Information Collection

Qualification/ Certification Program Request for MSHA Individual Identification Number (MIIN)-Individuals

IC 210355 under ICR 202003-1219-004 · OMB 1219-0143.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0143 can be found here:

Documents and Forms

Document Name Document Type
INTRO SCREENSHOTS Request an MIIN.pdf www.msha.gov/support-resources/forms-online-filing/2018/05/23/request-msha-individual-identification-number-miin Instruction
5000-46 Request for MSHA Individual Identification Number (MIIN) 5000-46 (rev).pdf www.msha.gov/support-resources/forms-online-filing/2018/05/23/request-msha-individual-identification-number-miin Form and Instruction
5000-46 Request for Individual Identification Number (MIIN) MIIN Screenshots.docx www.msha.gov/support-resources/forms-online-filing/2018/05/23/request-msha-individual-identification-number-miin Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Qualification/ Certification Program Request for MSHA Individual Identification Number (MIIN)-Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 70.210 30 CFR 71.207 30 CFR 75.100 30 CFR 75.150 30 CFR 75.153 30 CFR 75.155 30 CFR 77.100 30 CFR 77.101 30 CFR 77.102 30 CFR 77.103 30 CFR 77.104 30 CFR 77.105 30 CFR 90.3 30 CFR 90.100(b) 30 CFR 90.202 30 CFR 90.203 30 CFR 90.208 30 CFR 90.209

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			INTRO SCREENSHOTS Request an MIIN.pdf	https://www.msha.gov/support-resources/forms-online-filing/2018/05/23/request-msha-individual-identification-number-miin	Yes	Yes	Fillable Fileable
Form and Instruction	5000-46	Request for MSHA Individual Identification Number (MIIN)	5000-46 (rev).pdf	https://www.msha.gov/support-resources/forms-online-filing/2018/05/23/request-msha-individual-identification-number-miin	Yes	Yes	Fillable Printable
Form	5000-46	Request for Individual Identification Number (MIIN)	MIIN Screenshots.docx	https://www.msha.gov/support-resources/forms-online-filing/2018/05/23/request-msha-individual-identification-number-miin	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: DOL/MSHA-1	FR Citation: 81 FR 25766

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,000	0	2,000
Annual IC Time Burden (Hours)	167	0	167
Annual IC Cost Burden (Dollars)	20	1	19

Documents for IC

Title	Document	Date Uploaded
No associated records found

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