Table of Contents
The CG-719B form, officially titled the Application for Merchant Mariner Credential, serves as a crucial document for individuals seeking to navigate the waters of maritime employment in the United States. This form is primarily designed for applicants who wish to obtain or renew a Merchant Mariner Credential (MMC), which is essential for anyone looking to work on commercial vessels. It encompasses various transaction types, including original applications, renewals, duplicates, and endorsements for specific maritime roles. The form requires detailed personal information, such as legal name, Social Security number, date of birth, and citizenship status, ensuring that the Coast Guard can accurately assess each applicant's eligibility. Furthermore, it mandates the disclosure of any criminal history and the possession of a Transportation Worker Identification Credential (TWIC), reinforcing the importance of safety and security in maritime operations. The CG-719B also includes sections for emergency contact information and consent for third-party communication, reflecting the form's comprehensive approach to applicant verification and credentialing. By addressing both the administrative and safety aspects of maritime employment, the CG-719B form plays a pivotal role in maintaining the integrity and professionalism of the U.S. maritime industry.
Sample - Cg 719B Form
DEPARTMENT OF HOMELAND SECURITY
U.S. Coast Guard
APPLICATION FOR MERCHANT MARINER CREDENTIAL (FORM
OMB No.
Who must submit this form?
1.Applicants seeking a Merchant Mariner Credential (MMC), whether original, renewal, duplicate, raise of grade, or a new endorsement on a previously issued MMC and applicants requesting a Medical Certificate.
2.Application Assistance: Please call the National Maritime Center (NMC) at
Section I: Applicant Information
I.1 Legal Name - Enter complete legal name. Include any aliases you have used and your maiden or prior name(s).
I.2a Social Security Number - If you are applying for an original credential, enter your SSN.
I.2b Reference Number - If you have been credentialed by the Coast Guard in the past, enter your reference number.
I.2c Alien Registration Number - If you are a legal alien, also enter your alien registration number (ARN).
I.3 Date of Birth - If the applicant is under 18 years of age, a notarized statement from legal guardian is required. Attach a notarized statement, signed by a parent or legal guardian, authorizing the Coast Guard to issue a credential.
I.4 Citizen - If not a U.S. citizen, please indicate country of nationality.
Section I: Applicant Address and Contact Information (If NMC is unable to contact you, it could cause delays in processing your application.)
I.6a Home Address - Principle place of residence. PO Box is NOT acceptable.
I.6b Delivery/Mailing Address - The address to which you want all correspondence and issued credentials sent. If blank, correspondence and credentials will be sent to the Home Address.
I.6c Primary Phone Number - Provide a primary phone number.
I.6d Alternate Phone Number - Provide an alternate phone number if available.
I.6e
I.6f Other - Please provide additional means of communicating with you (satellite phone, work phone, etc.) if available.
Section I (continued): Next of Kin/Emergency Contact: (Check the box for preferred contact method)
I.7a Next of Kin/Emergency Contact - Name & Mailing Address, City, State, Zip Code.
I.7b Relationship - Provide relationship status to next of kin listed on application. (i.e. Mother, Father, Spouse)
I.7c Primary Phone Number - Phone number to contact the person listed in the event of an emergency.
I.7d Alternate Phone Number - Provide a cellular phone number, if available.
I.7e
Section II: Requested Merchant Mariner Credential (MMC) and endorsements (Including Certificate of Registry)
General Application Requirements:
An applicant must establish that he or she satisfies all the requirements for the MMC and endorsement(s) sought before the MMC is issued. The Coast Guard may refuse to process an incomplete MMC application.
•A quick reference table for the requirements of an MMC and any endorsement is available online at: 46 CFR 10.239
•More information is available on the National Maritime Center (NMC) website: www.uscg.mil/nmc
MMC and Endorsement Application Descriptions:
All Mariners will receive a single Merchant Mariner Credential. Describe all desired capacities and limitations both national and STCW including tonnage, waters, propulsion mode, horsepower, ratings (Ordinary Seaman, Able Seaman,
1.Original MMC - An applicant must apply for an original MMC if they have never held any Coast Guard issued credential or if the first credential issued to applicant after their previous credential was revoked pursuant to 46 CFR Part 10. Complete the application and ensure all mandatory documents are contained with application.
