CG-719K/E Application for Medical Certificate, Short Form

Application for Merchant Mariner Credentials and Medical Certificates

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1625-0040 can be found here:

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File Type	application/pdf
File Title	Application for Medical Certificate, Short Form (Form CG-719K/E)
Subject	Application for Medical Certificate, Short Form (Form CG-719K/E)
Author	FYI, Inc.
File Modified	2025-02-03
File Created	2025-02-03