Form A " To be submitted in Triplicate" Received at...(place) On........(date) Initial of Receiving Officer GOVERNMENT OF RAJASTHAN Application for Prospecting Licence {See clause 3(2) of Granite Policy 2002} Dated day of 20... To, The Mining Engineer / Assistant Mining Engineer, Mines & Geology Department, Government of Rajasthan, ....... Sir, 1. I/We request that a prospecting licence for granite and/or other associated minerals under the M.M.C.R. 1986 be granted to me/us. 2. A sum of Rs.1,000/- (Rs. One thousand) being the fee in respect of this application has been deposited. 3. Following are the required particulars: (a) In case the applicant is an individual: (1) Name of the Applicant (2) Father's Name/Husband's Name (3) Cast (4) Occupation (5) Permanent address (b) In case the applicant is Firm/Company/Association/Society: (1) Kind of business (2) Place of business (3) Place of registration (4) Nationality of director/Partners N.B. Please enclose copies of certificate of Firm's registration partnership deed, power of attorney certificate of incorporation, memorandum and Articles of Association and resolution of Board of Directors about applying for mining lease. 4. Details of mining leases and prospecting licences, held by the applicant in Rajasthan S.No. Name of Division Mineral for Extent of Period of Location of which lease area held lease from to lease area is held A. Mining Lease B. Prospecting Licence 5. Details of application, for mining lease and prospecting licences, already submitted/pending/applied for, simultaneously. S.No. Name of Division Mineral for Extent of Period of Location of which lease area lease from to lease area is applied A. Mining Lease B. Prospecting Licence 6. Total area required for the mineral applied for...... 7. Category to which the applicant belongs (as specified in Granite Policy, 2002) (Please attach necessary certificate). 8. (a) Please enclose plan and description report of the applied area with reference to the nearest permanent feature and showing length and bearing of all the lines. (b) Please enclose a copy of Khasra Map covering the applied area and a copy of Revenue jambandi to indicate the status of applied area i.e. to indicate whether the applied area is khatedari Land/Government land/Forest Land/Abadi Land/Charagah/Catchment area of any Dam/Tank etc. 9. Please indicate the distance of the following from the applied area: 10. No. and date of the valid clearance certificate of payment of mining dues (copy attached) 11. If on the date of application the applicant does not hold a prospecting licence, it should be stated whether an affidavit to this effect has been furnished to be satisfaction of the State Government. 12. Does the applicant have surface rights over the area for which he requires a prospecting licence? 13. If not, has he obtained the consent of the owner, and the occupier of the land for undertaking prospecting operations. If so, the consent of the owner and the occupier obtained in writing be filed. I/we do hereby declare that the particulars furnished above are correct and am/are ready A Any important tank or dam falling within 1.00 Km. radius of the applied area. B Any important temple, mosque or any other place of worship or place of archeological, tourist importance including burial ground etc. falling within 1 km. radius of applied area. C Any river, canal/pucca road/ rail line passing within 1.00 km. radius of the applied area. D Any permanent structure like power line/Microwave tower/water reserviir etc. within a radius of 1.00 km. from the applied area. to furnish any other details, including accurate plans as may be required by you. Yours faithfully, (Signature and designation of the applicant) Place: Date: 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. 3. Detailed plan and map is to be attached in triplicate with the original application for proper demarcation of the area. 4. The restriction on grant of Prospecting Licence shall remain same as envisaged in the CCDR 99, MMCR 86 and Granite Policy 2002.
