CG-4918 (10/15) Campaign Update Report

DEPARTMENT OF HOMELAND SECURITY

OMB No: 1625-0010
Exp. Date: 04/30/2019

U.S. Coast Guard
CAMPAIGN UPDATE REPORT

Mail to: U.S. Department of Homeland Security, Commandant (CG-BSX-23), U.S. Coast Guard Stop 7501
2703 Martin Luther King Jr Ave SE, Washington, DC 20593-7501
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The
Coast Guard estimates that the average burden for this report form is one hour. You may submit any comments concerning the accuracy of this burden estimate
or any suggestions for reducing the burden to: U.S. Department of Homeland Security, Commandant (CG-BSX-23), U.S. Coast Guard Stop 7501 2703 Martin
Luther King Jr Ave SE, Washington, DC 20593-7501 or Office of Management and Budget, Paperwork Reduction Project (1625-0010) Washington, DC 20503.

1. NAME AND ADDRESS OF COMPANY CONDUCTING DEFECT NOTIFICATION
CAMPAIGN (include ZIPCODE)

CAMPAIGN NUMBER
REPORT NUMBER

2. NUMBER OF UNITS WHICH MIGHT CONTAIN THE PROBLEM
(See item 10.a. of the Defect/Noncompliance Report)
3. NUMBER OF FIRST PURCHASERS NOTIFIED ABOUT THE PROBLEM
(See item 10.b. of the Defect/Noncompliance Report)
4. NUMBER OF DEALERS/DISTRIBUTORS NOTIFIED
(See item 10.c. of the Defect/Noncompliance Report)
5. NUMBER OF UNITS CORRECTED OR REPAIRED
(See item 10.d. of the Defect/Noncompliance Report)
6. NUMBER OF UNITS INSPECTED WHICH DID NOT HAVE THE PROBLEM
(See item 10.e. of the Defect/Noncompliance Report)
7. NUMBER OF OWNERS WHO REFUSED THE OFFER TO REPAIR OR CORRECT
(See item 10.f. of the Defect/Noncompliance Report) Your files must contain written
evidence of each owner's refusal.
8. SHOULD THE COAST GUARD CONSIDER TERMINATION OF THIS CAMPAIGN? (If yes, please state reasons)

NO
YES

THIS FORM IS AUTHORIZED BY 46 U.S.C. CHAPTER 43 AND 33 CFR 179 FOR THE COLLECTION OF INFORMATION CONCERNING THE PRODUCTS INVOLVED IN THIS
DEFECT NOTIFICATION AND RECALL CAMPAIGN. THE INFORMATION PROVIDED ON THIS FORM WILL BECOME A PART OF THE OFFICIAL U.S.COAST GUARD FILE
COVERING THIS CAMPAIGN AND WILL BE USED IN EVALUATING THE DILIGENCE WITH WHICH YOUR COMPANY CONDUCTS THIS CAMPAIGN. FAILURE TO SUBMIT THIS
REPORT FORM WITHIN SPECIFIED TIME CONSTRAINTS CAN RESULT IN A CIVIL PENALTY OF $1100.

Privacy Act Statement
a.  Authority: 

5 U.S.C. 301; 14 U.S.C. 93; the Federal Records Act; 46 U.S.C. 4310; and 33 C.F.R. 179.

b.  Purpose: 

This form is authorized by 46 U.S.C. Chapter 43 and 33 CFR 179 for the collection of information concerning the products involved in a
Defect Notification and Recall Campaign and used to evaluate the diligence with which the campaign is conducted.

c.  Routine Uses:  The information provided on this form will become a part of the official U.S. Coast Guard file covering this campaign to be used in evaluating
the diligence with which your company conducts this campaign.
d.  Disclosure: 

Completion/furnishing of this form is MANDATORY.
Failure to provide the information requested within 60 days after the manufacturer submits the Defect Noncompliance Report.  Additional CG
4918 forms must be submitted within 90-day intervals thereafter, until the recall campaign reaches and acceptable level of completion. 
Failure to submit this report within specified time may result in a civil penalty of up to $1100.

SIGNATURE OF PREPARER

TITLE

DATE

SPACE FOR ADDITIONAL INFORMATION

THE COAST GUARD MUST RECEIVE THIS REPORT ON OR BEFORE:
CG-4918 (10/15)

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