FORM - G

Register of Applications for Prospecting Licences

[See rule 21(1)]

1. Serial No.

2. Date of application of P.L.

3. Date on which application was received by the Receiving Officer.

4. Name of the applicant with full address.

5. Situation and boundaries of the land applied for.

6. Estimated area of the land.

7. Particulars of the minerals which the applicant desired to prospect.

8. Application fee paid.

9. Remarks.

10. Final disposal of the application together with number and date of the order.