Form number:

MSHA Form 5000-23

Form name:

Certificate of Training

Description:

The Certificate of Training Form 5000-23 provides a means for mine operators to record and certify mandatory training received by miners and MSHA with a monitoring tool for determining compliance requirements. This is a mandatory collection of information as required by 30 CFR Part 48.9 and 48.29.

OMB Control Number and Expiration Date:

1219-0009; 12/31/2010

Filing Options:

Form 5000-23 may be completed while on your PC screen, printed (or printed and filled in manually) and sent to MSHA according to the instructions provided below. This is not the same as on-line filing.

Fill in and print

Filing Instructions:

Detailed Instructions for completing Form 5000-23, Certificate of Training Form

Contact Information:

Questions regarding this form should be directed to MSHA at (877) 778-6055 or MSHAhelpdesk@dol.gov

Privacy Notice:

Privacy Notice

Legal Authority:

30 CFR 48.9 and 48.29.

Burden Statement:

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the collection of information, including suggestions for reducing this burden, to the Mine Safety and Health Administration, U.S. Department of Labor, Records Management Branch, 1100 Wilson Boulevard, Arlington, Virginia 22209-3939.