OMB control number

Applications for Merchant Mariner Credentials and Medical Certificates

OMB 1625-0040 · DHS/USCG.

OMB 1625-0040

In accordance with Title 46 CFR Parts 10, 11, 12, 13, and 16, the collection of this information is necessary to determine competency, character & physical qualifications for the issuance of a Merchant Mariner Credential (MMC) or Medical Certificate.

The latest form for Applications for Merchant Mariner Credentials and Medical Certificates expires 2028-09-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CG-719B Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical Form and Instruction
1625-0040_SS_r0_2025_calc-sheet_m2m-nprm_App_A-to-B.pdf Supplementary Document
46 CFR Part 13.pdf Supplementary Document
DHS_USCG_030 Merchant Seamens Records_20090625_74 FR 30308 (1).docx Supplementary Document
privacy-pia-uscg-015-MMLDS-2011 (1).pdf Supplementary Document
46 CFR Part 16.pdf Supplementary Document
46 CFR Part 12.pdf Supplementary Document
46 CFR Part 11.pdf Supplementary Document
46 CFR Part 10.pdf Supplementary Document
1625-0040_SS_r0_2025_m2m-nprm.docx Supporting Statement A
Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical Form and Instruction

All Historical Document Collections

202506-1625-001 Comment filed on proposed rule and continue	Revision of a currently approved collection	2025-07-17
202505-1625-001 Approved with change	Revision of a currently approved collection	2025-05-19
202502-1625-004	Revision of a currently approved collection	2025-03-19
202304-1625-003	Revision of a currently approved collection	2024-01-26
202102-1625-008 Approved with change	Extension without change of a currently approved collection	2021-03-11
201601-1625-009 Approved without change	Reinstatement with change of a previously approved collection	2018-03-01
201409-1625-011 Approved with change	Revision of a currently approved collection	2015-03-26
201404-1625-001 Improperly submitted and continue	Revision of a currently approved collection	2014-06-12
201301-1625-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2014-03-13
201209-1625-003 Approved with change	Revision of a currently approved collection	2012-09-28
201109-1625-003 Withdrawn and continue	Revision of a currently approved collection	2012-06-29
201009-1625-009 Withdrawn and continue	Revision of a currently approved collection	2011-06-17
201002-1625-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2010-04-16
200909-1625-001 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2009-11-04
200803-1625-010 Approved with change	Extension without change of a currently approved collection	2009-04-08
200606-1625-001 Approved without change	Revision of a currently approved collection	2006-06-05
200512-1625-002 Approved without change	Revision of a currently approved collection	2005-12-21
200507-1625-005 Approved without change	Reinstatement with change of a previously approved collection	2005-07-18
200303-1625-042 Approved without change	Revision of a currently approved collection	2003-03-01