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CG-719K/E Application for Medical Certificate, Short Form
Application for Merchant Mariner Credentials and Medical Certificates
Application for Medical Certificate, Short Form (Form CG-719K_E)
Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical
OMB: 1625-0040
OMB.report
DHS/USCG
OMB 1625-0040
ICR 202502-1625-004
IC 43932
CG-719K/E Application for Medical Certificate, Short Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1625-0040 can be found here:
2025-05-19 - Revision of a currently approved collection
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