Get the free MSHA Statement of Concern and Request For Action

OSHA Statement of Concern and Request For Action All submissions will be discussed by Policy Council1. State, as briefly as possible, the concern you wish to address:2. List reasons that action or

How to fill out msha statement of concern

How to fill out msha statement of concern

1. To fill out MSHA Statement of Concern, follow these steps:
2. Download the MSHA Statement of Concern form from the MSHA website or obtain a hard copy from the nearest MSHA office.
3. Read the instructions carefully to understand the information required and the purpose of the form.
4. Provide your personal details, including your name, address, contact information, and MSHA identification number if applicable.
5. Clearly state the nature of your concern and provide all relevant details. Use concise and specific language to describe the issue or problem you want to address.
6. If necessary, attach any supporting documents or evidence that can substantiate your concern.
7. Sign and date the form to certify the accuracy and truthfulness of the information provided.
8. Submit the completed form to the appropriate MSHA office either by mail or in person.
9. Keep a copy of the filled-out form for your records.

Who needs msha statement of concern?

1. Anyone who has concerns related to mine safety and health issues needs the MSHA Statement of Concern.
2. This includes mine workers, contractors, inspectors, or any individual who wants to report potential hazards, violations, or unsafe conditions in the mining industry.
3. By submitting the MSHA Statement of Concern, individuals can raise awareness and prompt MSHA to take appropriate actions to address the reported concerns.

For pdfFiller’s FAQs

Can I create an electronic signature for signing my msha statement of concern in Gmail?

You can easily create your eSignature with pdfFiller and then eSign your msha statement of concern directly from your inbox with the help of pdfFiller’s add-on for Gmail. Please note that you must register for an account in order to save your signatures and signed documents.

Can I edit msha statement of concern on an iOS device?

You certainly can. You can quickly edit, distribute, and sign msha statement of concern on your iOS device with the pdfFiller mobile app. Purchase it from the Apple Store and install it in seconds. The program is free, but in order to purchase a subscription or activate a free trial, you must first establish an account.

How do I complete msha statement of concern on an Android device?

On Android, use the pdfFiller mobile app to finish your msha statement of concern. Adding, editing, deleting text, signing, annotating, and more are all available with the app. All you need is a smartphone and internet.

What is msha statement of concern?

MSHA statement of concern is a written notification submitted to the Mine Safety and Health Administration regarding potential hazards or violations in a mine.

Who is required to file msha statement of concern?

Anyone who is aware of potential hazards or violations in a mine is required to file an MSHA statement of concern.

How to fill out msha statement of concern?

To fill out an MSHA statement of concern, one must provide detailed information about the potential hazard or violation, including location, description, and any supporting evidence.

What is the purpose of msha statement of concern?

The purpose of an MSHA statement of concern is to alert the Mine Safety and Health Administration to potential hazards or violations in a mine, in order to prevent accidents and ensure the safety of miners.

What information must be reported on msha statement of concern?

Information such as the location of the hazard or violation, a detailed description of the issue, any supporting evidence, and contact information of the person filing the statement must be reported on an MSHA statement of concern.