2.Renewal MMC - A credential may be renewed at any time during its validity and for one year after expiration; you must be qualified to renew all Domestic/STCW Officer and Rating endorsements to receive an MMC with a new five year expiration date. An MMC
Page 1 of 5 |
3.U.S. Registered Pilot - When only applying for an original or renewal, please scan and email the completed application along with supporting documentation to: [email protected], or send via regular mail to:
Commandant
ATTN: Great Lakes Pilotage Division
U.S. Coast Guard: Stop 7509
2703 Martin Luther King Jr. Ave., SE
Washington, DC
4.Duplicate MMC - In the event of a lost credential, a statement describing the circumstances of the loss must be submitted with the application. The duplicate will have the same authority, wording and expiration date as the lost credential. If a person loses a credential by shipwreck or other casualty that causes damage to a ship, a duplicate will be issued free of charge as per 46 CFR 10.229. If a person loses a credential by other means and applies for a duplicate, the appropriate fee set out in 46 CFR 10.219 must be paid. No application from an alien for a duplicate credential will be accepted unless the alien complies with the requirements of 46 CFR 10.229.
5.MMC Endorsement(s) - This is a statement on a mariner's MMC that indicates that he or she is qualified to serve in that capacity. All endorsements including National officer and National rating endorsements as well as all STCW endorsements (International) are listed in 46 CFR 10.109.
NOTE: Requests for an endorsement(s) will not change the expiration date of a mariner's MMC unless the applicant also requests a renewal MMC and meets the renewal requirements of all endorsements on the MMC in accordance with 46 CFR 10.227.
(a)Raise of Grade (ROG) Endorsement - The requirements for a ROG are found in 46 CFR 10.231. This is an increase in the level of authority and responsibility associated with an existing officer or rating endorsement.
(b)Increase in Scope - The requirements for an Increase in Scope are found in 46 CFR 10.223. This is a modification or a removal of limitations or scope to existing MMC endorsement(s).
6.Document of Continuity - This is a record of qualifications previously held and does not authorize the holder to sail in any capacity listed thereon. Documents of continuity do not expire, do not require medical or security evaluations, and do not require fees. STCW endorsements may not be placed in continuity. No credential expired beyond the
7.Entry Level Ratings - There are no professional requirements needed when applying for entry level credential. Ratings may include Ordinary Seaman, Wiper, and/or Stewards Department / Stewards Department (Food Handler - F.H.). Per 46 CFR Part 10, applicants requesting Stewards Department (F.H.) will be required to submit a statement from a physician attesting that the applicant is free from communicable disease.
Section III: Safety and Suitability
III.1 Transportation Worker Identification Credential ( TWIC):
•A TWIC is required for applicants who need access to secure areas designated in a vessel's security plan and a facility's security plan by the Maritime Transportation Security Act.
•Unless specifically exempted, the Coast Guard must have evidence that you hold a valid TWIC or, for original applicants, that you have applied for a TWIC and are awaiting the results.
III.
In accordance with 46 CFR 10.211, the Coast Guard may review the criminal record of an applicant to determine meet safety and suitability of all applicants before any MMC and any endorsement is issued. At the time of application you must provide a written disclosure of all prior convictions NOT previously disclosed.
•Original Applicants are required to list ALL convictions.
•Written Disclosures - Applicants may use the optional form
•Conviction means that the applicant for a merchant mariner credential has been found guilty, by judgment or plea by a court of record of the United States, the District of Columbia, any State, territory, or possession of the United States, a foreign country, or a military court, of a criminal felony or misdemeanor or of an offense described in section 205 of the National Driver Register Act of 1982, as amended (49 U.S.C. 30304). If an applicant pleads guilty or no contest, is granted deferred adjudication, or is required by the court to attend classes, make contributions of time or money, receive treatment, submit to any manner of probation or supervision, or forgo appeal of a trial court's conviction, then the Coast Guard will consider the applicant to have received a conviction. A later expungement of the conviction will not negate a conviction unless the Coast Guard is satisfied that the expungement is based upon a showing that the court's earlier conviction was in error.
III.3 National Driver Registry (NDR):
•No MMC will be issued as an original or reissued with a new expiration date, and no new officer endorsement will be issued if the applicant fails the criminal record review in accordance with 46 CFR 10.213.
Section IV: Applicant Consent and Certification
IV.1 Mariner Outreach System: This is an optional program used by the Maritime Administration in the event of a national emergency. Applicant will need to select whether Yes, they would like to participate, or No, they do not wish to participate in the Mariner Outreach System, by selecting either of the check boxes.
IV.2 Continuity: Credentials issued for continuity purposes are not valid for use.
IV.3 Consent: Applicants under the age of 18 must attach a notarized statement of parental/guardian consent.
