OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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 · DOL/MSHA.

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 2028-12-31 and is listed under ICR 202504-1219-004.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form MSHA Form 5000-1 Certificate of Electrical TrainingForm and Instruction
Form MSHA Form 5000-1 Certificate of Electrical TrainingForm and Instruction
Form MSHA Form 5000-1 Certificate of Electrical Training (State Grantees)Form and Instruction
Form MSHA Form 5000-1 Certificate of Electrical TrainingForm and Instruction
Form MSHA Form 5000-1 Certificate of Electrical TrainingForm and Instruction
Form MSHA Form 5000-1 Certificate of Electrical Training (instructors and contractors)Form and Instruction
1219-0001 60-Day FRN Published 7-3-2025.pdfSupplementary Document
1219-0001 60-Day FRN Published 7-3-2025.pdf Supplementary Document
1219-0001 Supporting Statement 2025.docxSupporting Statement A
Evidence of Eligibility Information collection
Certificate of Electrical Training (State Grantees) Form and Instruction
Certificate of Electrical Training (State Grantees) Form and Instruction
Certificate of Electrical Training (State Grantees) Form and Instruction
Certificate of Electrical Training (instructors and contractors) Form and Instruction
Certificate of Electrical Training (instructors and contractors) Form and Instruction
Certificate of Electrical Training (instructors and contractors) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202504-1219-004 Extension without change of a currently approved collection 2025-09-15
202502-1219-001 No material or nonsubstantive change to a currently approved collection 2025-04-07 Approved without change
202208-1219-004 Extension without change of a currently approved collection 2022-11-23 Approved without change
201909-1219-001 Extension without change of a currently approved collection 2019-11-22 Approved without change
201604-1219-003 Extension without change of a currently approved collection 2016-08-31 Approved without change
201304-1219-001 Revision of a currently approved collection 2013-09-23 Approved without change
201003-1219-011 Revision of a currently approved collection 2010-07-27 Approved without change
200703-1219-002 Extension without change of a currently approved collection 2007-04-18 Approved without change
200404-1219-001 Extension without change of a currently approved collection 2004-04-22 Approved without change
200102-1219-001 Extension without change of a currently approved collection 2001-02-01 Approved without change
199712-1219-003 Extension without change of a currently approved collection 1997-12-31 Approved without change
199410-1219-001 Reinstatement without change of a previously approved collection 1994-10-28 Approved without change
199104-1219-003 Revision of a currently approved collection 1991-04-08 Approved without change
198910-1219-017 No material or nonsubstantive change to a currently approved collection 1989-10-01 Approved with change
198903-1219-002 Revision of a currently approved collection 1989-03-08 Approved without change
198810-1219-014 No material or nonsubstantive change to a currently approved collection 1988-10-01 Approved with change
198609-1219-019 No material or nonsubstantive change to a currently approved collection 1986-09-12 Approved with change
198601-1219-004 Revision of a currently approved collection 1986-01-31 Approved without change
198409-1219-007 No material or nonsubstantive change to a currently approved collection 1984-09-05 Approved with change
198306-1219-002 Revision of a currently approved collection 1983-06-21 Approved without change
198305-1219-027 No material or nonsubstantive change to a currently approved collection 1983-05-27 Approved with change
198202-1219-004 Revision of a currently approved collection 1982-02-22 Approved without change
198112-1219-003 Reinstatement with change of a previously approved collection 1981-12-16 Approved without change
197811-1219-002 Reinstatement with change of a previously approved collection 1978-11-01 Approved without change
197811-1219-001 Revision of a currently approved collection 1978-11-01 Not subject to PRA
197707-1219-001 No material or nonsubstantive change to a currently approved collection 1977-07-01 Approved with change
197608-1219-001 No material or nonsubstantive change to a currently approved collection 1976-08-30 Approved with change
197512-1219-002 No material or nonsubstantive change to a currently approved collection 1975-12-31 Approved with change
197512-1219-001 Extension without change of a currently approved collection 1975-12-23 Approved without change

OMB Details

Certificate of Electrical Training (instructors and contractors)

Federal Enterprise Architecture: Workforce Management - Worker Safety

Information collection instruments
FormNameElectronic accessType
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.