Application forms FORM- B (See Rules 18, 39 and 48) Received at (Place).............................................................................................................................. On (date).............................................................................................................................................. at (hour) .............................................................................................................................................. Initials of Receiving officer ..................................................................................................................... Application for Grant/ Renewal of Quarrying Lease (For the all types of lands) to be submitted in triplicate. From To The Director of Mining & Geology,Through the Geologist,District Office, ..............................District. Sir, I / We beg to apply for the grant/ renewal of a quarrying lease under the Kerala Minor Mineral Concession Rules, 1967. 2. A sum of Rs.1000 being the application payable under Rule .................. of the said rules has been deposited. 3. The required particulars are given below: (i) Name and complete address of the applicant. (ii) Is the applicant a private individual/ private company/ public company/ firm/ association. (iii) In case the applicant is (a) an individual, his nationality(b) a private company, the names and nationality of all members and place of registration.(c) a public company, the names and nationality of Directors, the percentage of share capital held by Indian nationals and place of Incorporation(d) a firm or association, the names and nationality of all the partners of the firm or members of the association and place of registraion. (iv) Profession or nature of business of the applicant(v) Whether the application is for a fresh lease or for renewal of a lease previously granted.(vi) Minor Mineral or Minerals which the applicant intends to mine.(vii) Period for which the quarrying lease is required.(viii) Approximate quantity of mineral expected to be raised per year(ix) Manner in which the minor mineral raised is to be utilised. (a) for manufacture (b) for sale (c) any other purpose (In case of manufacture the industries in connection with which it is required should be specified) (x) Details of the area in respect of which quarrying lease is required. Attested copies of the survey map of the area with survey numbers clearly marked should be attached to each copy of the application vide rule 27. District: Taluk: Panchayat: Village: Survey No: Area: (xi) Nature of tenure of the land over which quarrying lease is applied for (Documentary proof to show the land owners right if any, over the mineral should be submitted in the case of lands in which the minerals vest partly with the registered holder of the land vide rule 48) (xii) No. and date of the income-tax clearance certificate attached (xiii) Financial resources of the applicant(xiv) Particulars of receipted treasury chalan attached for the amount referred to at 2 above.(xv) Any other particulars 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 security deposits etc. , as may be required by you. Yours faithfully, (Signature of the applicant) Place: Date: 1. Added by G.O.(Ms) 57/93/ID dt.18.5.1993 Pub. in K.G. No. 23 dt. 8.6.1993 as SRO 950/93 2. Substituted by G.O. (Ms) 276/68 dated 1.7.1968. (Note:-Applications made by the Kerala Mineral Development Corporation may be submitted directly to the Director of Mining and Geology)N.B: In respect of cases governed by chapter VI only the necessary details as specified in the related rules may be furnished.