Form DMM-200 "Application for Dmm Reciprocity for Certain Dm Certifications" - Virginia

What Is Form DMM-200?

This is a legal form that was released by the Virginia Department of Mines, Minerals and Energy - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2016;
  • The latest edition provided by the Virginia Department of Mines, Minerals and Energy;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DMM-200 by clicking the link below or browse more documents and templates provided by the Virginia Department of Mines, Minerals and Energy.

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Download Form DMM-200 "Application for Dmm Reciprocity for Certain Dm Certifications" - Virginia

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Division of Mineral Mining
900 Natural Resources Drive
Suite 400
Charlottesville, VA 22903
(434) 951-6316
(434) 951-6325 (fax)
Application for DMM Reciprocity for Certain DM Certifications
If you currently hold one or more of the following Division of Mines issued certifications – General Coal Miner,
Surface Foreman, First Class Mine Foreman, Surface Electrical Repairman, Underground Electrical
Repairman, or Chief Electrician, then you may request reciprocity using this form for certain equivalent Division
of Mineral Mining certifications.
Check each of the following Division of Mines certifications that you currently hold that you are requesting
DMM reciprocity:
Surface General Coal Miner or Underground General Coal Miner (reciprocates with DMM’s General
Mineral Miner certification)
Surface Foreman (reciprocates with DMM’s Surface Foreman certification)
First Class Mine Foreman (reciprocates with DMM’s Underground Foreman certification)
Surface Electrical Repairman (reciprocates with DMM’s Electrical Repairman certification)
Underground Electrical Repairman (reciprocates with DMM’s Electrical Repairman certification)
Chief Electrician (reciprocates with DMM’s Electrical Repairman certification)
Complete all sections below by either typing or printing clearly in ink, sign and date in the space indicated, and
submit it to the Division of Mineral Mining with clear copies of your current, valid driver’s license and Division
of Mines certification card.
1. Full Name: _________________________________________________________________________
2. Date of Birth: _________________________________
3. Address: __________________________________________________________________________
Street or P.O. Box
City
State
Zip Code
4. Phone Number (home or cell): _________________________________________________________
I hereby certify that the above answers are true to the best of my knowledge and belief.
Signed:
Date:
Signature of applicant for certification
DMM – 200
05/2016
Division of Mineral Mining
900 Natural Resources Drive
Suite 400
Charlottesville, VA 22903
(434) 951-6316
(434) 951-6325 (fax)
Application for DMM Reciprocity for Certain DM Certifications
If you currently hold one or more of the following Division of Mines issued certifications – General Coal Miner,
Surface Foreman, First Class Mine Foreman, Surface Electrical Repairman, Underground Electrical
Repairman, or Chief Electrician, then you may request reciprocity using this form for certain equivalent Division
of Mineral Mining certifications.
Check each of the following Division of Mines certifications that you currently hold that you are requesting
DMM reciprocity:
Surface General Coal Miner or Underground General Coal Miner (reciprocates with DMM’s General
Mineral Miner certification)
Surface Foreman (reciprocates with DMM’s Surface Foreman certification)
First Class Mine Foreman (reciprocates with DMM’s Underground Foreman certification)
Surface Electrical Repairman (reciprocates with DMM’s Electrical Repairman certification)
Underground Electrical Repairman (reciprocates with DMM’s Electrical Repairman certification)
Chief Electrician (reciprocates with DMM’s Electrical Repairman certification)
Complete all sections below by either typing or printing clearly in ink, sign and date in the space indicated, and
submit it to the Division of Mineral Mining with clear copies of your current, valid driver’s license and Division
of Mines certification card.
1. Full Name: _________________________________________________________________________
2. Date of Birth: _________________________________
3. Address: __________________________________________________________________________
Street or P.O. Box
City
State
Zip Code
4. Phone Number (home or cell): _________________________________________________________
I hereby certify that the above answers are true to the best of my knowledge and belief.
Signed:
Date:
Signature of applicant for certification
DMM – 200
05/2016