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Metalliferous Mines Regulations, 1961 - Directorate General of ...

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I have to furnish the following particulars in respect <strong>of</strong> (I) ……………… at …………(Name)<br />

………….(mineral) mine <strong>of</strong> ……………………………(owner) :<br />

____________________________________________________________________________________<br />

1. *In case <strong>of</strong> CHANGE OF NAME OR MINE :<br />

old name <strong>of</strong> mine …………………….. date <strong>of</strong> change ……………………………..<br />

____________________________________________________________________________________<br />

2. (a) Situation <strong>of</strong> the mine : Village …………………………… Police Station ………………..Sub-<br />

Division (Taluq) …………………State………………………………….<br />

*(b) In case <strong>of</strong> ANEW MINE, particulars <strong>of</strong> situation <strong>of</strong> mine :<br />

Post Office ……………………….. Telegraph Office ……………………………………..<br />

Railway Station …………………………………… Rest House ………………………………….<br />

(Give distance therefrom)<br />

Means <strong>of</strong> travelling ………………………………………………<br />

____________________________________________________________________________________<br />

Present Previous*<br />

3. (a) Name and Postal address <strong>of</strong> (ii)<br />

(a) Owner ………………………..<br />

(b) Managing agent ,if any …………..<br />

(c) Agents, if any………………….<br />

(d) Manager ………………………<br />

*(b) In case <strong>of</strong> change, date <strong>of</strong> change ………………….<br />

____________________________________________________________________________________<br />

*4. (a) Name and qualifications etc. <strong>of</strong> Manager/Assistant Manager/Underground Manger/<br />

Engineer/Surveyor (iii) whose appointment is terminated/who is appointed (iii):<br />

(b) Date <strong>of</strong> appointment/termination <strong>of</strong> appointment (iii) :<br />

____________________________________________________________________________________<br />

*5 Date on which it is intended to open/re-open/abandon/discontinue (iii) the mine :<br />

____________________________________________________________________________________<br />

*6 Actual date <strong>of</strong> opening/Re -opening abandonment/discontinuance (iii) <strong>of</strong> the mine :<br />

____________________________________________________________________________________<br />

INSTRUCTIONS<br />

(i) Mention the matter to which the notice refers.<br />

(ii) Need not be filled in if the notice relates to Item 4,<br />

(iii) Delete whatever is not applicable.<br />

*Only such columns to be filled in respect <strong>of</strong> which notice in given.<br />

-------------<br />

Yours faithfully,<br />

Signature …………………………<br />

Designation : Owner/Agent/Manager<br />

Date ………………………………..<br />

FORM II<br />

(See Regulation 4)<br />

Quarterly Return for the quarter ending ………..19<br />

1. Name <strong>of</strong> mine ………………….Mineral worked …………………….postal address <strong>of</strong> mine ……….<br />

2. Situation <strong>of</strong> Mine : Place District ……………………………..

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