Certificate of Electrical Training (30 CFR 75.153(a)(2) and 77.103(a)(2)

ICR 200102-1219-001

OMB: 1219-0001

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1219-0001 200102-1219-001
Historical Active 199712-1219-003
DOL/MSHA
Certificate of Electrical Training (30 CFR 75.153(a)(2) and 77.103(a)(2)
Extension without change of a currently approved collection   No
Regular
Approved without change 04/17/2001
Retrieve Notice of Action (NOA) 02/01/2001
Approved consistent with change described in DOL memo of 4-12-01.
  Inventory as of this Action Requested Previously Approved
05/31/2004 05/31/2004 04/30/2001
2,886 0 3,800
13,297 0 16,584
410,000 0 389,000

MSHA Form 5000-1 is used by instructors to report to MSHA for certification, those persons who have satisfactorily completed either a coal mine electrical training program.

None
None


No

1
IC Title Form No. Form Name
Certificate of Electrical Training (30 CFR 75.153(a)(2) and 77.103(a)(2) MSHA-5000-1

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,886 3,800 0 0 -914 0
Annual Time Burden (Hours) 13,297 16,584 0 0 -3,287 0
Annual Cost Burden (Dollars) 410,000 389,000 0 0 21,000 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/01/2001


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