
Reset Form Representative of Miners Designation Form U.S. Department of Labor Mine Safety and Health Administration Approved OMB Control Number 12190042, is approved for use through 12/31/2023 Purpose:.
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How to fill out the DOL MSHA Form 2000-238 online
The DOL MSHA Form 2000-238 allows individuals or organizations to declare their representation of two or more miners at a mine. This guide provides step-by-step instructions on how to complete this form online effectively.
Follow the steps to complete the DOL MSHA Form 2000-238 online
- Press the ‘Get Form’ button to access the online version of the DOL MSHA Form 2000-238.
- In Item 1, select the type of filing by checking the appropriate box based on whether this is an initial filing, an update, or if the type is unknown.
- In Item 2, indicate if you wish for the designation to remain confidential by checking the box if applicable, which will keep the miners' identities hidden.
- Complete Item 3 with the necessary information regarding the representative’s name, address, city, state, zip code, telephone number, and email address, ensuring all required fields are filled out accurately.
- In Item 4, provide the name of the mine operator or contractor, along with the Mine MSHA ID Number to accurately identify the mine related to this designation.
- For Item 5, specify the scope of designation by selecting whether the representative serves for all purposes or is limited to specific sections of the Mine Act.
- If applicable, use Item 6 to list any additional or alternate representatives. Make sure to fill in their respective details as required.
- Finally, complete Item 7 by providing the names and telephone numbers of at least two miners who designate you as their representative. Ensure compliance with confidentiality requirements if applicable before submitting.
- Once the form is completed, you can save your changes, download the form, print it, or share it as necessary.
Start filling out the DOL MSHA Form 2000-238 online today to ensure proper representation and compliance.
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