Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire

PROSPECT QUESTIONNAIRE, CHAT NOW QUESTIONNAIRE, AND THE OFFICER PROGRAM APPLICATION

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.