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Paperwork Reduction Act Statements

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 to complete this form is 5 minutes. You may submit any comments concerning the accuracy of this burden estimate or any suggestions for reducing the burden to: Commanding Officer, Coast Guard Recruiting Command, 2703 Martin Luther King Jr. Ave SE, Washington, DC 20593-7419 or Office of Management and Budget, Paperwork Reduction Project (1625-new), Washington DC 20503.

Privacy Act Statement

AUTHORITY: 10 U.S.C. §§ 504, 1475-1480; 14 U.S.C. §§ 211, 350, 632; Homeland Security Presidential Directive (HSPD) 12.
PURPOSE: To identify and process individuals interested in applying for enlistment or commission in the United States Coast Guard (CG) or CG Reserve.

ROUTINE USES: Authorized CG personnel will use this information to assess an individual’s interest for enlistment and/or commissioning, to screen qualified applicants, and to initiate pay and benefits for new members. Any external disclosures of data within this record will be made in accordance with DHS/USCG-014, Military Pay and Personnel System of Records, 76 Federal Register 66,933, October 28, 2011.

DISCLOSURE: Disclosure is voluntary. However, failure to provide requested information may result in not being contacted by a recruiter and ultimately, prohibit enlistment or commissioning.

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