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An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The Coast Guard estimates that the average burden for this collection of information is 60 minutes. You may submit any comments concerning the accuracy of this burden estimate or any suggestions for reducing the burden to: Commandant (CG-5521), U.S. Coast Guard, 2100 2ND St., SW, Washington D.C. 20593-7683 or Office of Management and Budget, Paperwork Reduction Project (1625-0008), Washington, DC 20593.
I have read the Paperwork Reduction Act Notice
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1. Please complete either this online form or a paper CG-4423.
2. This application must reach the appropriate Captain of the Port (selected via dropdown box) at least 135
days prior to the event.
3. Attach a section of a chart or scale drawing showing boundaries and/or courses and markers contemplated.
Click "add attachment" to attach a document in one of the following file formats ( .jpg, .pdf, .ppt, .doc, .docx)
4. Submit a copy of your entry requirements, and any special rules pertaining to equipment, rigs or procedures.
5. * Denotes required fields.
6. If you want to print out a copy of the form hit Shift PrintScreen.
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From:
To:
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From :
To :
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Yes
No
If yes, briefly explain
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Yes
No
If yes, briefly explain
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Yes
No
If No, briefly explain
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Yes
No
If Yes, how many vessels do you recommend and why?
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Note: You must attach a section of a chart or scale drawing showing the boundaries and/or courses and markers contemplated. You also must attach a copy of your entry requirements and any special rules pertaining to the equipment, rigs, or procedures.
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Privacy Act Statement
Authority: 33 U.S.C 1233 authorizes the collection of this information.
Purpose: The Coast Guard will use this information to determine whether an event poses an extra or unusual hazard to the safety of life and whether or not, and under which conditions, to permit the event on the navigable waters of the United States.
Routine Uses: The information will be used by and disclosed to Coast Guard personnel to evaluate the request. Additionally, the Coast Guard may share the information with facility operators, law enforcement or other government agencies as necessary to promote public safety during the requested marine event.
Disclosure: Furnishing this information is voluntary; however, failure to furnish the requested information may delay or prevent the approval of the requested marine event.
I have read the Privacy Act Statement
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