Various International Agreement Pollution Prevention Certificates and Documents, and Equivalency Certificates

OMB 1625-0041

Required by the adoption of the Int'l Convention for the Prevention of Pollution from Ships (MARPOL 73/78) and other int'l treaties, these certificates and documents are evidence of compliance with these treaties for U.S. vessels on int'l voyages. Without the proper certificates/documents, a U.S. vessel could be detained in a foreign port.

The latest form for Various International Agreement Pollution Prevention Certificates and Documents, and Equivalency Certificates expires 2023-07-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
PTA USCG - International Certificate on Inventory of Hazardous Materials (CG-16478) 20230510 PRIV Final.pdf Supplementary Document
PTA USCG - International Ballast Water Management Certificate (CG-9191) 20230508 PRIV Final.pdf Supplementary Document
PTA USCG - Record of Anti-Fouling Systems (CG-6059A) 20230502 PRIV Final.pdf Supplementary Document
PTA USCG - Supplement to the International Energy Efficiency Certificate (CG-6060A) 20230504 PRIV Final.pdf Supplementary Document
PTA USCG - International Energy Efficiency (IEE) Certificate (CG-6060) 20230427 PRIV Final.pdf Supplementary Document
PTA USCG - International Anti-Fouling Systems Certificate (CG-6059) 20230426 PRIV Final.pdf Supplementary Document
PTA USCG - Statement of Voluntary Compliance form (CG-6057) 20230424 PRIV Final.pdf Supplementary Document
PTA USCG - International Agreement Pollution Prevention Certificates Documents Equivalency Certificates (CG-6056C) 20230420 PRIV Final.pdf Supplementary Document
PTA USCG - Statement of Voluntary Compliance for Annex VI of MARPOL 73-78 (CG-6056B) 20230419 PRIV Final.pdf Supplementary Document
PTA USCG - Supplement to International Air Pollution Prevention Certificate (IAPP Certificate) CG-6056A 20230417 PRIV Final.pdf Supplementary Document
1625-0041 30-day FR Notice_88FR26324_20230428_.docx Supplementary Document
1625-0041 60-day FR Notice_88FR6291_20230131_.docx Supplementary Document
privacy_pia_uscg_misle_20090903.pdf Supplementary Document
DHS_USCG-013 MISLE SORN_20090625.pdf Supplementary Document
1625-0041_SS_r0_2022_calc-sheet_App-A-to-B_hk-conv.pdf Supplementary Document
33usc1901-1915_Chpt33_2019e.pdf Supplementary Document
CFR-2010-title33-vol2-sec151-21 (6).pdf Supplementary Document
CFR-2010-title33-vol2-sec151-21 (6).pdf Supplementary Document
CFR-2001-title33-vol2-part157_157.37d.pdf Supplementary Document
CFR-2001-title33-vol2-part159.pdf Supplementary Document
PLAW-111publ281.pdf Supplementary Document
Pub L. 96-478.pdf Supplementary Document
1625-0041_SS_r0_2022_hk-conv (1)_.docx Supporting Statement A
HW Certificate (Statement of Voluntary Compliance Instruction
BWM Certificate (Statement of Voluntary Compliance) Instruction
Recurring Ship-to-Ship Operations Plan Update Instruction
Initial Ship-to-Ship Operations Plan Prepartation Instruction
Various International Agreement Pollution Prevention Certificates and Documents, and Equivalency Certificates Instruction
Flag State documents Instruction
IAPP Certificates Instruction
Retain discharge data recorded by a cargo monitor Instruction
Evidence required for ships not party to MARPOL 73/78 Instruction

All Historical Document Collections

202304-1625-001 Approved without change	Revision of a currently approved collection	2023-06-07
201906-1625-012 Approved without change	Revision of a currently approved collection	2019-06-28
201604-1625-005 Approved without change	Reinstatement without change of a previously approved collection	2016-05-31
201502-1625-004 Improperly submitted and continue	Revision of a currently approved collection	2015-02-27
201110-1625-006 Approved without change	Revision of a currently approved collection	2011-11-22
200804-1625-013 Approved without change	Revision of a currently approved collection	2008-08-26
200506-1625-001 Approved without change	Revision of a currently approved collection	2005-06-06
200409-1625-002 Approved without change	Revision of a currently approved collection	2004-09-07
200402-1625-004 Approved without change	Extension without change of a currently approved collection	2004-02-06
200303-1625-043 Approved without change	Extension without change of a currently approved collection	2003-03-01

OMB Details

Various International Agreement Pollution Prevention Certificates and Documents, and Equivalency Certificates

Federal Enterprise Architecture: Transportation - Water Transportation