1625-0040 Calc-Sheet

1625-0028

Appendix A: Total Estimated Annual Burden on Industry
Respondents
MMC Applicants:
Med Cert Applicants:
Total:

56,500
12,000
68,500
Responses
per year

Burden
Hours/
Response

Annual
Hour
Burden

Wage
Rate

Annual
Cost
Burden

CG-719B

56,500

0.15

8,475

$51

$432,225

Application for Medical Certificate CG-719K

54,800

0.3

16,440

$51

$838,440

-513

0.3

-154

$65

-$10,004

13,700

0.167

2,283

$51

$116,452

56,500

0.25

14,125

$51

$720,375

56,500

0.083

4,708

$51

$240,115

8,475

0.167

1,413

$51

$72,039

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

Form
Number

Reduction in Medical Certificate
-submissons due to RIN 1625AC63
Application for Medical Certificate, CG-719K/E
Short Form
Small Vessel Sea Service Form

CG-719S

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

245,962

*Estimates may not sum due to rounding

Total Respondents

68,500

Total Responses

245,962

Total Hour Burden

47,290

Total Cost Burden

$2,409,643

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47,290

$2,409,643

1625-0040

Appendix B: Estimated Annual Federal Government Cost

Cost Element

Annual Cost

Direct Costs
Evaluation of Forms (personnel costs)

$11,394,464

MMLD database

$800,000

Shipping costs

$14,993

Safety and Suitability database

$31,303

Contractor Costs
In-Processing of forms/Production of
Credentials

Total

$2,488,896
$14,729,656

Total
Total Cost

$14,729,656

*Estimates may not sum due to rounding

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