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U.S. DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARD CG-950 Rev. 01-07 APPLICATION FOR PERMIT TO CARRY EXCURSION PARTY FORM APPROVED OMB NO 1625-0057 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 report is 5 mins. You may submit any comments concerning the accuracy of this burden estimate or any suggestion reducing the burden to Commandant CG-3PCV U*S* Coast Guard Washington DC 20593-0001 or Office of Management and Budget Paperwork Reduction Project 1625-0002 Washington DC 20503. This application may be used as a substitute for a written application from the owner or managing operator of the vessel for which the permit is requested* Name of Vessel Official or Award No* Home Port Gross tons Requested No* of Passengers Requested Dates Excursion Permit is Valid Requested Route and Special Conditions Person Submitting Application Title Signature Date Contact number or e-mail address Upon submission of this form to the cognizant OCMI a marine inspector will evaluate information contained on this form* If after inspection permission is granted it is given on Coast Guard form CG-949 Permit To Carry Excursion Party. The Coast Guard estimates that the average burden for this report is 5 mins. You may submit any comments concerning the accuracy of this burden estimate or any suggestion reducing the burden to Commandant CG-3PCV U*S* Coast Guard Washington DC 20593-0001 or Office of Management and Budget Paperwork Reduction Project 1625-0002 Washington DC 20503. This application may be used as a substitute for a written application from the owner or managing operator of the vessel for which the permit is requested* Name of Vessel Official or Award No* Home Port Gross tons Requested No* of Passengers Requested Dates Excursion Permit is Valid Requested Route and Special Conditions Person Submitting Application Title Signature Date Contact number or e-mail address Upon submission of this form to the cognizant OCMI a marine inspector will evaluate information contained on this form* If after inspection permission is granted it is given on Coast Guard form CG-949 Permit To Carry Excursion Party..

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