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Forms and Online Filing

These are the most frequently requested MSHA forms. You can complete some forms online, while you can download and print all others.

End of Year Data mailers containing Part 50 data, please utilize Mine Data Retrieval System to review injuries, employment/hours and coal production information submitted to MSHA.  

MSHA 7000-2, Quarterly Mine Employment and Coal Production Report (30 U.S.C. Subsection 813; 30 CFR Part 50) Filing Dates:

  • 1st Quarter (January-March): Due by April 15
  • 2nd Quarter (April-June): Due by July 15
  • 3rd Quarter (July-September): Due by October 15
  • 4th Quarter (October-December): Due by January 15 

For assistance with online forms and filings, please call MSHA's Help Desk at 1-877-778-6055.
 

For assistance with online forms and filings, please call MSHA's Help Desk at 1-877-778-6055.

                                                                                            **NOTICE**

EGov webpages and PDF downloads support the following browsers of Edge and Google Chrome for online filing.
If you are having an issue opening the PDF file, please right click the PDF icon and select “save link as” to download the file.

 

Forms & Online Filing
Form Identifier Name Description Online Filing Download More Info
N/A Hazardous Condition Complaint

Notify MSHA of a hazardous condition at a mine. Complaints can be filed anonymously using this system. Disponsible en español.

File Online for Hazardous Condition Complaint More Info
N/A Manage/Update Diesel Inventory

Manage and update a mine’s diesel equipment inventory. You can also view the diesel inventory of any mine here.

File Online for Manage/Update Diesel Inventory More Info
N/A Electronic Training Plan Advisor

Provides guidance in developing federally required training plans for Part 46 and Part 48 mines.

File Online for Electronic Training Plan Advisor More Info
N/A Electronic Mine Operator Dust Data Card

30 CFR Sections 70.210(a) and (c) and 71.207(a) and (c) require each Coal Mine Dust Personal Sampler Unit (CMDPSU) sample to be transmitted to MSHA with a completed Dust Data Card.  MSHA requires a Dust Data Card for every CMDPSU sample. 

File Online for Electronic Mine Operator Dust Data Card More Info
N/A Report Commencement/Closure of Operation – Metal and Nonmetal Mines

The owner, operator, or person in charge of any metal and nonmetal mine shall notify MSHA before starting operations of the approximate or actual date mine operation will commence. When a mine is closed, the person in charge shall indicate whether the closure is temporary or permanent.

File Online for Report Commencement/Closure of Operation – Metal and Nonmetal Mines More Info
7000-52 Contractor ID Request

All independent contractors may apply for MSHA contractor identification numbers. This information is used to assist MSHA in obtaining MSHA identification numbers for independent contractors.

File Online for Contractor ID Request More Info
7000-51 Mine ID Request

All mines are required to apply for an MSHA mine identification number. An MSHA Mine ID is required for each mine site and must be issued before any operations may begin at the mine site.

File Online for Mine ID Request Download PDF for Mine ID Request More Info
7000-2 Quarterly Mine Employment and Coal Production Report

Mine operators and independent contractors are required to report employment and production information to MSHA using this form for each quarter of operation and at each mine at which activity is performed.

File Online for Quarterly Mine Employment and Coal Production Report Download PDF for Quarterly Mine Employment and Coal Production Report More Info
7000-1 Mine Accident, Injury and Illness Report

If an accident, injury or illness occurs at or in conjunction with activity at a mine, mine operators and independent contractors are required to report the circumstances of the incident to MSHA using this form.

File Online for Mine Accident, Injury and Illness Report Download PDF for Mine Accident, Injury and Illness Report More Info
5000-46 Request an MSHA Individual Identification Number (MIIN)

MSHA personnel, mine operators, independent contractors, miners, state grantees, MSHA qualified and certified persons and approved instructors should apply for a MIIN. MIINs will be substituted for social security numbers, eliminating the need to provide social security numbers on documents submitted to MSHA.
 

File Online for Request an MSHA Individual Identification Number (MIIN) Download PDF for Request an MSHA Individual Identification Number (MIIN) More Info
5000-41 Health Activity Certification or Hoisting Engineers Qualification Request

All instructors are required to submit to MSHA the names of persons who have satisfactorily completed required mine foreman and pre-shift examiner or hoisting certification training. MSHA uses the form information to issue certification cards to qualified persons.

File Online for Health Activity Certification or Hoisting Engineers Qualification Request Download PDF for Health Activity Certification or Hoisting Engineers Qualification Request More Info
5000-3 Certificate of Physical Qualification for Mine Rescue Work

Each member of a mine rescue team must be examined annually by a physician who shall certify that he or she is physically fit to perform mine rescue and recovery work. The mine operator is required to keep the completed form on file for one year.

Download PDF for Certificate of Physical Qualification for Mine Rescue Work More Info
5000-23 Certificate of Training

The Certificate of Training Form allows mine operators and instructors to record and certify Part 48 mandatory training received by miners. 

Download PDF for Certificate of Training More Info
5000-1 Certificate of Electrical/Noise Training

All instructors are required to submit to MSHA the names of persons who have satisfactorily completed required electrical training. MSHA uses the form information to issue certification cards to those persons who are qualified.

File Online for Certificate of Electrical/Noise Training Download PDF for Certificate of Electrical/Noise Training More Info
4000-9 Record of Individual Exposure to Radon Daughters

Operators are required to calculate and record individual exposures to concentrations of radon daughters. This data allows MSHA to assure compliance with underground radiation standards; form a database for epidemiological studies; and provide information on cumulative radon exposures.

File Online for Record of Individual Exposure to Radon Daughters Download PDF for Record of Individual Exposure to Radon Daughters More Info
2000-7 Legal Identification Report

Within 30 days of applying for an MSHA mine ID or when there are any changes to the legal ownership structure for a mine, a mine operator must file a Legal Identification Report with MSHA.

File Online for Legal Identification Report Download PDF for Legal Identification Report More Info
2000-38 Electrically Operated Equipment Field Approval Application (Coal Only)

Apply for individual field approvals by MSHA for electrically operated machines commercially built, or constructed, by the owner-coal mine operator of such machines including any associated electrical equipment, electrical components, and electrical accessories.

Download PDF for Electrically Operated Equipment Field Approval Application (Coal Only) More Info
2000-238 Representative of Miners Designation Form

This voluntary form is a written declaration of any person or organization which represents two or more miners at a coal or other mine for the purposes of the Mine Act.

File Online for Representative of Miners Designation Form Download PDF for Representative of Miners Designation Form More Info
2000-224 Operator’s Annual Certification of Mine Rescue Teams Qualifications

This form can be used by underground coal mine operators to certify that each of a mine’s two designated mine rescue teams meets the requirements of 30CFR Part 49 Subpart B.

Download PDF for Operator’s Annual Certification of Mine Rescue Teams Qualifications More Info
2000-222 Self Contained Self Rescuer (SCSR) Inventory and Report

Mine operators are required to use this form to file a report of inventory of all Self-Contained Self-Rescuers (SCSRs) at a mine as well as report problems with SCSRs.

File Online for Self Contained Self Rescuer (SCSR) Inventory and Report Download PDF for Self Contained Self Rescuer (SCSR) Inventory and Report More Info