7/25/23, 12:31 PM mineralsportal.jharkhand.gov.in/portal/epass/ePassFormD.aspx?

9NEcg/4sZ+Ts2c9HqlYuzg0pJP+9+vRfny6H2H8FUrPzOK…
0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72…

Destination Copy C72302041/123 25-Jul-2023 JH02AW8735

Check Gate Copy
C72302041/123 25-Jul-2023 JH02AW8735
TRANSPORT TRANSPORT
445.250 25 Jul 2023CHALLAN
6:31:12 PM 445.250 25 Jul 2023CHALLAN
6:31:12 PM
C72302041/123 25-Jul-2023
FORM "D" JH02AW8735 C72302041/123 25-Jul-2023
FORM "D" JH02AW8735
[Rules 9]
445.250 25 Jul 2023 6:31:12 PM
[Rules 9]
445.250 25 Jul 2023 6:31:12 PM
(See section 23-C of Mines & Minerals (Developement & Regulation) Act, 1957) (See section 23-C of Mines & Minerals (Developement & Regulation) Act, 1957)
C72302041/123
ORIGINAL 25-Jul-2023 JH02AW8735
(NOT TRANSFERABLE) C72302041/123
ORIGINAL 25-Jul-2023 JH02AW8735
(NOT TRANSFERABLE)

445.250 25 Jul 2023 6:31:12 PM

Serial Number : C72302041/123 Date : 25-Jul-2023 445.250 25 Jul 2023 6:31:12 PM
Serial Number : C72302041/123 Date : 25-Jul-2023

Transportation for Inter State/Intra State Transportation for Inter State/Intra State
C72302041/123 25-Jul-2023 JH02AW8735 C72302041/123 25-Jul-2023 JH02AW8735
(To be filled by the Lessee/Dealers before transport of mineral)
(To be filled by the Lessee before transport of mineral)

445.250 25 Jul 2023 6:31:12 PMTRUSTLINE MINING AND 445.250 25 Jul 2023 6:31:12
TRUSTLINEPM
1. Name and Address of the
MINING AND
1. Name and Address of the Lessee MINERALS,TRUSTLINE MINING AND MINERALS,TRUSTLINE MINING AND
Lessee//Dealers Permits
Permits
C72302041/123 25-Jul-2023 JH02AW8735
MINERALS-KADAJAMDA C72302041/123 25-Jul-2023 JH02AW8735
MINERALS-KADAJAMDA

445.250 25 Jul 2023 6:31:12 PM

TRUSTLINE MINING AND 445.250 25 Jul 2023 6:31:12
TRUSTLINEPM
MINING AND
MINERALS,TRUSTLINE MINING AND
2. Details of the Lessee Permit
MINERALS,TRUSTLINE MINING AND
2. Details of the Lessee Permit
MINERALS-0101597101-KADAJAMDA
MINERALS-0101597101-KADAJAMDA
C72302041/123 25-Jul-2023 JH02AW8735 C72302041/123 25-Jul-2023 JH02AW8735
STONE Stone Chips -Less than 120mm 3. Name of Mineral/Grade STONE Stone Chips -Less than 120mm
3. Name of Mineral/Grade
445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM
4. Name and address of the purchaser to whom mineral has been sold and to be 4. Name and address of the purchaser to whom mineral has been sold and to be
C72302041/123 25-Jul-2023 JH02AW8735
supplied C72302041/123 25-Jul-2023 JH02AW8735
supplied

BIJOY SHANKAR MISHRA...-DOKATTA TO HARILA VIA KEONJHAR

445.250 25 Jul 2023 6:31:12 PM
DUDUCHU, , KENDUJHAR, ODISHA,Pin Code- 758001-
445.250 25 Jul 2023 6:31:12 PM
BIJOY SHANKAR MISHRA...-DOKATTA TO HARILA VIA KEONJHAR
DUDUCHU, , KENDUJHAR, ODISHA,Pin Code- 758001-

C72302041/123
5. Quantity (in 25-Jul-2023 JH02AW8735 C72302041/123
5. Quantity (in
445.250
25-Jul-2023 JH02AW8735
Vehicle No JH02AW8735
445.250 Vehicle No JH02AW8735 Cft)
Cft)
445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM
6. Sale Price as mentioned in 6. Sale Price as mentioned in
Total Total
C72302041/123 25-Jul-2023
INVOICE (Submitted to Sales
52.00 JH02AW8735
Sale 23153.00 C72302041/123 25-Jul-2023
INVOICE (Submitted to Sales
Tax Department) per
52.00 JH02AW8735
Sale 23153.00
Tax Department) per Price
Price MT/CFT/M3
MT/CFT/M3
445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM
Royalty Royalty
C72302041/123 25-Jul-2023
7. Rate of Royalty 7.08
AmountJH02AW8735
3152.37 C72302041/123
7. Rate of Royalty 7.08 25-Jul-2023 JH02AW8735
Amount
3152.37

