GOVERNMBNT OF RAJASTHAN

							                         +GOVERNMBNT OF RAJASTHAN
             DEPARTMENT OF MINES & GEOLOGY, RAJSTHAN
                                      FORM No.1-C
                       Application for grant of Quarry License
                                     [See rule 22]
To,
       The Mining Engineer/Assistant Mining Engineer,
       Department of Mines & Geology , Rajasthan,


Sir,
       I/We………………request you to grant me/us quarry licence for
mineral………..over Plot No…………..in area 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 23 vide
demand draft/treasury Challan No……………Receipt No………..dated………..
       3. Following are the required particulars:
       (A)    In case the applicant is an individual
       (1)    Father's Name/Husband's Name
       (2)    Cast
       (3)    Occupation
       (4)    Nationality
       (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 Directors/Partners.
N.B.   Please enclose copies of certificate of Firm's registration, partnership deed, power
       of attorney, Certificate of incorporation, Memorandum of Articles and Articles of
       Association and resolution of Board of Directors about applying for quarry
       licence.
       1.     Details of areas held by the applicant in Rajasthan (Mining leases or
              quarry licences already held).
S.No.   Name of Mineral for which Extent of area period of lease/                     Location of
        Division lease/        quarry held (Give plot Quarry Licence                  lease/
                 licence is held      Nos. of quarry                                  Quarry
                                                      from      to
                                      licence                                         licence
  1           2                3                      4                5       6             7


         5.       Details of Lease/Licence applied for simultaneously
         1…………………………………………………………………………………..
         2………………………………………………………………………………….
         3……………………………………………………………………………………..
         6.       Category to which the applicant belongs (please attach necessary
                  certificates)
                  (i)      manual workers belonging to Scheduled Caste/Scheduled Tribes;
                  (ii)     Manual workers other than those belonging to Scheduled
                           Caste/Scheduled Tribes, Village artisans & land less labourers;
                  (iii)    Persons belonging to Scheduled Caste/Scheduled Tribe other than
                           those specified in category (I);
                  (iv)     Persons selected under "Integrated Rural Development
                           Programme" of the State Government;
                  (v)      Village artisans and land-less labourers.
                  (vi)     Ex-soldiers including members of para-military forces belonging
                           to Rajasthan who have been permanently disabled and dependents
                           of those have been killed in action;
                  (vii)    State Government Servant who have been permanently disabled
                           while on duty or the dependents of those Stte Government servants
                           who have been killed on duty; and
                  (viii)   Persons from categories other than specified.
         7.       Are you intending to set up a mineral based industry in the area using this
                  mineral as raw material. (If so give particulars of the same)
                 I/We declare that particulars given above are correct and I / We will
         furnish any other details required in this connection on demand.
                                                                            Yours faithfully,
                                                                           (Signature………….)
                                                                           Name :………………
                                                                   Present address: ……………
   Place: ………………
   Date:…………