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MSHA-Forms and Online Filings

Form number: MSHA Form 5000-23
Form name: Certificate of Training
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.
OMB Control Number and
Expiration Date:
1219-0009; 01/31/2018
Options/Instructions for
Completing the Form:
Please read all instructions here before using the link (below) to obtain the detailed instructions.

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.

Form fill, print and mail or fax

Detailed Instructions for completing Form 5000-23, Certificate of Training Form.

Contact Information: Questions regarding this form should be directed to MSHA at
(877) 778-6055 or
Privacy Notice: Privacy Notice
Legal Authority: 30 CFR 48.9 and 48.29.
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, Arlington, Virginia 22202-5452.

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