Get Dhs Cg-5100 2019-2026

The DHS CG-5100 is an essential declaration of health form required by the U.S. Coast Guard for ships entering foreign ports. This guide will provide you with clear, step-by-step instructions to help you complete this form accurately and efficiently.

Follow the steps to complete the DHS CG-5100 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the port name where the ship is docking. Ensure that the name reflects the exact port destination.
3. Fill in the date in the format MMDDYYYY, representing the date of submission.
4. Input the ship name carefully, as it should match the name registered with the shipping authority.
5. Enter the hull number, which is a unique identifier for the vessel.
6. Specify the gross tonnage of the ship, which indicates its size and volume.
7. Indicate the name of the captain, ensuring correct spelling and details.
8. Enter the nationality of the captain.
9. Answer whether a valid sanitation control exemption or control certificate is on board by selecting 'Yes' or 'No'.
10. If you selected 'Yes', provide the details of the certificate and where it was issued.
11. Indicate whether the ship has visited an affected area as per the World Health Organization by answering 'Yes' or 'No'.
12. If 'Yes', specify the port name from where the ship is arriving.
13. Provide the date of issuance of the health declaration in the format MMDDYYYY.
14. Answer whether a re-inspection is required by selecting 'Yes' or 'No'.
15. If 'Yes', indicate the date of visit in the format MMDDYYYY.
16. List all ports of call from the commencement of the voyage, including departure dates.
17. Enter the total number of crew members currently on board.
18. Indicate the number of persons on board who are not part of the crew.
19. Respond to the health questions honestly, selecting 'Yes' or 'No' for each question. If applicable, provide particulars in the attached schedule.
20. Complete the declaration statement confirming the accuracy of the information provided.
21. The captain should sign the form and date it in the provided sections. If applicable, a senior medical department representative should also sign and date their section.
22. Finally, you can save changes, download, print, or share the filled-out form as required.

Complete your DHS CG-5100 online today to ensure timely processing.