Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form MSHA Form 5000-1 Certificate of Electrical Training	Form and Instruction	Modified	Available
Form MSHA Form 5000-1 Certificate of Electrical Training	Form and Instruction	Modified	Available
Form MSHA Form 5000-1 Certificate of Electrical Training (State Grantees)	Form and Instruction	Modified	Repair queued
Form MSHA Form 5000-1 Certificate of Electrical Training	Form and Instruction	Modified	Available
Form MSHA Form 5000-1 Certificate of Electrical Training	Form and Instruction	Modified	Available
Form MSHA Form 5000-1 Certificate of Electrical Training (instructors and contractors)	Form and Instruction	Modified	Repair queued
1219-0001 Supporting Statement 2022.docx	Supporting Statement A	Uploaded 2022-08-23	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
208114	Evidence of Eligibility		Modified
192599	Certificate of Electrical Training (State Grantees)	Form and Instruction	Modified	Certificate of Electrical Training
192599	Certificate of Electrical Training (State Grantees)	Form and Instruction	Modified	Certificate of Electrical Training
192599	Certificate of Electrical Training (State Grantees)	Form and Instruction	Modified
14333	Certificate of Electrical Training (instructors and contractors)	Form and Instruction	Modified	Certificate of Electrical Training
14333	Certificate of Electrical Training (instructors and contractors)	Form and Instruction	Modified	Certificate of Electrical Training
14333	Certificate of Electrical Training (instructors and contractors)	Form and Instruction	Modified

ICR Details

OMB Control No: 1219-0001	ICR Reference No: 202208-1219-004
Status: Historical Active	Previous ICR Reference No: 201909-1219-001
Agency/Subagency: DOL/MSHA	Agency Tracking No:
Title: Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/29/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/23/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2025	36 Months From Approved	01/31/2023
Responses	1,632	0	2,025
Time Burden (Hours)	772	0	849
Cost Burden (Dollars)	299	0	413

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Abstract: MSHA's Form 5000-1, "Certificate of Electrical Training," is required to be used by instructors for reporting to MSHA the qualification of those persons who have satisfactorily completed a coal mine electrical training program course. The Agency is also requesting approval for applications for MSHA approved tests and for State tests that are administered as part of an MSHA-approved State program.

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Authorizing Statute(s): US Code: 30 USC 813(h) Name of Law: Federal Mine Safety and Health Act of 1977
   US Code: 30 USC 811 Name of Law: Federal Mine Safety and Health Act of 1977
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 51151	08/19/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 71683	11/23/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Certificate of Electrical Training (State Grantees)	MSHA Form 5000-1, MSHA Form 5000-1	Certificate of Electrical Training ,   Certificate of Electrical Training
Certificate of Electrical Training (instructors and contractors)	MSHA Form 5000-1, MSHA Form 5000-1	Certificate of Electrical Training ,   Certificate of Electrical Training
Evidence of Eligibility

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,632	2,025	0	0	-393	0
Annual Time Burden (Hours)	772	849	0	0	-77	0
Annual Cost Burden (Dollars)	299	413	0	0	-114	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Respondents: The number of respondents increased from 266 to 294 due to an increase in the number of submissions from business or other for-profit instructors. Responses: The number of MSHA Form 5000-1 submissions decreased from 2,025 to 1,632, because the average number of submissions per respondent decreased from 9.5 submissions to 6.7 submissions. Burden Hours: There is a decrease in burden hours from 849 to 772. The decrease in burden hours is directly attributable to the decreased number of submissions by respondents, despite an increase in the average burden of evidence of eligibility. Cost to Respondents: A decrease in the number of forms submitted by respondents by mail has resulted in a decrease in the annual cost burden described in Item 13 from $413 to $299.

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Annual Cost to Federal Government: $35,801

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/23/2022

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