OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical

IC 43932 under ICR 202505-1625-001 · OMB 1625-0040.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical
 
No Modified
 
Required to Obtain or Retain Benefits
 
46 CFR 11 46 CFR 12 46 CFR 16 46 CFR 10

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CG-719B Application for Merchant Mariner Credential Application for Merchant Mariner Credential (Form CG-719B).pdf Yes Yes Fillable Printable
Form and Instruction CG-719C Disclosure Statement for Narcotics, DWI/DUI, and/or Other Convictions Disclosure Statement for Narcotics, DWI_DUI, and_or Other Convictions (Optional Form CG-719C).pdf Yes Yes Fillable Printable
Form and Instruction CG-719K Application for Medical Certificate Application for Medical Certificate (Form CG-719K).pdf Yes Yes Fillable Printable
Form and Instruction CG-719K/E Application for Medical Certificate, Short Form Application for Medical Certificate, Short Form (Form CG-719K_E.pdf Yes Yes Fillable Printable
Form CG-719P DOT/USCG Periodic Drug Testing Form CG719P.pdf Yes Yes Fillable Printable
Form CG-719S Small Vessel Sea Service Form CG719S.pdf Yes Yes Fillable Printable

Transportation Water Transportation

Merchant Seamen's Records  74 FR 30308

90,293 0
   
Private Sector Businesses or other for-profits
 
   90 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 310,091 0 -513 0 0 310,604
Annual IC Time Burden (Hours) 61,850 0 -154 0 0 62,004
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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