Certificate of Training _ Mine Safety and Health Administration (MSHA)

9/14/23, 2:27 PM

U.S. DEPARTMENT OF LABOR

Certificate of Training | Mine Safety and Health Administration (MSHA)

Mine Safety and Health Administration

Certificate of Training
Form ID: 5000-23
Description
This is a mandatory collection of information as required by 30 CFR Part 48.9 and 48.29. The

Certificate of Training Form 5000-23 provides a means for mine operators to record and certify
Part 48 mandatory training received by miners. The training certificates for each miner shall be
available at the operator minesite for inspection by MSHA and for examination by the miners,
the miner's representative, and State inspection agencies. At the completion of training, the
instructor MUST give the miner a copy of the training certificate. When a miner leaves the
operator's employ, the miner shall be entitled to a copy of his training certificates.
Control ID: 1219-0009
Expiration Date: Fri, 05/31/2024 - 13:45
Filing Options
Fill in, print and mail or fax
Filing Instructions
Please read all instructions that are included with the form.

Form 5000-23 may be completed while on your PC screen and printed (or printed and filled in
manually). MSHA does not receive or maintain copies of the 5000-23. DO NOT FILE THIS FORM
WITH MSHA.
Contact Information
Questions regarding this form should be directed to MSHA at (877) 778-6055

or [email protected]
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Certificate of Training | Mine Safety and Health Administration (MSHA)

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,
Office of Standards, Regulations and Variances, 201 12th Street South, Suite 401 Arlington, VA
22202-5450.

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Certificate of Training | Mine Safety and Health Administration (MSHA)

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