Mine Safety and Health Administration

Official Website: https://www.msha.gov/

The Mine Safety and Health Administration works to prevent mining related deaths, injuries, and illnesses through mine regulations, inspections, and training programs.

Forms & Documents

Browse all Mine Safety and Health Administration government forms

All 14 forms

Form Title Topics
Certificate of Electrical/Noise Training
Certificate of Physical Qualification for Mine Rescue Work
Certificate of Training
Electrically Operated Equipment Field Approval Application (Coal Only)
Health Activity Certification or Hoisting Engineers Qualification Request
Legal Identification Report
Mine Accident, Injury and Illness Report
Mine ID Request
Operator’s Annual Certification of Mine Rescue Teams Qualifications
Quarterly Mine Employment and Coal Production Report
Record of Individual Exposure to Radon Daughters
Representative of Miners Designation Form
Request an MSHA Individual Identification Number (MIIN)
Self Contained Self Rescuer (SCSR) Inventory and Report

Contact Information & Office Locations

1 contact point

Mine Safety and Health Administration

201 12th St S
Suite 401
Arlington, VA 22202-5450

Phone numbers:
  • (202) 693-9400

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