Information Collection

MSHA Performance Report Narratives and MSHA Form 5000-50, MSHA State Grant Program Performance Report

IC 228996 under ICR 202502-1219-011 · OMB 1219-0154.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5000-50 MSHA State Grant Program Performance Report MSHA Performance Report Narratives and MSHA Form 5000-50, MSHA State Grant Program Performance Report	Form
5000-50 MSHA State Grant Program Performance Report MSHA_5000-50.pdf www.msha.gov/training-education/training-programs-courses	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	5000-50			https://www.msha.gov/training-education/training-programs-courses	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 76

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	850	850
Annual IC Cost Burden (Dollars)	0	0

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.

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