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Mine Safety and Health
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MSHA - Protecting Miners'
Safety and Health Since 1978

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- MSHA Online Forms
Advisor

Forms and Online Filings

Form number:

MSHA Form 5000-23

Form name:

Certificate of Training

Description:

The Certificate of Training Form 5000-23 provides a means for
mine operators to record and certify mandatory training received by
miners and MSHA with a monitoring tool for determining compliance
requirements. This is a mandatory collection of information as
required by 30 CFR Part 48.9 and 48.29.

OMB Control Number and Expiration Date:

1219-0009; 05/31/2011

Filing Options:

Form 5000-23 may be completed while on your PC screen, printed
(or printed and filled in manually) and sent to MSHA according to
the instructions provided below. This is not the same as on-line
filing.

Form fill, print
and mail or fax

Filing Instructions:

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 [email-masked]

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,
Records Management Branch, 1100 Wilson Boulevard, Arlington,
Virginia 22209-3939.

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Mine Safety and Health Administration
(MSHA) | 1100 Wilson Boulevard, 21st Floor Arlington, VA
22209-3939
http://www.msha.gov/ | Telephone:
(202) 693-9400 | Fax-on-demand: (202) 693-9401