USCG CG-719B 2004 free printable template

DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARD CG-719B (Rev 03/04)-F5 Application for License as an Officer, Staff Officer, or Operator and for Merchant Mariner's Document (For CG Use Only) Date

How to fill out USCG CG-719B

How to fill out USCG CG-719B

1. Obtain the USCG CG-719B form from the official US Coast Guard website.
2. Read the instructions carefully before filling out the form.
3. Provide your personal information in Section I, including your full name, address, and date of birth.
4. Complete Section II by answering questions related to your citizenship status.
5. Fill out Section III regarding your medical history and any physical limitations.
6. In Section IV, disclose any past arrests or violations of maritime law, if applicable.
7. Sign and date the form in Section V, certifying that all the information provided is true and correct.
8. Submit the completed CG-719B form according to the instructions provided, either online or by mail.

Who needs USCG CG-719B?

1. Individuals applying for a Merchant Mariner Credential (MMC) from the United States Coast Guard.
2. Mariners seeking to renew or upgrade their existing credentials.
3. Applicants for certain licenses or endorsements that require a physical examination and verification of personal history.

• Who needs a CG-719B Form?
• What is the CG-719B Form for?
• Is the CG-719B Form accompanied by other forms?
• • When is the CG-719B Form due?
  • How do I fill out the CG-719B Form?
  • Where do I send the CG-719B Form?

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.

 

Instructions and Help about USCG CG-719B

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...

People Also Ask about

What is a 719B form?

What is the CG-719B form? Form CG-719B is used for all Coast Guard credentials, both for original first time Coast Guard applications and for license renewals.

How do I submit CG-719B?

Applications for an MMC (CG-719B) cannot be submitted directly to the NMC. Any application for a medical certificate that is submitted with a CG-719B (MMC and medical certificate) must be submitted to an REC. Medical certificate applications can be submitted to the NMC via e-mail at: MEDAIP@uscg.mil.

How can I get ordinary seaman certificate?

Requirements Be 18 years or older. Pass a drug test. Pass a medical and physical exam. Fall in line with the sea service requirements. Provide proof of citizenship and your Social Security card. TWIC.

How do I get CG-719B?

Application Assistance: Please call the National Maritime Center (NMC) at 1-888-IASKNMC (1-888-427-5662), or visit their website for more information. .uscg.mil/nmc.

Can anyone get a merchant mariner credential?

To acquire the MMC, you will have to make an application to the National Maritime Center. Along with this application, you must also submit the following: Documentation of Citizenship or Nationality. TWIC Card or receipt indicating you have applied for a TWIC.

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What is USCG CG-719B?

USCG CG-719B is a form used by the United States Coast Guard (USCG) for reporting an individual's application for a merchant mariner credential (MMC).

Who is required to file USCG CG-719B?

Individuals applying for a Merchant Mariner Credential (MMC) or renewing their credentials are required to file USCG CG-719B.

How to fill out USCG CG-719B?

To fill out USCG CG-719B, applicants must provide personal information, employment history, medical history, and other relevant details as instructed in the form. It may also require signatures and date entries.

What is the purpose of USCG CG-719B?

The purpose of USCG CG-719B is to collect necessary information for the evaluation of an applicant's qualifications for a Merchant Mariner Credential (MMC) and to ensure they meet the standards set by the USCG.

What information must be reported on USCG CG-719B?

Information that must be reported on USCG CG-719B includes personal identification data, medical history, any criminal convictions, previous maritime experience, and other background information relevant to the application.