Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
49.12 Modified 44 44 15
49.13 New 2 4 5
49.16 (Certify) New 14688 1469 0
49.16 (Record Corrective Actions) New 2448 612 0
49.17/ MSHA Form 5000-3 New 1232 308 308000 Form and Instruction MSHA Form 5000-3 Certificate of Physical Qualification for Mine Rescue Work
Form and Instruction MSHA FORM 5000-3 Certificate of Physical Qualification for Mine Rescue Work (Intro Screen)
49.18 New 1232 246 478720
49.19 New 44 88 0
49.50/ MSHA Form 2000-224 (Certifying) New 750 98 0 Form and Instruction MSHA Form 2000-224 Operator’s Annual Certification of Mine Rescue Team Qualifications
49.50/ MSHA Form 2000-224 (Clerical) New 750 98 188 Form and Instruction MSHA Form 2000-224 Operator’s Annual Certification of Mine Rescue Team Qualifications
75.1713-1 New 44 88 0
77.1702 New 145 290 0
Total burden requested under this ICR: 21379 3345 786928  
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