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OMB No. 2115-0017 DEPARTMENT OF HOMELAND SECURITY U.S. COAST GUARD CG-4423 Rev. 3-03 DA TE S UB MITTE D APPLICATION FOR APPROVAL OF MARINE EVENT 13. HAVE ANY OBJECTIONS BEEN RECEIVED FROM OTHER INTERESTED PARTIES INSTRUCTIONS NO 1. Submit this form in Triplicate. Please complete on a typewriter or print in black ink to permit reproduction. 2. This application must reach the District Office at least 30 days prior to the event. 3. Attach a section of a chart or a scale drawing showing boundaries and/or courses and markers contemplated* 4. Submit a copy of your entry requirements and any special rules pertaining to equipment rigs or procedures. 1. NAME OF EVENT 2. DATE OF EVENT 3. LOCATION YES Explain 14. VESSELS PROVIDED BY SPONSORING ORGANIZATION FOR SAFETY PURPOSES number and description 15. DOES THE SPONSORING ORGANIZATION DEEM THEIR PATROL ADEQUATE FOR SAFETY PURPOSES 4. TIME from to YES NO Explain 5. NAME AND ADDRESS OF SPONSORING ORGANIZATION Include Zip Code 16. IS A COAST GUARD OR COAST GUARD AUXILIARY PATROL REQUESTED FOR CONTROL OF SPECTATOR AND/OR COMMERCIAL TRAFFIC If YES how many vessels do you recommend and why 6. NO. PARTICIPANTS 17. PERSON IN CHARGE 7. SIZES OF BOATS 8. TYPES OF BOATS 9. NO. SPECTATOR CRAFT 18. WHERE WILL PERSON IN CHARGE BE DURING THE EVENT 19. HOW CAN PERSON IN CHARGE BE CONTACTED DURING THE EVENT 20. PERSON TO BE CONTACTED FOR FURTHER DETAILS Name address Zip code 10. DESCRIPTION OF EVENT AREA CODE AND TELEPHONE NO. The undersigned has full authority to represent the sponsoring organization 21. SIGNATURE 11. WILL THIS EVENT INTERFERE OR IMPEDE THE NATURAL FLOW OF TRAFFIC 22. TITLE 23. ADDRESS Include Zip code 12. WHAT EXTRA OR UNUSUAL HAZARD to participants or non-participants WILL BE INTRODUCED INTO THE REGATTA AREA PREVIOUS EDITIONS ARE OBSOLETE TO The Coast Guard estimates that the average burden for this report form is 25 minutes. You may submit any comments concerning the accuracy of this burden estimate or any suggestions for reducing the burden to Commandant G-NAB U*S* Coast Guard Washington DC 20593-0001 or Office of Management and Budget Paperwork Reduction Project 2115-0017 Washington D*C* 20503. HAVE ANY OBJECTIONS BEEN RECEIVED FROM OTHER INTERESTED PARTIES INSTRUCTIONS NO 1. Submit this form in Triplicate. Please complete on a typewriter or print in black ink to permit reproduction. 2. This application must reach the District Office at least 30 days prior to the event. Please complete on a typewriter or print in black ink to permit reproduction. 2. This application must reach the District Office at least 30 days prior to the event. 3. Attach a section of a chart or a scale drawing showing boundaries and/or courses and markers contemplated* 4. 3. Attach a section of a chart or a scale drawing showing boundaries and/or courses and markers contemplated* 4. Submit a copy of your entry requirements and any special rules pertaining to equipment rigs or procedures. Submit a copy of your entry requirements and any special rules pertaining to equipment rigs or procedures. 1. NAME OF EVENT 2. DATE OF EVENT 3. LOCATION YES Explain 14. VESSELS PROVIDED BY SPONSORING ORGANIZATION FOR SAFETY PURPOSES number and description 15.

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