Mineral Sale Management and Monitoring System

Name of the Village/Town ^*:

Hadbast Number ^*:

Tehsil ^*

District: ^*

Khasra no. ^*:

Khasra no. of the land (alongwith a copy of Jamabandi with No./date)^*:

Name of drainage system/Canal^*:

Reduce Distance (RD) number of drain/canal^*:

From^*:

To^*:

Approved estimate no. ^*:

Approved estimate date^*:

Copy of abstract of estimate^*

Copies of cross-sections of Channel^*:

Place of disposal^*:

Upload copy of NOC(s) :

Forest department (if applicable):

Not Applicable

Public works department (if applicable):

Not Applicable

Railway department (if applicable):

Not Applicable

Any other (if applicable):

Not Applicable

Work Executing Agency:

Contractor Department

Detail of officer nominated by concerned Executive engineer for creation of login ID to generate the weighment slips/Transit slips of material to be extracted:

Name of assigned officer^*:

Designation^*:

Email ID^*:

Mobile number^*:

Detail of contractor for creation of login ID to generate the weighment slips/Transit slips of material to be extracted:

Name of company/firm/agency^*:

Owner Name of Company^*:

Email ID^*:

Mobile number^*:

PAN Number^*:

GST Number^*:

Copy of Work order/Agreement between contractor and department ^*:

Bank account detail:

Name of Bank:

Account Holder Name:

Bank Account Number:

IFSC code:

Fees

Royalty
DMF
EMF
TCS @2%
Security @50%
Application Fees
Total	-

I hereby undertake that:

Area is free from Section 4 and/or 5 of the Punjab Land Preservation Act, 1900 and any kind of forest
Digging of the earth at the site is not prohibited by any court of law or any authority or otherwise
He will abide by all relevant provisions for excavation of earth; and
Compensation has been settled with the land owner mutually and a copy of the agreement signed between the applicant and the landowner qua-mutual settlement of the compensation is attached (in case land is owned by the applicant himself, the proof thereof).
Any other Condition applicable as per PMMR 2013
I hereby undertake that the work being executed under this permit shall be in accordance with National FrameWork issued by MoEF&CC

Applications submitted with any or whole wrong/ information will be rejected upon notice and the applicant will be debarred from applying for a period of ___years.

APPLICATION FOR FORM K3

Description of the land from which the minor mineral is to be extracted and removed

Upload copy of NOC(s) :

Detail of officer nominated by concerned Executive engineer for creation of login ID to generate the weighment slips/Transit slips of material to be extracted:

Detail of contractor for creation of login ID to generate the weighment slips/Transit slips of material to be extracted:

Bank account detail:

Fees

I hereby undertake that: