Coast Guard Boating Accident Report Form (CG-3865)

Forms and Documents

Document Name	Status
1625-0003 30-day FR Notice_86FR69064_20211206_.docx Supplementary Document	2021-12-04
1625-0003 60-day FR Notice_86FR48434_20210830_.docx Supplementary Document	2021-12-02
1625-0003 Privacy_PIA_20091112_USCG_BoatingAccidentReportDatabase (1).pdf Supplementary Document	2021-12-02
DHS-USCG-013_MISLE_SORN_2009-06-25.pdf Supplementary Document	2021-12-02
1625-0003 Supporting Statement_v3.docx Supporting Statement A	2021-12-09
CFR-2010-title33-vol2-part174.pdf Supplementary Document	2016-01-28
CFR-2010-title33-vol2-sec173-55.pdf Supplementary Document	2016-01-28
CFR-2001-title33-vol2-part173.pdf Supplementary Document	2016-01-28
USCODE-2011-title46-subtitleII-partD-chap61-sec6102.pdf Supplementary Document	2016-01-28

IC Document Collections

IC ID	Document Title	Status
250744	Coast Guard Boating Accident Report Form (CG-3865) Public Response Instruction	New
20444	Coast Guard Boating Accident Report Form (CG-3865) State Response Other-BARD Screenshot	Modified

ICR Details

OMB Control No: 1625-0003	ICR Reference No: 202112-1625-002
Status: Received in OIRA	Previous ICR Reference No: 201903-1625-002
Agency/Subagency: DHS/USCG	Agency Tracking No:
Title: Coast Guard Boating Accident Report Form (CG-3865)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/09/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2022
Responses	5,740	5,000
Time Burden (Hours)	10,430	2,500
Cost Burden (Dollars)	280,529	2,450

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Abstract: This report is submitted by State reporting authorities to the USCG. Data collected from these reports are used to establish USCG Marine Safety performance measures and publish statistics in accordance with Title 46 USC 6102.

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Authorizing Statute(s): US Code: 46 USC 6102 Name of Law: State marine casualty reporting system
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 48434	08/30/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 69064	12/06/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Coast Guard Boating Accident Report Form (CG-3865) Public Response	(CG-3865), CG-3865SP	Recreational Boating Accident Report ,   Recreational Boating Accident Report
Coast Guard Boating Accident Report Form (CG-3865) State Response

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ICR Summary of Burden

	Total Request	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	5,740	5,000	0	0	740	0
Annual Time Burden (Hours)	10,430	2,500	0	0	7,930	0
Annual Cost Burden (Dollars)	280,529	2,450	0	0	278,079	0

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: No

Burden Reduction Due to:

Short Statement: There are a number of changes in the burden with respect to respondent type, number of respondents, wage calculation, and postage calculation. The previous burden only focused on the public burden, while this renewal provides burden estimates for both the public and the State. The public burden estimate reflects changes with regards to the number of respondents, wage calculation, and postage calculation. The number of respondents has been reduced from 5,000 to 700. The wage has been added, and the cost of postage has increased. The previous cost burden to the public was $2,450 which only took into account the cost of postage to mail the form; with these revisions, the cost burden to the public is $9,880.50 which takes into account a reduced number of respondents, the respondent’s cost to fill out the form, and the postage to mail the form. The Coast Guard has added an estimated burden on the State to collect information on boating accidents. The burden for the State had not been previously reported; it is $280,123.20.

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Annual Cost to Federal Government: $300,000

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

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Common Form ICR:  No

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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: 12/09/2021

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