To fill out MSHA Form 5000-23, the Certificate of Training, you enter the miner’s name, check the type of training and the type of mine, record the completion date and training location, and have the person responsible for the training sign it. The form documents that a miner has completed the safety and health training required by the Mine Safety and Health Act of 1977, and a copy goes to the miner after each training event.1Mine Safety and Health Administration. MSHA Form 5000-23 The details that matter most vary by which regulation covers your operation, so start there before you touch the form.
Know Whether Part 46 or Part 48 Applies
Two sets of rules govern this certificate, and they impose different requirements on instructors and paperwork.
Part 46 covers surface non-metal mines: sand, gravel, surface stone, surface clay, colloidal phosphate, and surface limestone. Training may be delivered by any “competent person,” with no MSHA approval of the instructor required. You can use Form 5000-23 or any alternate form that contains everything listed in 30 CFR 46.9(b).2eCFR. 30 CFR Part 463eCFR. 30 CFR 46.9 – Records of Training
Part 48 covers underground mines, surface coal mines, and surface metal/non-metal operations not covered by Part 46. Instructors must be MSHA-approved, and training must be recorded on Form 5000-23 or an MSHA-approved alternate form.4eCFR. 30 CFR Part 48
Independent contractors working at both Part 46 and Part 48 surface operations can satisfy both by complying with Part 48 alone. Contractors working only at Part 46 sites need only Part 46 training.
Where to Get the Form
Download the printable PDF from the MSHA forms page at msha.gov.5Mine Safety and Health Administration. Forms and Online Filing The printed version is a four-part carbonless set:6Mine Safety and Health Administration. 5000-23 Instructions
- Copy 1 (white) is the employer’s personnel record.
- Copy 2 (pink) is the employee’s record copy.
- Copy 3 (yellow) is the employee’s separation copy, handed over when the miner leaves.
- Copy 4 (green) is the recordkeeping file.
MSHA also accepts online filing. A digital submission generates a downloadable PDF that meets distribution requirements without carbonless paper.
Completing Each Item
The form has eight numbered items and an optional serial number field at the top.
Serial Number and Item 1
The serial number is optional. Some operators use it as an internal employee tracking number, but nothing federal requires it.7Mine Safety and Health Administration. Instructions for Completing MSHA Training Form 5000-23 Item 1 takes the miner’s full legal name: first, middle, and last.
Item 2: Type of Approved Training Received
Check the box for the training the miner completed:
- New Miner, for someone with no mining experience. Under Part 48, underground new miners need at least 40 hours; surface new miners need at least 24, with a minimum of 8 hours before starting work duties.4eCFR. 30 CFR Part 48
- Experienced Miner, for miners already holding mining experience who are starting at a new site.
- New Task. When you check this box, write in the specific task name and have both instructor and miner initial each task entry.
- Annual Refresher, the eight hours required every 12 months.
- Hazard Training, site-specific hazard awareness training used primarily under Part 46.
Item 3: Type of Operation
This item has three parts. Mark the commodity (coal, metal, or nonmetal). Mark the location (surface or underground). Check the third box if the training relates to construction or shaft and slope work.7Mine Safety and Health Administration. Instructions for Completing MSHA Training Form 5000-23
Item 4: Date Training Requirements Completed
Enter the date training finished. A date alone signals that the entire program checked in Item 2 is complete. If it is only partially finished, such as the classroom portion of new miner training done but site-specific instruction still pending, check the box to the right of the date and fill out Item 5.7Mine Safety and Health Administration. Instructions for Completing MSHA Training Form 5000-23
Item 5: Subjects Completed (Partial Training Only)
Only use Item 5 when Item 4 shows partial completion. The form lists 19 subject areas covering hazard recognition, emergency medical procedures, self-rescue devices, roof and ground control, mine gases, explosives, and electrical hazards, plus an “Other” field.8Mine Safety and Health Administration. Certificate of Training MSHA Form 5000-23 Situations that call for a partial entry include running annual refresher training in segments over several months or delivering classroom training off-site before the miner arrives.
