1625-0040 calc-sheet

1625-0028

Appendix A: Total Estimated Annual Burden on Industry
Respondents
72,233
18,060
90,293

MMC Applicants:
Med Cert Applicants:
Total:

Responses
per year

Burden
Hours/
Response

Annual
Hour
Burden

Wage
Rate

Annual
Cost
Burden

CG-719B

72,233

0.15

10,835

$35

$379,225

Application for Medical Certificate CG-719K

85,778

0.3

25,734

$35

$900,690

Application for Medical Certificate, CG-719K/E
Short Form

4,515

0.167

753

$35

$26,355

Small Vessel Sea Service Form

72,233

0.25

18,059

$35

$632,065

72,233

0.083

6,020

$35

$210,700

3,612

0.167

603

$35

$21,105

Form/Req. Title
Application for Merchant Mariner
Credential (MMC)

Form
Number

CG-719S

DOT/USCG Periodic Drug Testing
CG-719P
Form
Disclosure Statement for
Narcotics, DWI/DUI, and/or Other CG-719C
Convictions
TOTAL

310,604

*Estimates may not sum due to rounding

Total Respondents

90,293

Total Responses

310,604

Total Hour Burden

62,004

Total Cost Burden

$2,170,140

Page 1 of 2

62,004

$2,170,140

1625-0040

Appendix B: Estimated Annual Federal Government Cost

Cost Element

Annual Cost

Direct Costs
Government Labor

$24,827,869

IT Systems & Desktop Support

$1,022,143

Federal Records Center/Postage

$232,697

Facility

$2,533,810

Other Operating Expenses

$2,064,677

Contractor Costs
Contracted Services

Total

$3,204,319
$33,885,515

Total
Total Cost

$33,885,515

*Estimates may not sum due to rounding

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