Information Collection

Training Plan Regulations and Certificate of Training

IC 38514 under ICR 201101-1219-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form 5000-23 Training Plan Regulations and Certificate of Training Form
MSHA Instructions for Completing MSHA Training Form 5000-23.htm www.msha.gov/forms/523INSTR.htm Instruction
msha_train_tool.pdf www.dol.gov/elaws/msha_train.htm Instruction
5000-23 Certificate of Training 5000-23 Certificate of Training - (OMB) 5-2011.pdf www.msha.gov/forms/elawsforms/5000-23.htm Form
elaws - MSHA Online Forms Advisor - MSHA Form 5000-23 Certificate of Training.mht elaws-MSHA On-Line Forms Advisors-MSHA Form 5000-23 IC Document
MSHA - Program Policy Manual - Volume III.mht MSHA-Program Policy Manual-Volume III IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Training Plan Regulations and Certificate of Training	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 48.9 30 CFR 48.3 30 CFR 48.29 30 CFR 48.23

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5000-23	Certificate of Training	5000-23 Certificate of Training - (OMB) 5-2011.pdf	http://www.msha.gov/forms/elawsforms/5000-23.htm	Yes	Yes	Fillable Fileable
Instruction			MSHA Instructions for Completing MSHA Training Form 5000-23.htm	http://www.msha.gov/forms/523INSTR.htm	Yes	Yes	Fillable Fileable
Instruction			msha_train_tool.pdf	http://www.dol.gov/elaws/msha_train.htm	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,331	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	108,367	-14,852	123,219
Annual IC Time Burden (Hours)	15,069	-4,117	19,186
Annual IC Cost Burden (Dollars)	269,541	24,397	245,144

Documents for IC

Title	Document	Date Uploaded
elaws-MSHA On-Line Forms Advisors-MSHA Form 5000-23	elaws - MSHA Online Forms Advisor - MSHA Form 5000-23 Certificate of Training.mht	05/09/2011
MSHA-Program Policy Manual-Volume III	MSHA - Program Policy Manual - Volume III.mht	05/09/2011

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