Qualification/Certification Program Request for MSHA 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⚠️ Notice: This information collection may be referencing outdated material.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) Form and Instruction
5000-46 Request for MSHA Individual Identification Number (MIIN) 1219-0NEW Form and Instr.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

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

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)	1219-0NEW Form and Instr.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 25 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	3,332	3,332
Annual IC Cost Burden (Dollars)	11,439	11,439

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.