Information Collection

Representative of Miners, Notification of Legal Identity, and Notification of Commencement of Operations and Closing of Mines

IC 14405 under ICR 201608-1219-002 · OMB 1219-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0042 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
7000-51 Intro.pdf www.msha.gov/forms/elawsforms/MineIDRequest.htm	Instruction
2000-238 Intro.pdf www.msha.gov/forms/elawsforms/MineRep.htm	Instruction
2000-7 Intro.pdf www.msha.gov/forms/elawsforms/2000-7.htm	Instruction
2000-7 Legal Identity Report 2000-7 Legal Identity Report UPDATED- OMB Form.pdf www.msha.gov/forms/elawsforms/2000-7.htm	Form
2000-238 Representative of Miners Designation Form 2000-238 Rep. of Miner's Designation Fillable Form UPDATED.pdf www.msha.gov/Forms/2000-238.pdf	Form
7000-51 Mine Operator Identification Request 7000-51.pdf www.msha.gov/forms/elawsforms/MineIDRequest.htm	Form
MSHA Form 2000-238 Representative of Miners Designation Form SCREENSHOTS Form Notification of Miners Rep Form.docx www.msha.gov/Forms/2000-238.pdf	Form and Instruction
MSHA Form 7000-51 Mine Operator Identification Request SCREENSHOTS Form 7000-51.docx www.msha.gov/forms/elawsforms/MineIDRequest.htm	Form and Instruction
MSHA Form 2000-7 Legal Identity Report SCREENSHOTS Form 2000-7.docx www.msha.gov/forms/elawsforms/2000-7.htm	Form and Instruction

IC Title:

Representative of Miners, Notification of Legal Identity, and Notification of Commencement of Operations and Closing of Mines

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 40.3 30 CFR 57.1000 30 CFR 40.4 30 CFR 40.2 30 CFR 56.1000 30 CFR 41.20 30 CFR 40.5

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
Instruction			2000-238 Intro.pdf	http://www.msha.gov/forms/elawsforms/MineRep.htm	Yes	Yes	Fillable Fileable
Instruction			2000-7 Intro.pdf	http://www.msha.gov/forms/elawsforms/2000-7.htm	Yes	Yes	Fillable Fileable
Form and Instruction	MSHA Form 2000-238	Representative of Miners Designation Form	SCREENSHOTS Form Notification of Miners Rep Form.docx	http://www.msha.gov/Forms/2000-238.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	MSHA Form 7000-51	Mine Operator Identification Request	SCREENSHOTS Form 7000-51.docx	http://www.msha.gov/forms/elawsforms/MineIDRequest.htm	Yes	Yes	Fillable Fileable
Instruction			7000-51 Intro.pdf	http://www.msha.gov/forms/elawsforms/MineIDRequest.htm	Yes	Yes	Fillable Fileable
Form	2000-7	Legal Identity Report	2000-7 Legal Identity Report UPDATED- OMB Form.pdf	http://www.msha.gov/forms/elawsforms/2000-7.htm	Yes	Yes	Fillable Fileable
Form	2000-238	Representative of Miners Designation Form	2000-238 Rep. of Miner's Designation Fillable Form UPDATED.pdf	http://www.msha.gov/Forms/2000-238.pdf	Yes	Yes	Fillable Fileable
Form	7000-51	Mine Operator Identification Request	7000-51.pdf	http://www.msha.gov/forms/elawsforms/MineIDRequest.htm	Yes	Yes	Fillable Fileable
Form and Instruction	MSHA Form 2000-7	Legal Identity Report	SCREENSHOTS Form 2000-7.docx	http://www.msha.gov/forms/elawsforms/2000-7.htm	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: Privacy Act Systems of Records Notice DOL/MSHA-21, Assessments and Civil Penalty Debt Collection Activity and Reporting System

FR Citation: 67 FR 16816

Number of Respondents: 10,481

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	10,481	285	10,196
Annual IC Time Burden (Hours)	2,027	-2	2,029
Annual IC Cost Burden (Dollars)	842	-1,577	2,419

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.