View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1625-0040
ICR Reference No:
202502-1625-004
Status:
Historical Inactive
Previous ICR Reference No:
202102-1625-008
Agency/Subagency:
DHS/USCG
Agency Tracking No:
Title:
Application for Merchant Mariner Credentials and Medical Certificates
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Comment filed on proposed rule and continue
Conclusion Date:
05/14/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/19/2025
Terms of Clearance:
In accordance with 5 CFR 1320, OIRA is withholding approval at this time. Prior to publication of the final rule, the agency must submit to OIRA a summary of all comments related to the information collection contained in the proposed rule and the agency response. The agency should clearly indicate any changes made to the information collection as a result of these comments. Any previous terms of clearance continue to apply.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2026
36 Months From Approved
04/30/2026
Responses
310,604
0
310,604
Time Burden (Hours)
62,004
0
62,004
Cost Burden (Dollars)
0
0
0
Abstract:
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.
Authorizing Statute(s):
US Code:
46 USC Subtitle II, Part E
Name of Law: Mechant Seamen Licenses, Certificates, and Documents
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
1625-AC63
Proposed rulemaking
86 FR 48090
08/27/2021
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical
CG-719C, CG-719K, CG-719B, CG-719P, CG-719S, CG-719K/E
Application for Merchant Mariner Credential
,
Disclosure Statement for Narcotics, DWI/DUI, and/or Other Convictions
,
Application for Medical Certificate
,
Application for Medical Certificate, Short Form
,
DOT/USCG Periodic Drug Testing Form
,
Small Vessel Sea Service Form
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The change in burden is a PROGRAM CHANGE due to the 1625-AC63 PMC NPRM. The reporting and recordkeeping requirements, and the methodology for calculating burden, remain unchanged.
Annual Cost to Federal Government:
$14,729,656
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Michael Toth 304 433-3729 michael.p.toth2@uscg.mil
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/19/2025
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