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Sample Letter of Intent to Participate

MSHA is providing a sample letter for you to send to the local MSHA District Manager. The letter will inform the District Manager of your intent to participate and describe the terms and conditions for participating in the program. Further, MSHA agrees that if the technology fails or shuts down during the trial, we will not consider it a defect affecting safety provided that certain conditions, noted in the sample letter, are met. This agreement will remain in effect for the duration of the trial period. You will be notified in writing at least 60 days before the program is scheduled to end. If you wish to participate, complete the letter and send it to your local MSHA district office.

  • Sample Letter
  • Return to the Accident Prevention Program home page.