Certificate of Electrical Training

OMB Control No: 1219-0001	ICR Reference No: 201003-1219-011
Status: Historical Active	Previous ICR Reference No: 200703-1219-002
Agency/Subagency: DOL/MSHA	Agency Tracking No:
Title: Certificate of Electrical Training
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/04/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/27/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2013	36 Months From Approved	10/31/2010
Responses	2,796	0	2,294
Time Burden (Hours)	890	0	138
Cost Burden (Dollars)	29,483	0	9,257

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Abstract: 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.

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Authorizing Statute(s): PL: Pub.L. 91 - 173 101(a); 103(a)(2); 305(g) Name of Law: Federal Mine Safety and Health Act of 1977

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 5807	02/04/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 143	07/27/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

IC Title Form No. Form Name Mined-based Certificate of Electrical Training (State Grantees) MSHA Form 5000-1 Certificate of Electrical Training Mined-based Certificate of Electrical Training (in-house instructors) MSHA Form 5000-1 Certificate of Electrical Training Mined-based Certificate of Electrical Training (Contractor Instructors) MSHA Form 5000-1 Certificate of Electrical Training

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,796	2,294	0	0	502	0
Annual Time Burden (Hours)	890	138	0	0	752	0
Annual Cost Burden (Dollars)	29,483	9,257	0	0	20,226	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: An increase in the estimate of the time needed to complete form 5000-1 from 5 minutes to 25 minutes resulted in an increase in hours from 138 to 1,165. In addition, both wages and postage rates have increased since Fiscal Year 2006, resulting in an increase in the annual cost burden described in Item 13 (from $9,257 to $29,483). MSHA’s Standardized Information System (MSIS) is expected to remain in a maintenance-only mode and enhancements (upgrades) to the Q&C portion of the system are not anticipated; as a result, the total cost to the Federal Government in item 14 decreased from $99,386 to $54,045.

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Annual Cost to Federal Government: $54,045

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Mario Distasio 2026939455 [email protected]

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(i) Why the information is being collected;
			(ii) Use of information;
			(iii) Burden estimate;
			(iv) Nature of response (voluntary, required for a benefit, or mandatory);
			(v) Nature and extent of confidentiality; and
			(vi) Need to display currently valid OMB control number;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date: 07/27/2010

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