(Office Use Only)
www.dme.qld.gov.au ABN 98 628 485 885
APPLICATION TO AMEND RELINQUISHMENT
CONDITION OF MINING LEASE
Mineral Resources Act 1989
Form Number MRA-47 Version Number 1
OFFICIAL USE ONLY The completed original of this application and any attachments must be submitted with
the prescribed fee at the Office of the Mining Registrar for the mining district in which
the land is situated.
Received AT Received BY
Note: A document containing information that is false or misleading may attract a maximum
penalty of 200 penalty points.
DATE TIME If form is to be completed by hand please print clearly in ink and use block letters.
NOTE: This application is to be used where a Mining Lease is granted for coal or oil
/ / : PM shale and contains a relinquishment condition, and the whole or part of the tenure area
of the lease is in the tenure area of an Authority to Prospect for Petroleum.
FEE Paid RECEIPT no. 1. MINING LEASE AND MINING LEASE HOLDER DETAILS
Mining Lease Number 1.1
ENTERED on register by Specify Mining District 1.2
Company Name/Surname 1.3
DATE / / Given Name(s) 1.4
GUIDE FOR ACN (if company) 1.5 Percentage 1.6 %
Question 1.1 Company Name/Surname 1.3
Inset the mining lease number.
Given Name(s) 1.4
Insert the Mining District in which
mining lease is situated. ACN (if company) 1.5 Percentage 1.6 %
Question 1.3 - 1.6
Specify current holder(s) details and Company Name/Surname 1.3
percentage of interest held.
Question 1.7 Given Name(s) 1.4
The total interest must equal 100%.
If you are entering these details
online, right click the ‘0’ and select ACN (if company) 1.5 Percentage 1.6 %
Company Name/Surname 1.3
Given Name(s) 1.4
ACN (if company) 1.5 Percentage 1.6 %
Total Percentage 1.7 %
APPLICANTS 2. MINING TENEMENT DETAILS
Was the mining lease granted with a specific relinquishment condition?
Indicate if the2.1, 2.2 & 2.3granted
Question mining lease is
with the corresponding box to indicate
Tick a relinquishment condition.
2.1 YES (go to Q 2.2) NO (see below)
if a caveat is registered.
Note: conditions attached to the mining
If there is and the section forbids theof
lease pursuant to caveat 276(1)(n) Note: This form can only be used if the mining lease was granted with specific
the MRA will be stated in the grant
approval of this assignment, the relinquishment condition.
letter and written consent using
caveator’sInstrument of Lease MRA-
document this assignment must be
23 form to (if issued).
State the condition to be amended
Provide details of the condition to be 2.2
Question 2.3 & 2.6
Provide a written copy of the proposed
If there are mortgages registered
please tick the YES box and state the
full name of the mortgagee and
indicate if assignment is attached.
State if the mining lease in the area of Provide a written copy of the amended condition the mining lease shall be
an ATP. subject to.
Provide details of the ATP. Is the mining lease in an area of an Authority to Prospect (ATP)?
If the assignment is subject to an
exercise a power of sale under a
Question 2.6 MRA-34 application
mortgage, attach 2.4 YES (go to Q 2.5) NO (see below)
The mining lease holder must have
made reasonable attempts to consult
with the ATP holder prior to lodgement Note: This form can only used for mining leases overlapping with an ATP.
of this application as outlined in
State the ATP number.
Enter the name of place where the Number(s) Expiry Date(s)
Question 3.1 - 3.3 the day of the
application was signed,
If the mining lease is granted for coal
month, the month and the year when 2.5 Authority to Prospect / /
or oil shale and is
the form is signed.within an area of a
petroleum lease, the assignee and
Question 3.2holder must be parties
to a coordination arrangement.
Has the holder made reasonable attempts to consult with the ATP holder about the
Insert full name of the applicant(s). amendment and proposed later development plan.
Question 3.3 2.6 YES (go to Q 3) NO (see below)
Signature of applicant(s).
Execution of Documents by Note: This application can only be made if the holder, before making this application
an Agent has made reasonable attempts to consult with the ATP holder.
If an agent or the holder of a power of
attorney is signing a document,
required to be lodged by an Act, on 3. SIGNATURES
behalf of another, the agent or holder
of the power of attorney must produce
current, written evidence of their I/We:
authority to act at the time of solemnly sincerely and truly declare that the information provided in this form
lodgement. is true and correct.
All of the holders of the tenure MUST understand that any false or misleading information may attract a maximum
execute the appointment of agent or penalty of 200 penalty points.
the power of attorney for the
appointment or power of attorney to be
effective. A company signing an
appointment of agent or power of 3.1 Signed at this day of , 20
attorney must do so in accordance with
the Corporation Law and/or the articles
of association of the company. 3.2 3.3
Insert full name of Witness.
Signature of Witness 3.2 3.3
GUIDE FOR 3.2 3.3
Tick the appropriate boxes to indicate 3.2 3.3
Note: The applicant must immediately
after making the application give the Full name and title of Applicant(s) Signature
authority to prospect holder a copy of
Full name of Witness Signature of Witness
The Department of Mines and Energy
is collecting the information on this
form to process your application for
amendment to a relinquishment 4. ACCOMPANIMENTS
condition on a mining lease. This is
required by section 318DC of the The following must accompany this form:
Mineral Resources Act 1989 (the Act).
Information collected on this form may
be provided to other Queensland • Prescribed fee
Government Agencies to assist in the
processing of applications, where such
disclosure is necessary for the • A statement detailing whether the current development plan has
effective management of the mineral been complied with. If the development plan has not been
resources and industry in Queensland. complied with, state the details of and reasons for non-
These agencies may include the
Environmental Protection Agency, the compliance
Department of Primary Industries and
Fisheries and the Department of
Natural Resources and Water.
• A Coal Seam Gas (CSG) Statement
For more information on Information
Privacy, please contact the Privacy
• Proposed later development plan for the lease as amended
Contact Officer for the Department of under section 318DA
Mines and Energy on (07) 324 73239.
• Written copy of the amended condition the mining lease shall be
• Instrument of Mining Lease for endorsement
• A detailed statement specifying-
o The details of the consultation carried out under section
o The results of the consultation;
o Whether the proposed development plan includes all
provisions proposed by the ATP holder under section
o If the proposed development does not include a provision
proposed by the ATP holder – why it was not included;
o The applicant’s assessment of the potential for the
applicant and the ATP holder to make a coordination
arrangement about –
A. Coal or oil shale or incidental coal seam gas mining
under the amended mining lease; and
B. Petroleum production under any future petroleum
lease over the land that may be granted to the ATP