U.S. Coast Guard CGES Scholarship Program Application

Coast Guard Exchange System Scholarship Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0119 can be found here:

Documents and Forms

Document Name Document Type
CG 5867_Inst_r0_2016.docx Instruction
CG-5687 (07/17) Coast Guard Exchange System Scholarship Program Applicat CG5687 (Rev July2017).pdf Form

Information Collection (IC) Details

IC Title:	U.S. Coast Guard CGES Scholarship Program Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CG 5867_Inst_r0_2016.docx		Yes	Yes	Printable Only
Form	CG-5687 (07/17)	Coast Guard Exchange System Scholarship Program Application	CG5687 (Rev July2017).pdf		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title: DHS/USCG-018 Exchange System and Morale Well-Being and Recreation	FR Citation: 73 FR 77736

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	30	0	30
Annual IC Time Burden (Hours)	120	0	120
Annual IC Cost Burden (Dollars)	15	15	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.