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Schedule 9: Application for Renewal of Mining Licence

Mineral Resources (Sustainable Development) Act 1990 - Section 29(1)
Mineral Resources Development Regulations 2002 - Regulation 22

Application for Renewal of Mining Licence No:

1. Name and address of applicant(s) (if the applicant is a company, the registered address of the company):

Name:

Address:

Postcode:

Telephone:

Name:

Address:

Postcode:

Telephone:

Name:

Address:

Postcode:

Telephone:

Name:

Address:

Postcode:

Telephone:

2. Correspondence and email Addresses:

Address:
Postcode:
Email Address:
Reason for renewal:

4. Program of work:

5. Estimated expenditure for next five years:

6. Term of renewal required:

year/s

7. Signature of applicant(s) see notes 1 and 2 below:

8. Date of Application:

NOTES:

1. Applications made by a company must be signed by a company director or company secretary or alternatively by a person who provides written evidence that he or she is authorised to act on behalf of the company with respect to the application.

2. If an application is made and submitted by a person acting on behalf of another party, the applicant must provide written evidence that he or she is authorised to act on behalf of that other party with respect to the application.

Department of Primary Industries

earth resources

Schedule 9: Application for Renewal of Mining Licence

1. Name and address of applicant(s) (if the applicant is a company, the registered address of the company):

2. Correspondence and email Addresses:

4. Program of work:

5. Estimated expenditure for next five years:

6. Term of renewal required:

7. Signature of applicant(s) see notes 1 and 2 below:

8. Date of Application: