USCG CG-2692B 2019-2024 free printable template
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Name PRINT Last First Middle 11. Signature 13. Title 15. Telephone No. 16. Email CG-2692B 04/18 12. Date Page 1 of 2 Reset INSTRUCTIONS FOR COMPLETION OF FORM CG-2692B Report of Chemical Testing Following a Serious Marine Incident Involving a Commercial Vessel An agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it displays a valid OMB control number. Http //www. uscg. mil/top/units/ 6. Upon receipt of a report of chemical test...
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Instructions and Help about 1991 cg2692b alcohol get form
Welcome to the National Maritime Center's instructional video on completing the U.S. Coast Guard 719 series of applications. Forms CG-719B is the application for license as an officer, staff officer or operator, and for Merchant Mariner's documents. The first three pages provide detailed instructions on filling out the CG 719 B form each section listed in the instruction corresponds with a specific section of the application form Figure 1 on page 3 provides a table detailing the different endorsement categories and transaction types to assist you in making the appropriate selection during the application process. Please read these instructions carefully prior to filling out the application. Section 1 of this form consists of personal data. Fill out each block in this section or write “N/A” if not applicable when your credential is issued by mail the address in this section is used. Please make sure your personal information is accurate and report changes immediately. Section two consists of the type of transaction you are requesting. Please check marks in the applicable boxes. Multiple selections in this section are acceptable In the description of endorsement desired box, be specific about the credential you are requesting. This box applies to renewal transactions only. If you wish to have your renewal MMC issued immediately instead of having its issuance coincide with the expiration of your previous credentials please check this box. Section 3 covers safety and suitability. Part one should be marked if you are exempt from holding a valid TWIC under Coast Guard policy Letter 11-15. For more information on this exemption please refer to the policy letter section of our website. For part two: convictions and drug use mark the appropriate response and complete the CG-719C form for all areas marked quot;yes.” Remember to complete all blocks in this section. For part 3 quot;National Driver Registry, *?? Mark this box to authorize the NDR search. Consent authorization is mandatory for applications for originals, renewals or new officer endorsements. Section 4 covers Mariner's consent and certification. In part 1 you are given the option to participate in the Mariner outreach system. Please read this section and choose the appropriate response. The box in part 2 should only be marked when you're applying for a document of continuity. This section acknowledges your awareness that a document of continuity is not valid for use. Part 3 should be used for Mariners under 18 years of age. If applicable please check the box and provide a notarized statement of consent from a parent or guardian. Part 4 denotes that the National Maritime Center is authorized to release information to a third party. If applicable, please fill out this section completely. Part 5 of section 4 addresses certification and oath. Read the certification carefully. Sign and date certifying that the information is true and correct. The oath is for original applications only. There are...
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