445.250 25 Jul 2023 6:31:12

8. Name and address of Vehicle PM
B S MISHRA-NA
445.250 25 Jul 2023 6:31:12
8. Name and address of Vehicle PM
B S MISHRA-NA
owners owners
C72302041/123 25-Jul-2023 JH02AW8735 C72302041/123 25-Jul-2023 JH02AW8735
9. Name and address of the Driver in case the minerals is to be transported by Road 9. Name and address of the Driver in case the minerals is to be transported by Road
445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM
LOKESH,NOAMUNDI-9661378533 LOKESH,NOAMUNDI-9661378533
C72302041/123 25-Jul-2023 JH02AW8735 C72302041/123 25-Jul-2023 JH02AW8735
DOKATTA TO HARILA VIA
DOKATTA TO HARILA VIA

445.250 25 Jul 2023 6:31:12

10. Place of delivery
KENDUJHAR, PM Route Destination by
ODISHA,Pin
KEONJHAR DUDUCHU, , Direct to
445.250 25 JulKEONJHAR
10. Place of delivery
KENDUJHAR,
DUDUCHU, ,
2023 6:31:12 PM Route Direct
ODISHA,Pin
to
Destination by
of Mineral of Mineral Code- 758001 KENDUJHAR Road
Code- 758001 KENDUJHAR Road
C72302041/123 25-Jul-2023
ODISHA PIN-758001 JH02AW8735 C72302041/123 25-Jul-2023
ODISHA PIN-758001 JH02AW8735
Distance in(K.M.)
445.250 25 Jul 2023 6:31:12 PM
50.000
445.250 25 Jul50.000
Distance in(K.M.)
2023 6:31:12 PM
11. Date of dispatch of 11. Date of dispatch of
C72302041/123
Mineral 25-Jul-2023
25 Jul 2023 JH02AW8735
Time 12:31:12 PM C72302041/123
Mineral 25-Jul-2023
25 Jul 2023 JH02AW8735
Time 12:31:12 PM

445.250 25 Jul 2023 6:31:12 PM

I/We here by declare that the above statements are correct and complete to the best 445.250 25 Jul 2023 6:31:12 PM
I/We here by declare that the above statements are correct and complete to the best
of my/our Knowledge and belief.
of my/our Knowledge and belief.
C72302041/123 25-Jul-2023 JH02AW8735 C72302041/123 25-Jul-2023 JH02AW8735
Seal of Competent Officer Signature Of the Lessee/Permit holder Seal of Competent Officer Signature Of the Lessee/Permit holder
445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM
Challan Valid 25 Jul 2023 12:31:13 Challan Valid 25 Jul 2023 12:31:13
C72302041/123
Upto
25 Jul 2023 6:31:12 PM
25-Jul-2023 JH02AW8735
Printed on PM C72302041/123
Upto 25-Jul-2023 JH02AW8735
25 Jul 2023 6:31:12 PM Printed on PM

445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM

C72302041/123 25-Jul-2023
RESULT OF CHECKINGJH02AW8735
IN ROUTE C72302041/123 25-Jul-2023
RESULT OF CHECKINGJH02AW8735
IN ROUTE
Designation and Head Description Quantity of the Dated signature of the Designation and Head Description Quantity of the Dated signature of the
445.250 25 Jul 2023
Quaters of the authority by 6:31:12
of mineral MineralPM authority mentioned 445.250 25 Jul 2023 6:31:12
Quaters of the authority by
of mineral MineralPM authority mentioned
whom the transport of the actually in column-1 and place of whom the transport of the actually in column-1 and place of
C72302041/123 25-Jul-2023
mineral was checked. JH02AW8735
transported checking. C72302041/123 25-Jul-2023
mineral was checked. JH02AW8735
transported checking.

445.250 25 Jul 2023 6:31:12 PM 445.250 25 Jul 2023 6:31:12 PM

Note- (1) Separate form should be used for each consignment Note- (1) Separate form should be used for each consignment
C72302041/123
(2) (a) In case of 25-Jul-2023 JH02AW8735
transport accross or byond check post a copy of the form C72302041/123
(2) (a) In case of25-Jul-2023 JH02AW8735
transport accross or byond check post a copy of the form
should accompany the consignment. should accompany the consignment.
445 250 25 J l 2023 6 31 12 PM 445.250 25 Jul 2023 6:31:12 PM
0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72302041/123|25 Jul 2023 12:31:13 PM|445.250|0101597101|C72…

https://mineralsportal.jharkhand.gov.in/portal/epass/ePassFormD.aspx?9NEcg/4sZ+Ts2c9HqlYuzg0pJP+9+vRfny6H2H8FUrPzOKVbyn3VRHNJc… 1/1