Form MSHA Form 5000-1 MSHA Form 5000-1 Certificate of Electrical Training

Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program

5000-1

Certificate of Electrical Training (State Grantees)

OMB: 1219-0001

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1219-0001 can be found here:

2022-11-23 - Extension without change of a currently approved collection

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File Type	application/pdf
File Title	MSHA - Forms - 5000-1 Certificate of Electrical Training
Author	DOL - Mine Safety and Health Administration
File Modified	2017-03-29
File Created	2015-08-28