Information Collection

Work Experience Certification (training Plan Regulations)

IC 122985 under ICR 197908-1219-001 · OMB 1219-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0009 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	WORK EXPERIENCE CERTIFICATION (TRAINING PLAN REGULATIONS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MSHA 500-26				No	No
Form	MSHA 5000-30				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25,000	3,000	22,000
Annual IC Time Burden (Hours)	11,100	100	11,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.