OMB control number

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

OMB 1625-0041 · DHS/USCG.

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 statutory authority is 33 U.S.C. 1901-1911. The authority is delegated to the Coast Guard through the Department of Homeland Security Delegation No. 0170.1, Revision No. 01.2. (II)(77).

The latest form for Various International Agreement Pollution Prevention Certificates and Documents, and Equivalency Certificates expires 2026-11-30 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