FORM No.

1-A

(To be submitted in triplicate)

APPLICATION FOR MINING LEASE
(See Rule 5)

To
Affix your
The Mining Engineer /
passport size
Assistant Mining Engineer,
photograph
Department of Mines and Geology,
Rajasthan………………………………

Sir,

1. I/We ……………………………………………………………………request you to

grant me/us Mining Lease for mineral……….over an area of………hectares for a
period of ……..years under the Rajasthan Minor Mineral Concession Rules, 1986.

2. I have deposited Rs……………..as the application fee payable under rule 5 vide
demand draft / treasury challan No…..........…..dated…................…..

3. Following are the required particulars:-

(A) Name of the applicant and address…………………………………

………………………………………………………………………

(B) Telephone No. Office …………… Residence ………….………

Fax No. ……………………….…. Cell No. ………………...….
Email address ………………………………………………...…….

(C) In case the applicant is an individual:

(1) Father’s Name/Husband’s Name
(2) Caste
(3) Occupation
(4) Nationality

(D) 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 areas held by the applicant in Rajasthan

S. Name M.L. Mineral for Extent of area Period of lease Location

No. of No. which lease held (in From To of leased
Office is held hectares) area

5. Total area already acquired for the mineral applied for (in hectares)..............….

6. Details of applications already submitted / applied simultaneously:-

1. ……………………………………………………………………
2. ……………………………………………………………………
3. ……………………………………………………………………

7. Are you intending to set up a mineral based industry in the area and consuming this
mineral as raw material. (If so, give particulars of the same.)
……………………………………………….……..…

8. Category to which the applicant belongs (as specified in rules) (Please attach
necessary certificates)
…………..……………………………………..…….

9. (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 along
with latitude and longitude of reference point.
......……………………………………….……....….

(b) Please enclose a copy of khasra map covering the applied area and a copy of
Revenue jamabandi 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.
………………………………………………….…….

10. Number and date of no dues certificate in respect of payment of mining dues (Copy
attached). …………………………………………………..………

(If on the date of application the applicant does not hold a prospecting licence /
mining lease / contract etc., an affidavit to this effect shall be enclosed)

11. Please indicate the distance of the following from the applied area:

(a) Any important tank or dam falling within 1.00Km. radius of applied area.
……………………………………….……………………….
 (b) Any important temple, mosque or any other place of worship or place of
archaeological, tourist importance including burial ground etc. falling within 1.00
Km. radius of the 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 reservoir etc.
within a radius of 1.00 Km. from the applied area. ..………

12. Please indicate if the applied area has been notified by the Government or by any
local authority for any other public or special purposes, give details.……

13. Self attested copy of anyone of the following document is to be enclosed –

(i) Copy of PAN Card;

(ii) Copy of Driving Licence;
(iii) Copy of Voter Identification Card;
(iv) Copy of Passport
(v) Bank Pass Book

I / We declare that particulars given above are correct and I / We will furnish any other
details required in the connection on demand.

Yours Faithfully

Signature of applicant

Submitted by
Signature …………………..
Name & Address
……………………………….
Place:_____________
Date:_____________

Note: 1. The information from para 9 (b) to 11 is required to have an idea of the status
and the surface features of the applied area. The said information shall be furnished
within a period of 30 days of the presentation of the application failing which the
application shall be liable to be rejected.

Note: 2. The restrictions on the grant of mining lease will remain the same as envisaged
in chapter II of these rules.