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Forms & Online Filing

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

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

Search by Form Name or ID

Form Identifier Name Description Online Filing Download
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.

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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.

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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.

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N/A Certificates of Achievement in Safety

All active and intermittently active mines required to report injury and employment data under the Mine Act are eligible to receive a Certificate of Achievement in Safety. Learn more about the program, and find out if you are eligible.

Online submissions are required by June 30, 2017.

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N/A Electronic Training Plan Advisor

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

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7000-52 Contractor ID Request

All independent contractors are required to apply for an MSHA contractor identification number. An MSHA ID is required for each contractor operating at a mine site and must be issued before they begin specific activities.

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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.

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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.

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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.

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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.
 

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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.

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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.

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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. 

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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.

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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.

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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.

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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.

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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.

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2000-224 Operator’s Annual Certification of Mine Rescue Teams Qualifications

This voluntary 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.

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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.

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