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OMB Control No: 1219-0001	ICR Reference No: 202504-1219-004
Status: Received in OIRA	Previous ICR Reference No: 202502-1219-001
Agency/Subagency: DOL/MSHA	Agency Tracking No:
Title: Certificate of Electrical Training and Applications for MSHA Approved Tests and State Tests Administered as Part of an MSHA-approved State Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 09/15/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	1,512	1,632
Time Burden (Hours)	695	772
Cost Burden (Dollars)	331	299

Abstract: 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.

Authorizing Statute(s): US Code: 30 USC 811 Name of Law: Federal Mine Safety and Health Act of 1977
US Code: 30 USC 813(h) Name of Law: Federal Mine Safety and Health Act of 1977

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 2958	07/03/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 44397	09/15/2025
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	1,512	1,632	-120
Annual Time Burden (Hours)	695	772	-77
Annual Cost Burden (Dollars)	331	299	32

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Number of Respondents: The estimated number of respondents decreased from 294 to 248 due to a decline in the number of submissions of MSHA Form 5000-1 and evidence of eligibility. Number of Responses: The estimated number of responses decreased from 1,632 to 1,512 due to a decline in the number of submissions. Annual Time Burden: The estimated annual time burden decreased from 772 hours to 695 hours due to the decrease in the number of responses. Annual Burden Costs: The estimated annual burden costs increased from $52,687 to $53,568 due to an increase in wages. Annual Other Burden Costs: The estimated annual other burden cost increased, from $299 to $331 due to an increase in the share of forms submitted by mail. Federal Hours: The estimated annual federal hours remained the same at 730 hours as the time to spent maintaining the database remained constant. Federal Costs: The estimated annual federal costs increased from $35,081 to $42,766 due to an increase in the number of certification cards mailed to miners.

Annual Cost to Federal Government: $42,766

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Joanna Moore 202 693-9825 moore.joanna@dol.gov

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