Training Plan Regulations and Certificate of Training

MSHA - Forms and Online Filings - Form 5000-23 - Certificate of Training

UNITED STATES
DEPARTMENT OF LABOR

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Form number:

MSHA Form 5000-23

Form name:

Certificate of Training

Description:

This is a mandatory collection of information as required by 30
CFR Part 48.9 and 48.29. The Certificate of Training Form 500023 provides a means for mine operators to record and certify
Part 48 mandatory training received by miners. The training
certificates for each miner shall be available at the operator
minesite for inspection by MSHA and for examination by the
miners, the miner's representative, and State inspection
agencies. At the completion of training, the instructor MUST give
the miner a copy of the training certificate. When a miner leaves
the operator's employ, the miner shall be entitled to a copy of
his training certificates.

OMB Control Number
and
Expiration Date:

1219-0009; 7/31/2014

Options/Instructions
for
Completing the Form:

Please read all instructions here before using the link (below) to
obtain the detailed instructions.
Form 5000-23 may be completed while on your PC screen and
printed (or printed and filled in manually). MSHA does not
receive or maintain copies of the 5000-23. DO NOT FILE
THIS FORM WITH MSHA.
Form fill, print and mail or fax
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, Office of Standards,
Regulations and Variances, 1100 Wilson Boulevard, Arlington,
Virginia 22209-3939.

http://www.msha.gov/forms/elawsforms/5000-23.htm[2/6/2014 11:45:59 AM]

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http://www.msha.gov/forms/elawsforms/5000-23.htm[2/6/2014 11:45:59 AM]