Qualification/ Certification Program Request for MSHA Individual Identification Number (MIIN)-Individuals

Qualification/Certification Program Request for Mine Safety and Health Administration Individual Identification Number (MIIN)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0143 can be found here:

Documents and Forms

Document Name Document Type
Form 5000-46 Qualification/ Certification Program Request for MSHA Individual Identification Number (MIIN)-Individuals Form and Instruction
5000-46 Web Instruc. for Completing MSHAs MIIN (Feb. 11) OMB.pdf lakegovprod3.msha.gov/MIIN/MIIN.aspx Instruction
5000-46 web p2 MSHA -.pdf lakegovprod3.msha.gov/MIIN/MIIN.aspx Instruction
5000-46 web p3 MSHA -.pdf lakegovprod3.msha.gov/MIIN/MIIN.aspx Instruction
5000-46 Request for MSHA Individual Identification Number (MIIN) 5000-46 MIIN Miner Individual Identification No. (OMB).pdf www.msha.gov/forms/5000-46.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Qualification/ Certification Program Request for MSHA Individual Identification Number (MIIN)-Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 75 30 CFR 77 30 CFR 48 30 CFR 90 30 CFR 70 30 CFR 71

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5000-46	Request for MSHA Individual Identification Number (MIIN)	5000-46 MIIN Miner Individual Identification No. (OMB).pdf	http://www.msha.gov/forms/5000-46.pdf	Yes	Yes	Fillable Printable
Instruction			5000-46 Web Instruc. for Completing MSHAs MIIN (Feb. 11) OMB.pdf	https://lakegovprod3.msha.gov/MIIN/MIIN.aspx	Yes	Yes	Fillable Fileable
Instruction			5000-46 web p2 MSHA -.pdf	https://lakegovprod3.msha.gov/MIIN/MIIN.aspx	Yes	Yes	Fillable Fileable
Instruction			5000-46 web p3 MSHA -.pdf	https://lakegovprod3.msha.gov/MIIN/MIIN.aspx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: DOL/MSHA–13 & -15	FR Citation: 67 FR 16816

Number of Respondents: 4,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	14,707	14,707

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.