Information Collection

Records of All Certified and Qualified Persons; and Man Hoist Operators Physicial Fitness (30 CFR 75.155, 75.159 - 161, 77.105, 77.107, 77.107-1, 77.106)

IC 38555 under ICR 200502-1219-005 · OMB 1219-0127.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0127 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Records of All Certified and Qualified Persons; and Man Hoist Operators Physicial Fitness (30 CFR 75.155, 75.159 - 161, 77.105, 77.107, 77.107-1, 77.106)	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-5000-41				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,049	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	Previously Approved
Annual Number of Responses for this IC	12,509	12,509
Annual IC Time Burden (Hours)	21,002	21,002
Annual IC Cost Burden (Dollars)	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.