Various International Agreement Safety Certificates and Documents

OMB 1625-0017

These Coast Guard-issued forms are used as evidence of compliance with the International Convention for Safety of Life at Sea, 1974 by certain U.S. vessels on international voyages. Without the proper certificates or documents, a U.S. vessel could be detained in foreign ports.

The latest form for Various International Agreement Safety Certificates and Documents expires 2021-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
1625-0017_SS_r0_2020_calc-sheet-App-A--B.pdf Supplementary Document
1625-0017 30-day FR Notice.docx Supplementary Document
1625-0017 60 day FR Notice.docx Supplementary Document
USCG--013 MISLE SORN_74 FR 30305_20090625.doc Supplementary Document
privacy_pia_uscg_misle.pdf Supplementary Document
CFR-2014-title46-vol1-sec2-01-25.pdf Supplementary Document
USCODE-2015-title46-subtitleII-partB-chap37-sec3703.pdf Supplementary Document
USCODE-2010-title46-subtitleII-partB-chap33-sec3316.pdf Supplementary Document
USCODE-2015-title46-subtitleII-partB-chap33-sec3307.pdf Supplementary Document
USCODE-2011-title46-subtitleII-partB-chap33-sec3306.pdf Supplementary Document
1625-0017_SS_r0_2020.docx Supporting Statement A
Permit to Operate High-Speed Craft Instruction
Cargo Ship Safety Equipment Certificate Instruction
High-Speed Craft Safety Certificate, Record of Equipment Instruction
Cargo Ship Safety Construction Certificate Instruction
Passenger Ship Safety Certificate, Record of Equipment Instruction
Exemption Certificate Instruction
Document of Compliance Instruction
Notice of Completion of Examination for Safety Certificate Instruction
International Ship Security Certificate Instruction
Interim International Ship Security Certificate Instruction
Amendments to the Continuous Synopsis Record (CSR) Document Number, for the Ship with IMO Number Instruction
High-speed Craft Safety Certificate Instruction
Continuous Synopsis Record (CSR) Document Number for the Ship with IMO Number Instruction
Safety Management Certificate Instruction
Cargo Ship Safety Equipment Certificate, Record of Equipment Instruction
Passenger Ship Safety Certificate Instruction

All Historical Document Collections

202101-1625-004 Approved with change	Extension without change of a currently approved collection	2021-02-24
201711-1625-006 Approved with change	Reinstatement without change of a previously approved collection	2017-12-27
201405-1625-003 Approved without change	Extension without change of a currently approved collection	2014-05-28
201106-1625-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2011-06-07
200904-1625-002 Approved with change	Revision of a currently approved collection	2011-02-24
200706-1625-002 Approved without change	Revision of a currently approved collection	2007-11-28
200408-1625-002 Approved without change	Extension without change of a currently approved collection	2004-08-11
200402-1625-002 Approved without change	Revision of a currently approved collection	2004-02-06
200311-1625-003 Approved without change	Extension without change of a currently approved collection	2003-11-17
200303-1625-019 Approved without change	Revision of a currently approved collection	2003-03-01

OMB Details

Exemption Certificate

Federal Enterprise Architecture: Transportation - Water Transportation