In accordance with WV Code 22A-2-63, application for extension of Certificates of Approval must be submitted to the Office of Miners’ Health, Safety and Training within thirty days after the first day of January of each year. Please keep in mind that NO EXTENSIONS for the new year will be ISSUED BEFORE January 1. Approved Extensions will be issued the first week in February.
Please carefully read the instructions and if you have questions, contact one of our offices or use the contact link below to email your question.
The Office of Miners’ Health, Safety and Training is providing PDF forms for extensions. You will need a current version of Adobe Reader in order to complete the application. You can complete these forms digitally, but they cannot be sent electronically without a legal signature of a company official. The Application and General Information forms have been combined into one PDF Document.
1. Download the appropriate form:
- 2024 Independent Contractor Certificate of Approval Extension Application
- Application for Exemption
- Approved Inactive Status
2. Complete the form. Your WV MHS&T Permit Number is critical for your application to be processed properly. Not sure of your permit number? View a status list of all current permits here: WV Permits Listings
Verify your Permit Number before you enter data!
3. Once the form is complete you will need to print it out (you can save a copy to your hard drive if you want a digital copy).
4. The completed form must be signed and dated by a company official. We must have a legal signature of a company official on the form.
5. The completed form may be mailed or faxed to our Charleston Office (304-558-6091). The address and fax number is on the Application. You have the option to email the completed PDF form if you have a digital signature, or you can scan the signed document and send it as an email attachment to the Email addresses below.
6. Your permit fee of $100 may be paid on-line Use this link to pay your Extension fee
7. Penalty Assessments may also be paid on-line Use this link to Pay Penalty Assessments
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