FORM A

To be submitted in quadruplicate

Received at........................(place) on...................(Date)

Initial of Receiving Officer

GOVERNMENT OF……………

(Application for Reconnaissance Permit)

[See rule 4]

                                                                       Dated....................day of..................20

To

Through

Sir,

I/We request that a reconnaissance permit under the Mineral Concession Rules, 1960 be granted to me/us.

2. A sum of Rs...............being the fee in respect of this application at the rate of Rs.5/- per square kilometre or part thereof payable in accordance with the Mineral Concession Rules, 1960 has been deposited.

3. The required particulars are given below:

(i) Name of the applicant with complete address;

(ii) Is the applicant a private individual/private company/public company/firm or association?

(iii) In case applicant is:

(a) an individual, his nationality;

(b) a company, an attested copy of the certificate of registration of the company shall be enclosed;

(c) firm or association, the nationality of all the partners of the firm or members of the association;

(iv) Profession or nature of business of applicant;

(v) No. and date of the valid clearance certificate of payment of mining dues(copy attached);

(vi) If on the date of application the applicant does not hold a reconnaissance permit, it should be stated whether an affidavit to this effect has been furnished to the satisfaction of the State Government;

(vii) Mineral or minerals which the applicant intends to prospect;

(viii) Period for which the reconnaissance permit is required;

(ix) Extent of the area the applicant wants to prospect;

(x) Details of the area in respect of which reconnaissance permit is required:

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              District                                Taluq                                    Area

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(xi) Particulars of the areas mineral-wise within the jurisdiction of the State Government for which the applicant or any person joint in interest with him;

(a) already holds under reconnaissance permit;

(b) has already applied for but not granted;

(c) being applied for simultaneously.

(xii) Nature of joint interest, if any;

(xiii) If the applicant intends to supervise the works, his previous experience of reconnaissance, prospecting or mining operations should be explained; if he intends to appoint a manager, the name of such manager, his qualifications, nature and extent of his previous experience should be specified and his consent letter should be attached;

(xiv) Financial resources of the applicant.

(xv) Particulars of receipted treasury challan attached for the amount referred to at 2 above;

(xvi) The works proposed to be undertaken alongwith their physical annual targets;

(xvii) The scheme of relinquishment of the area;

(xviii) Anticipated minimum annual expenditure (activity of workwise);

(xix) Any other particulars or sketch map which the applicant wishes to furnish.

I/We do hereby declare that the particulars furnished above are correct and am/are ready to furnish any other details, including accurate plans as may be required by you.

                                                                                              Yours faithfully,

(Signature and designation of the applicant)

Place

Date

* The topographical map of 1"=1 mile scale [or 1 : 50,000] is obtainable from the office of the Survey of India,      Hathibarkhala, Dehradun.

   Detailed plan and topographical map are to be attached in quadruplicate with the original    application.

Note: 1. If the application is signed by an authorised agent of the applicant, Power of Attorney                   should be attached.

2.   The application should relate to one compact area only.