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OMB-1625-0066
Expires 01/31/2020
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 collection of information is 55 minutes. You may submit any comments
concerning the accuracy of this burden estimate or any suggestions for reducing the burden to: Commandant (CG-5521), U.S. Coast Guard, 2100 2ND
St., SW, Washington D.C. 20593-7683 or Office of Management and Budget, Paperwork Reduction Project (1625-0008), Washington, DC 20593.

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