Item 6: Signature of Person Responsible for Training
Signing here certifies that the miner actually received the training shown. Under Part 46, the signer must be the individual named in the MSHA-approved training plan as responsible for health and safety training.9Mine Safety and Health Administration. Compliance Guideline for MSHA’s Part 46 Training Regulations Under Part 48, it is typically the mine operator or someone acting on the operator’s behalf. Falsifying this signature is a criminal offense under Section 110(a) and (f) of the Mine Act.7Mine Safety and Health Administration. Instructions for Completing MSHA Training Form 5000-23
Item 7: Mine Name, ID, and Location of Training
Enter the mine name, the seven-digit MSHA Mine ID (formatted like 01-23456), and the physical location where training took place.5Mine Safety and Health Administration. Forms and Online Filing If training happened at an outside institution rather than on-site, list the institution’s name and address here.
Independent contractors use their own MSHA contractor identification number, obtained by filing Form 7000-52, in place of the production-operator’s mine ID.10Mine Safety and Health Administration. Contractor ID Request
Item 8: Date and Signature of Person Trained
The miner may sign and date this field to acknowledge the training. Their signature is not required for the form to be valid, but it adds verification if the record is later questioned during an inspection.1Mine Safety and Health Administration. MSHA Form 5000-23
Extra Fields Part 46 Operators Have to Add
Even if you use the standard Form 5000-23, 30 CFR 46.9(b) requires you to record the duration of training, and the printed form has no dedicated hours field. Add the duration in the margin or on an attached sheet so the record is complete.
If you use an alternate form under Part 46 instead of the 5000-23, that form must include the training duration, the name of the competent person who provided it, the MSHA mine ID or independent contractor ID number, and the location where training occurred. It must also display, in bold conspicuous lettering, the statement: “False certification is punishable under ยง 110(a) and (f) of the Federal Mine Safety and Health Act.”3eCFR. 30 CFR 46.9 – Records of Training
Giving the Miner a Copy
Under Part 48, the operator must give the miner a copy of the completed certificate at the completion of training.11eCFR. 30 CFR 48.29 – Records of Training Under Part 46, miners can request a copy at any time.12Mine Safety and Health Administration. Training FAQs for Miners With the printed four-part form, the pink Copy 2 goes to the miner as their personal record. The yellow Copy 3 stays with the employer and is handed to the miner on separation.6Mine Safety and Health Administration. 5000-23 Instructions
Miners moving between sites should hold onto their personal copies. A certificate doesn’t automatically transfer the training obligation to a new employer, who still evaluates experience and may require site-specific training, but the record can shorten what the next operator has to provide.
How Long to Keep Certificates
Under Part 48, certificates for currently employed miners must be kept at the mine site for two years. After a miner leaves, retain the records for at least 60 days following termination. Certificates must be available at the mine site for MSHA inspection, examination by miners or their representatives, and review by state inspection agencies.11eCFR. 30 CFR 48.29 – Records of Training
Under Part 46, keep certificates for the entire duration of a miner’s employment for most training types. Annual refresher training under 30 CFR 46.8 is the exception: two years is enough, even while the miner is still on staff. After a miner leaves, retain all records for at least 60 calendar days.3eCFR. 30 CFR 46.9 – Records of Training
Under both parts, records live at the mine site or a nearby location where they are readily accessible. Inspectors can ask for them at any point during an inspection, and miners or their authorized representatives have the right to examine them.
Falsification Is a Crime
Signing a Form 5000-23 that misrepresents the training given is prosecutable under Section 110(a) and (f) of the Mine Act, which can carry both fines and imprisonment. Civil penalties for training and recordkeeping violations range from $112 to $70,000 per violation depending on severity, calculated on the operator’s violation history, business size, negligence, gravity, and how quickly the problem was corrected.13Mine Safety and Health Administration. Mine Safety and Health Enforcement14Mine Safety and Health Administration. Penalty Assessments and Payments A minor paperwork error corrected promptly lands near the low end. A pattern of missing or falsified certificates, especially where miners were sent to work untrained, pushes penalties higher and can bring a temporary shutdown until training is verified.