Form Eia-7a - Annual Survey Of Coal Production And Preparation Page 3

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Department of Energy
OMB No. 1905-0167
U.S. Energy Information Administration
Expiration Date: XX/XX/XXXX
1000 Independence Ave., S.W.
Burden: 3.25 hours
Washington, DC 20585
MSHA ID#:
PART 2: MINE OWNERSHIP INFORMATION
❶
What is the name and location of the mining operation for which you are reporting?
Name:
County:
State:
Report any changes to the pre-populated name and location of the mining operation below:
❷
What is the contact information for the company that owns the mining operation?
Report contact information for the company that owns the Mine Safety and Health Administration (MSHA) ID #.
The company contact person must be able to verify all the information submitted and answer any questions
concerning the information reported on this survey.
The company contact person should NOT be the preparer.
Company’s Name:
Street Address:
City:
State:
Zip Code:
Company’s Contact Person:
Title:
Contact Person’s Telephone:
Contact Person’s Fax:
(
)
―
(
)
―
Contact Person’s Email:
Report any changes to the pre-populated contact information for the company that owns the mining operation below:
❸
Did the company that owns the mining operation cease operations during the reporting year?
Yes — Enter the date the company that owns this mining operation ceased operations
Ceased Operation Date:
/
/
(DD/MM/YY)
No
PART 2 continues on the next page.
Page 3
Form EIA-7A, Annual Survey of Coal Production and Preparation

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