IV.4 Certification: Applicant certifies that the information provided is true and correct. Every person who applies for an original MMC must first take an oath. The applicant must sign and date the application stating they have taken the oath. Failure to sign will result in the application being returned. Per 46 CFR 10.225(c), an oath may by administered by any Coast Guard designated individual or any person legally permitted to administer oaths in the jurisdiction where the person taking the oath resides.
IV.5 Signature and Date: Failure to sign and date the application will result in the application being returned.
IV.6 Third Party Authorization (optional): If you want the NMC to be able to discuss, release, or receive information/documents regarding your credential application with a third party (spouse, employer, school, union, etc.) you must provide specific guidance to the NMC regarding what issues we may discuss and with whom. You may allow release of all information to certain individuals or entities. If you limit the release of certain information you must be specific by making a selection on the application or by attaching additional documentation. For each selection made, ensure the Name of the Organization or Third Party, Organization Point of Contact (if applicable), Address and Phone Number is completed. If you wish to provide multiple Third Party Releases, attach additional pages as needed. A sample may be found on the NMC website: http://www.uscg.mil/nmc/.
Page 2 of 5 |
File Specs
| Fact Name | Description |
|---|---|
| Purpose | The CG-719B form is used by individuals applying for a Merchant Mariner Credential (MMC) or a Medical Certificate. |
| Eligibility | All applicants, including those seeking original, renewal, duplicate, or endorsement MMCs, must submit this form. |
| Contact Information | Applicants must provide accurate contact details to avoid processing delays. This includes a primary phone number and email address. |
| Criminal Record Disclosure | Applicants must disclose any prior convictions. This is essential for determining safety and suitability for credential issuance. |
| Third Party Authorization | Applicants may authorize a third party to receive information regarding their application, which must be clearly specified in the form. |
| Consent Requirement | Individuals under 18 years of age must attach a notarized statement of consent from a parent or guardian. |
| Governing Law | The issuance of MMCs and the use of the CG-719B form are governed by federal regulations, specifically under Title 46 of the Code of Federal Regulations (CFR). |
Cg 719B - Usage Guidelines
Filling out the CG-719B form is an important step for those seeking a Merchant Mariner Credential. This form collects essential information about the applicant, including personal details, contact information, and the type of credential being requested. After completing the form, applicants will need to submit it along with any required documentation to the appropriate authority for processing.
- Gather Required Information: Before you start filling out the form, collect all necessary information, including your legal name, Social Security Number, date of birth, and contact details.
- Complete Section I - Applicant Information: Fill in your full legal name, Social Security Number (if applicable), date of birth, and place of birth. If you are not a U.S. citizen, indicate your country of nationality.
- Provide Address and Contact Information: Enter your home address, mailing address (if different), and your primary and alternate phone numbers. Include your email address for updates on your application status.
- Next of Kin/Emergency Contact: Provide the name, relationship, and contact information for your next of kin or emergency contact.
- Section II - Requested Merchant Mariner Credential: Specify the type of credential you are applying for, such as original, renewal, or duplicate. Describe any desired endorsements.
- Section III - Safety and Suitability: Answer questions regarding your TWIC status and disclose any criminal convictions or drug use. Ensure you provide complete and accurate information.
- Section IV - Consent and Certification: Sign and date the form, certifying that all information is true. If you are under 18, include a notarized consent statement from a parent or guardian.
- Optional Third Party Authorization: If you wish to allow a third party to discuss your application with the Coast Guard, complete this section with the necessary details.
- Review and Submit: Double-check all entries for accuracy. Once confirmed, submit the completed form along with any required documents to the appropriate Coast Guard office.
Your Questions, Answered
What is the purpose of the CG-719B form?
The CG-719B form is used to apply for a Merchant Mariner Credential (MMC) from the U.S. Coast Guard. This credential is essential for individuals who wish to work in various capacities on commercial vessels. The form covers applications for original credentials, renewals, duplicates, and endorsements, as well as requests for medical certificates.
Who needs to fill out the CG-719B form?
Anyone seeking a Merchant Mariner Credential must submit this form. This includes individuals applying for their first credential, those renewing an existing credential, or those who need a duplicate due to loss. Additionally, applicants requesting endorsements on their existing credentials must also complete this form.
What information is required in Section I of the form?
Section I requires personal information, including your legal name, Social Security Number (if applying for an original credential), date of birth, citizenship status, and place of birth. You will also need to provide your home address, contact information, and details about your next of kin or emergency contact. This information is crucial for the Coast Guard to process your application efficiently.
