Forms

Document Name Document Type
1625-0005_Inst_r2_2018-fac.doc Instruction
CG-4260 (01/18) Application and Permit to Handle Hazardous Materials CG-4260_01-18_w-o-x.pdf www.uscg.mil/forms Form and Instruction

Information Collection (IC) Details

IC Title:	Application and Permit to Handle Hazardous Material (Management, Clerical, and Recordkeeping)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 49 CFR 176.100 33 CFR 126.17 49 CFR 176.415

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			1625-0005_Inst_r2_2018-fac.doc		Yes	Yes	Printable Only
Form and Instruction	CG-4260 (01/18)	Application and Permit to Handle Hazardous Materials	CG-4260_01-18_w-o-x.pdf	http://www.uscg.mil/forms	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title: DHS/USCG - 013 MISLE	FR Citation: 74 FR 30305

Number of Respondents: 280	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	280	115	165
Annual IC Time Burden (Hours)	308	126	182
Annual IC Cost Burden (Dollars)	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.