Captain's Application Process Disclosure Statement for Convictions: Form CG-719C

You can download and print Form CG-719C here

 

What is the CG-719C form? 

Form CG-719C is used to disclose convictions from the applicant's history. Be truthful on these forms and do not attempt to hide anything as the Coast Guard will find out. 

 

Here is a quick video on court convictions. 

 

Do I need to submit this form if I have no history of convictions?  

If you have no history of convictions, you will not need to submit form CG-719C to the Coast Guard.