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Federal forms, ICRs, and supporting documents

Information Collection Request

Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program

ICR 201909-1219-001 · OMB 1219-0001 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form MSHA Form 5000-1 Certificate of Electrical Training (State Grantees) Form and Instruction Modified Repair queued
Form MSHA Form 5000-1 Certificate of Electrical Training (instructors and contractors) Form and Instruction Modified Available
1219-0001 Sup Statement 2019.docx Supporting Statement A Uploaded 2019-10-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
208114 Evidence of Eligibility Modified
192599 Certificate of Electrical Training (State Grantees) Form and Instruction Modified
14333 Certificate of Electrical Training (instructors and contractors) Form and Instruction Modified
ICR Details
1219-0001 201909-1219-001
Active 201604-1219-003
DOL/MSHA
Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program
Extension without change of a currently approved collection   No
Regular
Approved without change 01/03/2020
Retrieve Notice of Action (NOA) 11/22/2019
  Inventory as of this Action Requested Previously Approved
01/31/2023 36 Months From Approved 01/31/2020
2,025 0 1,414
849 0 599
413 0 274
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.
US Code: 30 USC 813(h) Name of Law: Federal Mine Safety and Health Act of 1977
   US Code: 30 USC 811 Name of Law: Federal Mine Safety and Health Act of 1977
  
None
Not associated with rulemaking
  84 FR 43620 08/21/2019
84 FR 64345 11/21/2019
No
  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 2,025 1,414 0 0 611 0
Annual Time Burden (Hours) 849 599 0 0 250 0
Annual Cost Burden (Dollars) 413 274 0 0 139 0
No
No
Cost to Respondents: An increases in the number forms submitted by respondents to has resulted in increase the annual cost burden described in Item 13 from $274 to $413. Burden hours: There is an increase in burden hours from 599 to 849. The increase in burden hours is directly attributable to the increased number of submissions by respondents. Respondents: There was a decrease in the number of total respondents from 289 to 266. This results from a decrease in the number of mines and new individual respondents submitting applications. Responses: There was an increase in responses from 1,414 to 2,025. This due to an increase in the expected number of MSHA Form 5000-1s submitted.
$38,286
No
    No
    No
No
No
No
Uncollected
Nicole Bouchet 202 646-2814 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/22/2019