FORM-F Sec Rule 19 (2) Application for Renewal of quarrying lease. From: Dated: Telephone No: To, Sir, I /We submit an application for the renewal of the quarrying lease under the Goa, Daman & Diu Minor Mineral Concession Rules 1985. 2. The required particulars are given below: (i) Name and address of the applicant stating whether he or it is an individual, company or society ________________. (ii) Mineral/Minerals for which the renewal is applied.____________. (iii) Particulars of the original quarrying lease: (a) Village/Forest Block or range __________________________. (b) Survey No. /Nos _____________________________________. (c) Area in each Survey No._________________________. (d) Mineral/Minerals ____________________________________. (e) No. and date of order granting the lease __________________________________________________. (f) Rate of Dead Rent __________________________________. (g) Period for which the lease was granted __________________ __________________________________________________. (h) Date of expiry of the lease ____________________________. (i) Quarrying lease No. _________________________________. 3. Details about the area in regard to which renewal is applied for; (i) Whether the area applied for is the whole or part of the lease hold______________________________________________. 2 (ii) in case it is for a part of the lease hold : (a) The area applied for _______________________. (b) Description of the area _____________________. (c) Whether a map is enclosed._________________. 4. Means by which the mineral/minerals is/are to be raised (Manual or Mechanical) _____________________________. 5. Investment in the quarrying operation (give details) __________________________________________________. 6. Period for which renewal is applied for __________________. 7. Manner in which the Mineral/Minerals is/are to be utilized : (a) For manufacture: ______________________________. (b) For sale ______________________________________. (c) For any other purpose ___________________________. 8. Details of output during the last three years and quantity expected to be raised during the next three years (separate sheet to be attached). 9. Have all dues on the existing quarrying lease been paid to Government _______________________________________. 10. Any other particulars which the applicant wishes to furnish____________________________________________. I/we hereby declare that the particulars furnished above are correct an I/We am/are ready to furnish any other details plans, etc. as may be required. Yours faithfully, Signature of the applicant. Place; Date: N.B. If the application is signed by an authorized agent of the applicant, the power of the Attorney should be attached.
