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MSHA Form 5000-23, May 13 (revised)-2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the full name of the person trained in the designated field. Ensure accuracy as this is a critical component of the certification.
- Select the type of approved training received by checking the appropriate box. Options include Annual, Experienced Miner, Refresher, New Task, and New Miner. If applicable, specify any new tasks below.
- Indicate the type of operation and related industry by checking one or more boxes that apply, such as Surface, Underground, Coal, or Metal.
- Fill in the date when training requirements were completed. If not completed, check the corresponding box and proceed to item 5.
- If training is partially completed, check all subjects that have been completed from the provided list.
- Ensure that both signatures are obtained: one from the person responsible for training and another from the person trained.
- Finally, enter the mine name, ID, and location of training before saving your document.
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Related links
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