United States
Department of Labor

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Certificate of Training

Form ID: 
5000-23
Description: 

This is a mandatory collection of information as required by 30 CFR Part 48.9 and 48.29. The Certificate of Training Form 5000-23 provides a means for mine operators to record and certify Part 48 mandatory training received by miners. The training certificates for each miner shall be available at the operator minesite for inspection by MSHA and for examination by the miners, the miner's representative, and State inspection agencies. At the completion of training, the instructor MUST give the miner a copy of the training certificate. When a miner leaves the operator's employ, the miner shall be entitled to a copy of his training certificates.

Control ID: 
1219-0009
Expiration Date: 
May 31, 2024
Filing Instructions: 

Please read all instructions that are included with the form.
Form 5000-23 may be completed while on your PC screen and printed (or printed and filled in manually). MSHA does not receive or maintain copies of the 5000-23. DO NOT FILE THIS FORM WITH MSHA.

Contact Information: 

Questions regarding this form should be directed to MSHA at (877) 778-6055 or desk.help@dol.gov

Privacy Notice: 
Burden Statement: 

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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, 201 12th Street South, Suite 401 Arlington, VA 22202-5450.