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USCG CG-719B 2017-2024 free printable template

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DEPARTMENT OF HOMELAND SECURITY U.S. Coast Guard OMB No. 1625-0040 Exp. Date 03/31/2021 APPLICATION FOR MERCHANT MARINER CREDENTIAL FORM CG-719B ------ Instructions -----Who must submit this form 1. CG-719B 04/17 Reset Page 1 of 5 U.S. Registered Pilot - When only applying for an original or renewal please scan and email the completed application along with supporting documentation to GreatLakesPilotage uscg. A Have you ever been a user of/or addicted to a dangerous drug including marijuana...
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How to fill out cg 719b 2017-2024 form

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How to fill out CG 719B:

01
Begin by filling out your personal information in Section I of the form.
02
Provide the details of your vessel in Section II, including its name, official number, and what type of vessel it is.
03
In Section III, indicate the purpose of the form and provide any additional information required.
04
Section IV requires you to disclose any accidents, injuries, or illnesses that have occurred on the vessel within the past three years.
05
In Section V, provide information on the medical condition of the applicant, including any medications or treatments they are currently receiving.
06
Section VI is to be completed by the medical practitioner conducting the examination, who will assess the applicant's overall health and fitness for the specified duties.
07
Finally, review the form for accuracy and completeness before submitting it.

Who needs CG 719B?

01
Any individual applying for a Coast Guard issued Merchant Mariner Credential (MMC) and intends to serve on a vessel.
02
Ship owners or operators may also be required to complete this form for their crew members as part of the licensing process.
03
Additionally, individuals seeking to renew or upgrade their existing MMC may need to fill out CG 719B.
Please note that specific requirements and procedures may vary, so it is advisable to consult the official instructions or contact the appropriate maritime authority for accurate and up-to-date information.

Who needs a CG-719B Form?

An applicant willing to obtain a Merchant Mariner Credential (MMC), whether original, renewal, duplicate, raise of grade or a new endorsement on a previously issued MMC must submit an Application for Merchant Mariner Credential CG Form 719B.

What is the CG-719B Form for?

The Coast Guard application form (CG-719B) is the primary form which should be filed in a USCG License application process.

Is the CG-719B Form accompanied by other forms?

To obtain a Merchant Mariner Credential, it is required to submit several completed forms and supporting documents, like:

  • TWIC — Transportation Worker’s Identification Credential;

  • CG-719K — Merchant Mariner Physical Examination Report, or Merchant Marine Certification for Entry Level Ratings (CG-719K/E)

  • CG-719P — DOT/USCG Periodic Drug Testing Form or alternate evidence

  • CG-719S — Sea Service Form or other proof of sea service

  • Authorization for Credit Card Transactions (only if paying by credit card)

When is the CG-719B Form due?

To ensure regular employment, Mariners should make the appropriate provisions in advance before the expiration or employment dates. Therefore, it is recommended that the application package (Form CG-719B and the supporting documentation) be sent 8-10 weeks before MMC’s necessity. It is worth mentioning that applicants having had criminal convictions or with medical conditions, consideration of which might require additional time, should submit their applications 14-18 weeks early.

How do I fill out the CG-719B Form?

To prevent any delays or controversial issues, the Form CG-719B should be filled out in accurate and comprehensive manner and include the following information:

  • Personal Data

  • Type of Transaction

  • Narcotic, DWI/DUI, and Conviction Record

  • Character References

  • Mariner’s Consent

  • Certification and Oath.

The rest is filled out by Coast Guard personnel.

Where do I send the CG-719B Form?

The signed and dated USCG application must be delivered to a Local Regional Exam Center (REC) in person or by mail, email, or fax.

 

Video instructions and help with filling out and completing cg 719b

Instructions and Help about uscg mmc application forms

Welcome to the National Maritime Center's instructional video on completing the U.S. Coast Guard 719 series of applications. Forms CG-719B is the application for license as an officer, staff officer or operator, and for Merchant Mariner's documents. The first three pages provide detailed instructions on filling out the CG 719 B form each section listed in the instruction corresponds with a specific section of the application form Figure 1 on page 3 provides a table detailing the different endorsement categories and transaction types to assist you in making the appropriate selection during the application process. Please read these instructions carefully prior to filling out the application. Section 1 of this form consists of personal data. Fill out each block in this section or write “N/A” if not applicable when your credential is issued by mail the address in this section is used. Please make sure your personal information is accurate and report changes immediately. Section two consists of the type of transaction you are requesting. Please check marks in the applicable boxes. Multiple selections in this section are acceptable In the description of endorsement desired box, be specific about the credential you are requesting. This box applies to renewal transactions only. If you wish to have your renewal MMC issued immediately instead of having its issuance coincide with the expiration of your previous credentials please check this box. Section 3 covers safety and suitability. Part one should be marked if you are exempt from holding a valid TWIC under Coast Guard policy Letter 11-15. For more information on this exemption please refer to the policy letter section of our website. For part two: convictions and drug use mark the appropriate response and complete the CG-719C form for all areas marked quot;yes.” Remember to complete all blocks in this section. For part 3 quot;National Driver Registry, *?? Mark this box to authorize the NDR search. Consent authorization is mandatory for applications for originals, renewals or new officer endorsements. Section 4 covers Mariner's consent and certification. In part 1 you are given the option to participate in the Mariner outreach system. Please read this section and choose the appropriate response. The box in part 2 should only be marked when you're applying for a document of continuity. This section acknowledges your awareness that a document of continuity is not valid for use. Part 3 should be used for Mariners under 18 years of age. If applicable please check the box and provide a notarized statement of consent from a parent or guardian. Part 4 denotes that the National Maritime Center is authorized to release information to a third party. If applicable, please fill out this section completely. Part 5 of section 4 addresses certification and oath. Read the certification carefully. Sign and date certifying that the information is true and correct. The oath is for original applications only. There are...

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CG 719b is a form used by the U.S. Coast Guard to document the transfer of a vessel from one owner to another. The form is also used to document changes in vessel ownership, such as when an owner adds or removes a partner in the ownership of the vessel.
The CG 719B form is used by the U.S. Coast Guard to report the details of all casualties and accidents that occur on or near navigable waters. Information reported on the CG 719B includes the date and time of the incident, the vessel’s name and type, the location and description of the incident, the name of the vessel's operator, the names of any witnesses, the name and contact information for the investigating officer, and any other relevant details.
The penalty for late filing of the CG-719B form is a civil penalty of up to $1,000 per day for each day the return is late.
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