What types of Merchant Mariner Credentials can I apply for using this form?
The CG-719B form allows you to apply for several types of credentials, including an original MMC, renewal MMC, duplicate MMC, and various endorsements. Endorsements indicate your qualifications for specific roles, such as officer or rating positions. You can also request a Certificate of Registry or a Document of Continuity.
What are the requirements for renewing my Merchant Mariner Credential?
To renew your MMC, you can do so at any time during its validity and for up to one year after it expires. You must meet the qualifications for all Domestic/STCW Officer and Rating endorsements to receive a new MMC with a five-year expiration date. The form also allows you to waive the post-dating feature, enabling immediate issuance of your renewed credential.
How does the criminal record review process work?
As part of the application process, the Coast Guard will review your criminal history to ensure you meet safety and suitability standards. You must disclose any prior convictions, and original applicants are required to list all convictions. This includes any court findings, even if they are minor traffic violations. Failure to disclose this information may result in delays or denial of your application.
What is the Transportation Worker Identification Credential (TWIC) requirement?
If you need access to secure areas of a vessel or facility, you must possess a valid TWIC. If you are applying for an original MMC, you must either hold a valid TWIC or have applied for one and be awaiting results. The Coast Guard may require proof of your TWIC status to process your application.
What happens if I need to authorize a third party to discuss my application?
If you wish to allow a third party, such as a family member or employer, to discuss your application with the Coast Guard, you can provide specific authorization on the form. This includes detailing what information they may access and ensuring that their contact details are included. This option can help streamline communication regarding your application status.
Common mistakes
-
Incomplete Personal Information: Failing to provide your complete legal name, including any aliases or maiden names, can lead to application delays or rejections.
-
Incorrect Social Security Number: Entering the wrong Social Security Number, especially for original applications, can cause significant issues. Always double-check this information.
-
Missing Reference Number: If you have been credentialed before, not including your reference number can result in processing delays. Ensure this is filled out if applicable.
-
Improper Address Format: Using a P.O. Box for your home address is not acceptable. Make sure to provide a valid residential address to avoid complications.
-
Neglecting Emergency Contact Information: Failing to include or update your next of kin or emergency contact can hinder communication in urgent situations.
-
Omitting Criminal History: Not disclosing all prior convictions can lead to severe consequences. Be thorough and honest about your history.
-
Missing Signature: Forgetting to sign and date your application will result in immediate rejection. Always double-check for your signature before submission.
-
Ignoring TWIC Requirements: If you need a Transportation Worker Identification Credential, not indicating this on your application can delay processing. Be aware of these requirements.
-
Not Following Up: After submitting your application, failing to check on its status can lead to missed updates or additional requirements. Stay proactive in your follow-up.
Documents used along the form
The CG-719B form is essential for individuals seeking a Merchant Mariner Credential (MMC) in the United States. However, it is not the only document that applicants may need to submit. Below is a list of other forms and documents that are often used in conjunction with the CG-719B. Each of these plays a critical role in the application process.
- CG-719C - This optional form is used for disclosing any criminal convictions that an applicant may have. It is particularly important for original applicants, as they must provide a complete history of their criminal record, if any.
- Medical Certificate - Applicants may need to submit a medical certificate to demonstrate that they meet the health requirements necessary to operate a vessel safely. This certificate is crucial for ensuring the safety of both the mariner and those on board.
- TWIC (Transportation Worker Identification Credential) - This credential is required for individuals needing access to secure areas on vessels and at maritime facilities. Applicants must either hold a valid TWIC or provide proof of application for one.
- Proof of Sea Service - Documentation showing the applicant's sea service is often required. This may include letters from employers or other records that verify the time spent working on a vessel.
- Form I-551 (Permanent Resident Card) - If the applicant is not a U.S. citizen, they may need to provide this form to verify their legal residency status in the United States.
- Third Party Authorization - If an applicant wishes to allow someone else (like a spouse or employer) to discuss their application with the National Maritime Center, they must complete this optional form.
- Entry Level Ratings Documentation - For those applying for entry-level positions, documentation showing that they meet the basic requirements for those roles may be necessary.
- Criminal Record Review Consent - This consent form allows the Coast Guard to review the applicant's driving record and criminal history as part of the safety and suitability assessment.
- Oath of Office - All applicants must take an oath affirming the truthfulness of their application and their commitment to fulfilling their duties as a mariner.
