Information Collection

MSHA Performance Report Narratives and MSHA Form 5000-50, MSHA State Grant Program Performance Report

IC 228996 under ICR 202502-1219-011 · OMB 1219-0154.

Documents and Forms

Document Name Document Type
Form 5000-50 MSHA Performance Report Narratives and MSHA Form 5000-50, MSHA State Grant Program Performance Report Form
5000-50 MSHA State Grant Program Performance Report MSHA_5000-50.pdf www.msha.gov/training-education/training-programs-courses Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	MSHA Performance Report Narratives and MSHA Form 5000-50, MSHA State Grant Program Performance Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5000-50	MSHA State Grant Program Performance Report	MSHA_5000-50.pdf	https://www.msha.gov/training-education/training-programs-courses	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 76	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	850	850
Annual IC Cost Burden (Dollars)	0	0

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.