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APPLICATION FOR MERCHANT MARINER CREDENTIAL …

CG-719B (01/14)Page 1 of 6 DEPARTMENT OF HOMELAND SECURITY OMB No. 1625-0040 Coast Guard Exp. Date: 01/31/2016 APPLICATION FOR MERCHANT MARINER CREDENTIAL (MMC)------ Instructions ------Who must submit this form?Applicants seeking a MERCHANT MARINER CREDENTIAL (MMC), whether original, renewal, duplicate, raise of grade, or a new endorsement on a previously issued I: Personal Legal name - Enter complete legal name . Include any aliases you have used and your maiden or prior name (s). Social Security number - If you are applying for an original CREDENTIAL , enter your SSN. Reference number - If you have been credentialed by the Coast Guard in the past, enter your reference number .

Legal Name - Enter complete legal name. Include any aliases you have used and your maiden or prior name(s). I.2a . Social Security Number - If you are applying for an original credential, enter your SSN. I.2b . Reference Number - If you have been credentialed by the Coast Guard in the past, enter your reference number. I.2c . Alien Registration ...

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