Understanding these additional forms and documents is crucial for a smooth application process. Each serves a specific purpose and helps ensure that all applicants meet the necessary standards for maritime safety and professionalism.
Similar forms
The CG-719B form is closely related to the CG-719C form, which is used for disclosing criminal history and drug use. Like the CG-719B, the CG-719C requires applicants to provide detailed information regarding any past convictions or drug use within a specific time frame. This form serves as a supplementary document, ensuring that the Coast Guard has a comprehensive understanding of an applicant's background, which is crucial for determining their suitability for a Merchant Mariner Credential. Both forms emphasize the importance of honesty and transparency in the application process, as any discrepancies could lead to serious consequences.
Another document similar to the CG-719B is the TWIC application, or Transportation Worker Identification Credential application. This form is essential for individuals who need access to secure areas of vessels and facilities. Just like the CG-719B, the TWIC application requires personal information, including social security numbers and citizenship status. Both documents aim to enhance security in the maritime industry by ensuring that only qualified individuals are granted access to sensitive areas. The TWIC application also necessitates a background check, similar to the criminal record review in the CG-719B, to assess the applicant's safety and suitability.
The Form CG-719K, or the Medical Certificate, is another document that parallels the CG-719B. This form is vital for mariners as it assesses their medical fitness to perform duties at sea. Like the CG-719B, the CG-719K includes sections for personal information and requires the applicant to disclose any medical conditions that may affect their ability to work. Both forms are integral to the credentialing process, ensuring that mariners meet the necessary health standards to safely operate vessels. The focus on health and safety in both documents reflects the Coast Guard's commitment to maintaining a secure maritime environment.
Lastly, the Document of Continuity serves as a related document to the CG-719B. This form is issued to individuals who have previously held credentials but do not currently possess an active Merchant Mariner Credential. While the CG-719B is used for applying for or renewing credentials, the Document of Continuity provides a record of qualifications previously held. Both documents play a role in the credentialing process, but the Document of Continuity does not require the same level of medical evaluation or background checks. This distinction highlights the different purposes each document serves within the broader context of maritime credentialing.
Dos and Don'ts
When filling out the CG-719B form, it’s essential to follow certain guidelines to ensure your application is processed smoothly. Here’s a list of things to do and avoid:
- Do enter your complete legal name, including any aliases or maiden names.
- Do provide your Social Security Number if you are applying for an original credential.
- Do include your home address, ensuring it is not a PO Box.
- Do list all required contact information, including phone numbers and email addresses.
- Do disclose any criminal convictions, even if they seem minor.
- Don't leave any sections blank; incomplete applications may be returned.
- Don't forget to sign and date the application; failing to do so will delay processing.
- Don't use a PO Box for your home address; it is not acceptable.
- Don't submit the application without a notarized statement if you are under 18.
- Don't forget to include any required supporting documents for endorsements or renewals.
Misconceptions
- Misconception 1: The CG-719B form is only for new applicants.
- Misconception 2: Submitting the CG-719B form guarantees the issuance of a credential.
- Misconception 3: The CG-719B form does not require personal information.
- Misconception 4: Once submitted, applicants will receive updates about their application status automatically.
This form is not limited to new applicants. It is required for various purposes, including renewals, duplicates, and endorsements for those who already hold a Merchant Mariner Credential (MMC). Anyone seeking to modify their credential must complete this form.
Submitting the form does not guarantee approval. The Coast Guard will review the application to ensure all requirements are met. Incomplete applications may be refused processing, leading to delays.
The form requires detailed personal information, including legal name, Social Security Number, date of birth, and contact information. This information is necessary for the Coast Guard to verify identity and eligibility.
While the Coast Guard may attempt to contact applicants via email for updates, it is crucial for applicants to provide accurate contact information. Without a valid email or phone number, applicants may miss important communications regarding their application status.
Key takeaways
Key Takeaways for Filling Out and Using the CG-719B Form
- Ensure that all personal information is complete and accurate. This includes your legal name, Social Security Number, and contact details. Incomplete applications may be delayed or rejected.
- Understand the type of Merchant Mariner Credential (MMC) you are applying for. Whether it’s an original, renewal, or duplicate, each type has specific requirements and documentation that must be included.
- Be aware of the safety and suitability requirements. Applicants must disclose any criminal convictions and provide a Transportation Worker Identification Credential (TWIC) if necessary. Failing to do so can result in denial of the application.
- Sign and date the application. Your signature certifies that the information is true and correct. Applications lacking a signature will be returned, causing further delays in processing.