Information Collection

Mine Rescue Teams

IC 181977 under ICR 201003-1219-001 · OMB 1219-0144.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0144 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MSHA 2000-224 Mine Rescue Teams	Form
MSHA 2000-224 Operator's Annual Certification of Mine Rescue Team Qual 2000-224 MRT-CertificationForm .pdf www.msha.gov/forms/forms.asp	Form
5000-3 Certificate of Physical Qualification for Mine Rescue Wo FORM 5000-3.pdf www.msha.gov/forms/forms.asp	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Mine Rescue Teams

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 49.50 30 CFR 75.1713-1 (a),(b), and (e) 30 CFR 77.1702 (a),(b), and (e) 30 CFR 49.12 30 CFR 49.13 30 CFR 49.16 30 CFR 49.17 30 CFR 49.18 30 CFR 49.19

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MSHA 2000-224	Operator's Annual Certification of Mine Rescue Team Qualifications	2000-224 MRT-CertificationForm .pdf	http://www.msha.gov/forms/forms.asp	Yes	No	Printable Only
Form	5000-3	Certificate of Physical Qualification for Mine Rescue Work	FORM 5000-3.pdf	http://www.msha.gov/forms/forms.asp	Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 583

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	24,767	22,565	2,202
Annual IC Time Burden (Hours)	5,181	3,631	1,550
Annual IC Cost Burden (Dollars)	863,397	862,744	653

Documents for IC

table that charts IC Documents
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.