APPLICATION FOR REGISTRATION AS U.S. REGISTERED PILOT

ICR 198703-2115-001

OMB: 2115-0022

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
140435 Migrated
ICR Details
2115-0022 198703-2115-001
Historical Active 198402-2115-001
DOT/USCG
APPLICATION FOR REGISTRATION AS U.S. REGISTERED PILOT
Revision of a currently approved collection   No
Regular
Approved without change 06/22/1987
Retrieve Notice of Action (NOA) 03/27/1987
  Inventory as of this Action Requested Previously Approved
06/30/1990 06/30/1990 03/31/1987
70 0 80
105 0 80
0 0 0

THIS APPLICATION FORM IS USED BY INDIVIDUALS TO APPLY TO BE REGISTERED PILOTS ON THE GREAT LAKES, FOR RENEWAL EVEY FIVE YEARS BY ALREADY REGISTERED PILOTS, BY ALREADY REGISTERED PILOTS TO REPORT THE RESULTS OF THEIR ANNUAL PHYSICAL EXAM, AND BY THE COAST GUARD TO DETERMINE THE QUALIFICATIONS OF INDIVIDUALS WHO DESIRE TO BE REGISTERED PILOTS.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR REGISTRATION AS U.S. REGISTERED PILOT CG-4509

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 70 80 0 0 -10 0
Annual Time Burden (Hours) 105 80 0 0 25 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
03/27/1987


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