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MSHA State Grant Program Technical Progress Report

Form ID
5000-50
Description

This form will report an aggregate summary at the end of each quarter on the type of service that the grantee is provided.

Control ID
1219-0154
Expiration Date
Sat, 07/31/2027 - 12:42
Filing Options

Form 5000-50, MSHA State Grant Program Technical Progress Report can be printed, and mailed to MSHA according to the instructions provided below. 
Form fill, print and mail or fax

Filing Instructions

The completed Form 5000-50 should be uploaded into GrantsSolutions.

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 form is estimated to average 2.5 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the form. This collection of information is required to retain benefits. You are not required to respond to this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: USDOL-Mine Safety and Health Administration, 201 12th Street South, 4th Floor West, Arlington, VA 22202-5452, Paperwork Reduction Project
(1219-0154).