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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Documentation of medical fitness
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
46 CFR 12.02-17
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
1625-0079_Inst_r5_2019-mmc.doc.docx
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Water Transportation
Privacy Act System of Records
Title:
DHS/USCG 030 Merchant Seamen's Records
FR Citation:
74 FR 30308
Number of Respondents:
35,108
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
75 %
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
33,875
0
0
-2,115
0
35,990
Annual IC Time Burden (Hours)
11,281
0
0
-704
0
11,985
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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