|
Item |
Form # |
ANSC |
Form Title |
Filled out by: |
Sent to: |
Sent to: |
Send/Copy to: |
Notes: |
| PERSONNEL SECURITY |
| 4 |
FD-258 |
|
Finger Print Card (2 copies) |
Member & Fingerprint Tech or local Law Enforcement
(must be filled-out in Black Ink) |
New Member then FC for enclosure in Membership Packet |
DIRAUX |
|
See current required
for on
personnel_security.htm OS or DO sent to Unit PSI Coord or JR Addington then DIRAUX with PSI packet). Form held by JR
or Fingerprint Tech. |
| 5 |
OFI Form 86C |
|
Special Agreement Check (SAC) (1 copy) |
New Member or Ops Support (OS) Member |
See note |
DIRAUX |
|
See current required
for on the D13 Aux website,
security page. New Member: Part of the
new Member packet
OS Member: send to PSI Coord or JR then DIRAUX |
| 6 |
SF-85 |
|
Authorization for Release of Official Information (1 copy) |
Member/New Member |
Unit PSI Coord or JR |
DIRAUX |
|
See current required
for on the D13 Aux website,
security page, included with the OFI Form 86C PSI packet |
| 7 |
SF-86 |
|
Questionnaire for National Security Positions (2 copies) |
DO
Members or OS Members who wish to change to DO |
Unit PSI Coord or JR |
DIRAUX |
|
See current required
for on the D13 Aux website,
security page, included in the DO PSI packet |
| 8 |
SF-86 |
|
Authorization for Release of Information and/or Medical Information |
Member |
Unit PSI Coord or JR |
DIRAUX |
|
See current required
for on the D13 Aux website,
security page, included in the SF 86 PSI packet |
| 9 |
DHS Form 110000-9 |
|
Disclosure and Authorization Pertaining to Consumer Reports Pursuant to
the Fair Credit Reporting Act (1 copy) |
Member |
Unit PSI Coord or JR |
DIRAUX |
|
See current required
for on the D13 Aux website,
security page, included in the SF 86 PSI packet. Sign, but do not
date form. |
| 10 |
|
|
USCG Auxiliary / SECCEN – Verification of U.S. Citizenship (optional) with
a Photocopy a an acceptable verification document |
New Member (new Member packet); OS or DO Member |
Unit PSI Coord or JR |
DIRAUX |
|
See current required for
on the D13 Aux website,
security page, include with PSI packet |
| 11 |
|
|
DO
SF-86 & OS/new Member Check List (dated: 16 Apr 2005) |
New Member/Member |
Unit PSI Coord or JR |
DIRAUX |
|
See current required
for on the D13 Aux website,
security page, include with PSI packet |
|
Item |
Form # |
ANSC |
Form Title |
Filled out by: |
Sent to: |
Sent to: |
Send/Copy to: |
Notes: |
| ADMINISTRATION |
| 12 |
CG-1650 |
7002 |
Coast Guard Award Recommendation |
See Auxiliary Manual & confer with Awards Team |
VCO |
DIRAUX |
|
See the Pub/Forms page on the D13 Aux website –
national_forms.htm |
| 13 |
|
7006 |
Change of Officer Report |
FC
or DCP |
SO-IS |
|
|
Entered In AUXDATA |
| 14 |
|
7007 |
Annual Unit Officer’s Report |
FC
or DCP |
SO-IS |
|
|
Entered In AUXDATA |
| 15 |
|
7014 |
Instructor Qualification Record |
Instructor & Exam proctor |
FC |
DSO-MT |
DIRAUX |
IT Qual. Award |
| 16 |
|
7028 |
Change of Member Information |
Member |
FSO-IS |
SO-IS |
|
Entered in AUXDATA |
| 17 |
|
7035 |
Change of Member Status |
FC |
Member |
DSO-PS |
DIRAUX |
Copy back to FC/DCP |
| 18 |
|
7056 |
Member Transfer Request within District |
Member |
FC |
DIRAUX |
Copy Both FC’s |
Transfer effective when
Approved & accepted |
| 19 |
|
7056 |
Member Transfer Request Outside District |
Member |
FC |
DIRAUX |
Jacket to New District |
|
| 20 |
|
7057 |
Member Qualification Changes |
DIRAUX Use only |
|
|
|
|
| 21 |
CG-5223 |
7059 |
Short Term Training Request (STTR), Resident C-School
|
Member |
FC |
DIRAUX |
|
See C-School Portal website
http://cschool.auxservices.org/ |
| 22 |
|
7062 |
National Staff Application |
Member |
DVC-PS or designee |
|
|
See the Pub/Forms page on the D13 Aux website –
national_forms.htm. Send Completed resume |
|
Item |
Form # |
ANSC |
Form Title |
Filled out by: |
Sent to: |
Sent to: |
Send/Copy to: |
Notes: |
| TRAINING AND
CERTIFICATIONS |
| 23 |
|
7022 |
AIM Candidate Travel Worksheet |
DSO-CC |
DIRAUX |
Academy |
Form Distribution |
Refer to the Career Counseling
Guide |
| 24 |
|
7023 |
Notice of Intent to Teach PE Class |
FSO-PE |
DSO-CS for web posting |
|
Electronic Copy is sent to BOAT US |
See the Pub/Forms page on the D13 Aux website –
