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

OMB 1219-0001

OMB 1219-0001

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.

The latest form for Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program expires 2023-01-31 and can be found here.

All Historical Document Collections
Extension without change of a currently approved collection 2022-11-23
Approved without change
Extension without change of a currently approved collection 2019-11-22
Approved without change
Extension without change of a currently approved collection 2016-08-31
Approved without change
Revision of a currently approved collection 2013-09-23
Approved without change
Revision of a currently approved collection 2010-07-27
Approved without change
Extension without change of a currently approved collection 2007-04-18
Approved without change
Extension without change of a currently approved collection 2004-04-22
Approved without change
Extension without change of a currently approved collection 2001-02-01
Approved without change
Extension without change of a currently approved collection 1997-12-31
Approved without change
Reinstatement without change of a previously approved collection 1994-10-28
Approved without change
Revision of a currently approved collection 1991-04-08
Approved with change
No material or nonsubstantive change to a currently approved collection 1989-10-01
Approved without change
Revision of a currently approved collection 1989-03-08
Approved with change
No material or nonsubstantive change to a currently approved collection 1988-10-01
Approved with change
No material or nonsubstantive change to a currently approved collection 1986-09-12
Approved without change
Revision of a currently approved collection 1986-01-31
Approved with change
No material or nonsubstantive change to a currently approved collection 1984-09-05
Approved without change
Revision of a currently approved collection 1983-06-21
Approved with change
No material or nonsubstantive change to a currently approved collection 1983-05-27
Approved without change
Revision of a currently approved collection 1982-02-22
Approved without change
Reinstatement with change of a previously approved collection 1981-12-16
Approved without change
Reinstatement with change of a previously approved collection 1978-11-01
Not subject to PRA
Revision of a currently approved collection 1978-11-01
Approved with change
No material or nonsubstantive change to a currently approved collection 1977-07-01
Approved with change
No material or nonsubstantive change to a currently approved collection 1976-08-30
Approved with change
No material or nonsubstantive change to a currently approved collection 1975-12-31
Approved without change
Extension without change of a currently approved collection 1975-12-23
OMB Details

Certificate of Electrical Training (instructors and contractors)

Federal Enterprise Architecture: Workforce Management - Worker Safety

Form MSHA Form 5000-1Certificate of Electrical Trainingwww.msha.gov/support-resources/forms-online-filing/2015/04/15/certificate-electricalnoise-trainingForm and instruction
Form MSHA Form 5000-1Certificate of Electrical Trainingwww.msha.gov/support-resources/forms-online-filing/2015/04/15/certificate-electricalnoise-trainingForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.


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