Documentation of medical fitness

Standards of Training, Certification and Watchkeeping for Seafarers (STCW), 1995 and 1997 Amendments to the International Convention

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0079 can be found here:

Documents and Forms

Document Name Document Type
1625-0079_Inst_r5_2019-mmc.doc.docx Instruction

Information Collection (IC) Details

IC Title:	Documentation of medical fitness	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 46 CFR 12.02-17

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			1625-0079_Inst_r5_2019-mmc.doc.docx		Yes	Yes	Printable Only

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title: DHS/USCG 030 Merchant Seamen's Records	FR Citation: 74 FR 30308

Number of Respondents: 35,990	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	35,990	2,663	33,327
Annual IC Time Burden (Hours)	11,985	887	11,098
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.