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.
Form 5000-1, Certificate of Electrical/Noise Training can be filed online or completed online, printed (or printed and filled in manually) and sent to MSHA according to the instructions provided below.
File Online
Fill in, print and mail or fax
Change online filing registration information
Questions regarding this form should be directed to MSHA at (877) 778-6055 or desk.help@dol.gov
30 CFR 75.153(g) and 77.103(g) require that an individual who is a qualified electrical person in accordance with Section 75.153 and 77.103 shall annually certify to the district manager that he has satisfactorily completed a coal mine electrical retraining program approved by the Secretary in order to retain that qualification.
Send comments regarding the collection of information, including suggestions for reducing this burden, to the Mine Safety and Health Administration, U.S. Department of Labor, Office of Standards, Regulations and Variances, 200 Constitution Avenue, NW, Room C3522, Washington, DC 20210. Persons are not required to respond to this collection of information unless it displays a currently valid OMB Control Number. NOTE: Do not send your completed form to this address.