Forms and Online Filings
Form number: |
None |
Form name: |
MSHA Notification of Representative of Miners |
Description: |
A written declaration of an individual or union as the
representative of miners for a given operator. |
OMB Control Number and Expiration Date: |
1219-0042; 10/31/2004 |
Filing Options: |
MSHA Notification of Representative of Miners can be filed
online.
File
online
This notification may also be filed by submitting a printed
letter to your local MSHA District Office.
District
office contact information for coal mines
District
office contact information for metal/nonmetal mines
|
Contact Information: |
Questions regarding this form should be directed to MSHA at (877) 778-6055 or
zzMSHA-PEIRHelpDesk@dol.gov |
Privacy Notice: |
Privacy Notice |
Legal Authority: |
30 CFR Part
40.3 |
Burden Statement: |
Public reporting burden for this collection of information is
estimated to average 45 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. This
is a voluntary collection of information (30 CFR Section 40.3). This
information is used to identify a person or organization designated as a
representative of miners for all purposes provided for in the Mine Act. Send
comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden, to the Office
of Information Management, Department of Labor, Room N-1301, 200 Constitution
Avenue, N.W., Washington, D.C. 20210; and to the Office of Management and Budget,
Paperwork Reduction Project (1219-0042), Washington, D.C. 20503. Persons are not
required to respond to this collection of information unless it displays a
currently valid OMB control number. |
Complete and File Form Online
Return to MSHA Online Forms Advisor Main Menu
|