Continuous Discharge Book, Application, Physical Exam Report, Sea Service Report, Chemical Testing, Entry Lvl Physical

Application for Merchant Mariner Credentials and Medical Certificates

OMB: 1625-0040

IC ID: 43932

Documents and Forms

Document Name Document Type
1625-0040_Inst_r0_2021-mmc_pmc-nprm.docx Instruction
CG-719B Application for Merchant Mariner Credential CG719B.pdf Form and Instruction
CG-719C Disclosure Statement for Narcotics, DWI/DUI, and/or Other Convictions CG719C (002).pdf Form and Instruction
CG-719K Application for Medical Certificate CG-719K Application for Medical Certificate.pdf Form and Instruction
CG-719K/E Application for Medical Certificate, Short Form Application for Medical Certificate, Short Form (Form CG-719K_E).pdf Form and Instruction
CG-719P DOT/USCG Periodic Drug Testing Form CG719P.pdf Form
CG-719S Small Vessel Sea Service Form CG719S.pdf Form