Information Collection

Qualification/Certification Program Request for MSHA Individual Identification Number (MIIN)-Private Sector

IC 181962 under ICR 201401-1219-001 · OMB 1219-0143.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0143 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5000-46 Qualification/Certification Program Request for MSHA Individual Identification Number (MIIN)-Private Sector	Form and Instruction
5000-46 Web Instruc. for Completing MSHAs MIIN (Feb. 11) OMB.pdf lakegovprod3.msha.gov/MIIN/MIIN.aspx	Instruction
5000-46 web p2 MSHA -.pdf lakegovprod3.msha.gov/MIIN/MIIN.aspx	Instruction
5000-46 web p3 MSHA -.pdf lakegovprod3.msha.gov/MIIN/MIIN.aspx	Instruction
5000-46 Request for MSHA Individual Identification Number (MIIN) 5000-46 MIIN Miner Individual Identification No. (OMB).pdf www.msha.gov/forms/elawsforms/5000-46.htm	Form and Instruction

IC Title:

Qualification/Certification Program Request for MSHA Individual Identification Number (MIIN)-Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 77 30 CFR 75 30 CFR 48 30 CFR 90 30 CFR 70 30 CFR 71

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 and Instruction	5000-46	Request for MSHA Individual Identification Number (MIIN)	5000-46 MIIN Miner Individual Identification No. (OMB).pdf	http://www.msha.gov/forms/elawsforms/5000-46.htm	Yes	Yes	Fillable Printable
Instruction			5000-46 Web Instruc. for Completing MSHAs MIIN (Feb. 11) OMB.pdf	https://lakegovprod3.msha.gov/MIIN/MIIN.aspx	Yes	Yes	Fillable Fileable
Instruction			5000-46 web p2 MSHA -.pdf	https://lakegovprod3.msha.gov/MIIN/MIIN.aspx	Yes	Yes	Fillable Fileable
Instruction			5000-46 web p3 MSHA -.pdf	https://lakegovprod3.msha.gov/MIIN/MIIN.aspx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: DOL/MSHAâ13 & -15

FR Citation: 67 FR 16816

Number of Respondents: 12,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,000	1,000	11,000
Annual IC Time Burden (Hours)	1,000	84	916
Annual IC Cost Burden (Dollars)	44,120	38,950	5,170

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.