Destination Copy
TRANSPORT CHALLAN
                                                                   FROM "D"
                                                                    [Rules 9]
                            (See section 23-C of Mines & Minerals (Development & Regulation )Act, 1957)
ORIGINAL (NOT TRANSFERABLE)
Serial Number : C122695470/233                                                                                Date: 20-Mar-25
                                                 Transportation for Inter State/Intra State
(To be filledby the lessee before transport of mineral)
1. Name and Address of the lessee permits                         MS C.C L.M/S C. C. L-Bonjimihary 1
2. Details of the Lessee Permit                                   MS C.C L.M/S C. C. L-0413220602Bonjimihary 1
3. Name of the Mineral/Grade                                      STEAM-COAL & STEAM COAL (GCV(5401-5600))
4. Name and Address of the Purchaser to whome mineral has been sold and to be supplied
ASHAR PRADIP BRICKFIELD- BAGNAN SHYAMPUR HOWRAH
WEST BENGAL 711303-19ACBFS4518C1ZB
5.Quantity (in MT)                           24.92                                    Vehicle No                   CG12S4814
6. Sale Price as mentioned in INVOICE (Submitted                                                   Total Sale
to Sels Tax Department) per MT/CFT/M3                                      8000                    Price              1,99,360.00
7. Rate of Royalty                 400                            Royalty Amount                   9,968.00
8. Name and Address of Vehicle owners                             MD Osama
9. Name and Address of the Driver in case the minerls is to be transported by Road
                                   NA
                                                     SHYAMPUR HOWRAH
10. Place of Delivery of Mineral                                                                   Route           Direct to Destination
                                                     WEST BENGAL 711303
Distance in (KM)                                     210 KM
11. Date of dispatch of Mineral                      20-Mar-25                                     Time            19:41:34
I We here by declare that the above statements are correct and complete to the best of my/our knowledge and belief.
Seal of Competent Officer                                                                      Signatureb of the Lessee Permit holder
Challan Valid Upto                       22-Mar-25                                Printed on       20-03-2025 19:41
                                                      RESULT OF CHECKING IN ROUTE
Designation and Head Quarters of the authority by                 Description     Quantity of the Mineral          Date signature of the
whom the transport of the mineral was checked.                    of Mineral      actuallytransported              authority mentioned
                                                                                                                   in column-1 and
                                                                                                                   place of checking
        Note- (1) Separate form shouldbe used forcach consignment.
                (2) (a) In case of transport across or byond checkpost a copy of the form should accompany the consignment.