Information Collection

Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire

IC 231490 under ICR 201805-1625-003 · OMB 1625-0128.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0128 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CGRC-1130 (01/17) Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire	Form and Instruction
1625-new_Inst_r1_2016.docx	Instruction
CGRC-1130 (01/17) USCG Prospect Questionnaire CGRC-1130, Prospect Questionnaire Unencrypted.pdf	Form and Instruction
CGRC-1131 (02/17) USCG Officer Program Applicatoin CGRC-1131, Officer Application Form Unencrypted.pdf	Form and Instruction
CGRC-1132 (02/17) USCG "Chat Now" Questionnaire CG-1132 Chat Now Online Questionnaire.pdf	Form

IC Title:

Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CGRC-1130 (01/17)	USCG Prospect Questionnaire	CGRC-1130, Prospect Questionnaire Unencrypted.pdf	Yes	Yes	Fillable Printable
Form and Instruction	CGRC-1131 (02/17)	USCG Officer Program Applicatoin	CGRC-1131, Officer Application Form Unencrypted.pdf	Yes	Yes	Fillable Printable
Form	CGRC-1132 (02/17)	USCG "Chat Now" Questionnaire	CG-1132 Chat Now Online Questionnaire.pdf	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
	Approved	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.