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MSHA-Forms and Online Filings

Form number: MSHA Form 5000-46
Form name: Request for MSHA Individual Identification Number (MIIN)
Description: The Mine Safety and Health Administration (MSHA) will issue a MSHA Individual Identification Number (MIIN) to persons that are already qualified or certified or who are seeking qualifications and/or certifications under 30 CFR Part 48, Part 70, Part 71, Part 75.00, 75.153, 75.155, Part 77.100, 77.103, 77.104, 77.105 and Part 90. Completion of this form is mandatory, as this number will be substituted for the social security number. This number should be supplied by the individual for all occurrences of training or applications to MSHA that are submitted by the mining operator, instructor, State, or person applying to be an MSHA approved instructor. This number will also be used to identify miners who have exercised their option to work in areas of a mine with respirable dust concentration at or below 1.0 milligrams per cubic meter of air under 30CFR Part 90. Information on this form will be kept confidential to the extent allowed by the law.
OMB Control Number and
Expiration Date:
1219-0143 05/31/2017
Filing Options: Form 5000-46, MSHA Individual Identification Number can be filed online or completed online and printed, and mailed to MSHA according to the instructions provided below.

File Online
Form fill, print and mail or fax
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Filing Instructions: Detailed Instructions for completing Form 5000-46, MSHA Individual Identification Number are included on the form, or may be downloaded separately using this link.

If filing by mail or fax, completed printed forms should be sent to:
U.S. Department of Labor
Mine Safety and Health Administration
Qualification and Certification Unit
P.O. Box 25367 DFC
Denver, Co 80225-0367
Contact Information: Questions regarding this form should be directed to MSHA Qualification and Certification Unit at above address or locally in Colorado (303) 231-5472, toll free (800) 579-2647, Fax (303) 231-5474, E-Mail to
Privacy Notice: The information collection includes Privacy Act material, which is covered under "Computer Security Guidelines for Implementing the Privacy Act of 1974". It is also covered under OMB Circular A-130, Management of Federal Information Resources Computer Fraud & Abuse Act of 1986, DLMS- Chapter 800- Network Operations and LAN Management, DLMS - Chapter 1500- Privacy Policy on Data Collection over DOL Web Sites, Federal information Security Management Act (FISMA) of 2002, Title III [Public Law 107-347] as part of the E-Government Act of 2002.
Legal Authority: 31USC7701 Section 7701 (c)(2)(B), 5 USC 551(8)(A), 30 CFR Part 48, Part 70, Part 71, Part 75 , 75.153, 75.155, Part 77.100, 77.103, 77.104, 77.105 and Part 90
Burden Statement: Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions. An agency may not conduct or sponsor, and persons are not required to respond to this collection of information unless it displays a valid OMB Control Number. Comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to:
Office of Standards, Regulations and Variances, MSHA
201 12th Street South
Arlington, VA 22202-5452.
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