national_forms.htm#7023 |
| 25 |
|
7039 |
Workshop Attendance Report |
Workshop Instructor |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 26 |
|
7049 |
AIM Application
(this is now an online form) |
Applicant/Parents |
Electronically to Academy |
DSO-CC |
|
Refer to the Career Counseling
Guide |
| 27 |
|
|
D13 Annual Boat Crew Currency Maintenance |
Member & signed by the Coxswain (Annual) or QE (5yr) |
Original: SO-IS
Copy:
FSO-IS & Member records |
DIRAUX |
|
Available from the D13 Aux Website
D13 Forms |
| 28 |
|
|
D13 Annual PWC Currency Maintenance |
Member & signed by the Qual PWC Op (Annual) or QE (5yr) |
Original: SO-IS
Copy:
FSO-IS & Member records |
DIRAUX |
|
Available from the D13 Aux Website
D13 Forms |
|
Item |
Form # |
ANSC |
Form Title |
Filled out by: |
Sent to: |
Sent to: |
Send/Copy to: |
Notes: |
| OPERATIONS AND
ACTIVITIES |
| 29 |
Aux 204 |
|
Vessel Safety Check |
Qualified VE |
FSO-IS or kept by the VE |
|
|
Copy to Boat Owner |
| 30 |
Aux 204A |
|
PWC Vessel Safety Check |
Qualified VE |
FSO-IS or kept by the VE |
|
|
Copy to PWC Owner |
| 31 |
|
7003 |
Vessel Facility Inspection Offer of Use |
Vessel Owner & Facility Inspector |
DIRAUX |
|
|
Only one copy (the original) |
| 32 |
CG-2736A |
7004 |
Radio Facility Inspection Form |
AUXCOM Member |
DSO-CM |
DIRAUX |
|
|
| 33 |
CG-2736-C |
7008 |
PWC Facility Inspection Offer of Use |
Owner & Inspector |
DIRAUX |
|
|
|
| 34 |
|
7029 |
Member Activity Report |
Member |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 35 |
|
7030 |
Activity Report-Mission |
Member |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 36 |
CG-4612 |
7034 |
Aux. SAR Incident Report |
Coxswain |
Order Issuing Authority |
|
|
|
| 37 |
NOAA-77-5 |
7037 |
NOS Chart Updating Program |
AV Verifier Member |
NOAA |
Distribution |
CG Group |
|
| 38 |
|
7038 |
VSC - Activity Report |
Member |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 39 |
CG-5232 |
7045 |
VSC Action Information |
VE |
DSO-VE |
|
|
|
| 40 |
|
7046 |
RBS Visitation Report |
Member |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 41 |
CG-5093 |
7047 |
Manufacturer ID Code Mail System |
Qualified RBS Member |
DSO-RBS |
G-OPB-3 |
|
Refer to the RBS Staff Guide |
| 42 |
CG-5132 |
|
CG
AUX Patrol Order (POMS)
(Processed online only) |
Check with your Order Issuing Authority |
Coxswain |
Order Issuing Authority |
|
Computer Generated by POMS |
| 43 |
NOAA Charts |
|
Request for Charts |
FSO-AN |
DSO-AN |
BC-ONC |
|
|
| 44 |
|
|
Certificate In Lieu of Receipt |
Coxswain |
Order Issuing Authority |
|
|
Available from:
http://www.uscg.mil/d13/diraux or
national_forms.htm |
| 45 |
|
|
Request for Voluntary Removal of
Certification |
Member |
D13 DIRAUX (dpa) |
|
|
Used by a member to voluntarily remove
their operational
certifications. |
|
Item |
Form # |
ANSC |
Form Title |
Filled out by: |
Sent to: |
Sent to: |
Send/Copy to: |
Notes: |
| Recreational Boating
Safety |
| 53 |
|
7046 |
RBS Visitation Report |
Member |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 54 |
Aux 204 |
|
Vessel Safety Check |
Qualified VE |
FSO-IS or kept by the VE |
|
|
Copy to Boat Owner |
| 55 |
Aux 204A |
|
PWC Vessel Safety Check |
Qualified VE |
FSO-IS or kept by the VE |
|
|
Copy to PWC Owner |
| 56 |
|
7038 |
VSC - Activity Report |
Member |
FSO-IS |
SO-IS |
|
Entered In AUXDATA |
| 57 |
CG-5232 |
7045 |
VSC Action Information |
VE |
DSO-VE |
|
|
|
| 58 |
|
7023 |
Notice of Intent to Teach PE Class |
FSO-PE |
DSO-CS for web posting |
|
Electronic Copy is sent to BOAT US and State Reps. |
See the Pub/Forms page on the D13 Aux website –
national_forms.htm#7023 |
| 58 |
|
|
Notice of Intent to Teach PE Class
(D13 Online version) |
FSO-PE |
DSO-CS for web posting |
|
Electronic Copy is sent to BOAT US and State Reps |
See the Pub/Forms page on the D13 Aux website –
national_forms.htm#7023 |
| 59 |
|
|
Request for Instructor
Certification |
Member |
Qualified IT/elected
officer |
DSO-PE |
D13 DIRAUX (dpa) |
|
| 60 |
|
|
Request for RBS Visitor Program
Certification |
Member |
Qualified RBS Program Visitor/elected
officer |
DSO-PV |
D13 DIRAUX (dpa) |
|
| 61 |
|
|
Request for Vessel
Examiner Certification |
Member |
Qualified VE/elected
officers |
DSO-VE |
D13 DIRAUX (dpa) |
|