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Mining Licence Application Form

Mineral Resources (Sustainable Development) Act 1990 (MRSDA)

All information required by Schedule 3 of the Mineral Resources (Sustainable Development) (Mineral Industries) Regulations 2013 must be provided or the application is invalid. Section 15 of the MRSDA also sets out additional requirements for Mining Licences.

Question 1. Name and Address of applicant(s):

(Do not show a Post Box Number. Must be registered office address if a company.)

(Do not show a Post Box Number. Must be registered office address if a company.)

Note: If more than two applicants please attach details on a separate page.

Contact details and postal address (if not as above):

Note: All applicants (or authorised agent) must sign at end of application.

Question 2: If the applicant is a company, you must attach the following items to the application.
Question 3: Description of application area

A map of scale 1:25,000 or larger must be attached clearly showing the boundaries of private land and Crown land. You must also attach a note describing the relationship of the application area to land title boundaries where applicable.

Does the application area include privately-owned agricultural land which is not owned by the applicant(s)?

(If YES you must attach a map clearly showing the extent of land used as agricultural land.) (Map scale 1:25,000 or larger)

Question 4: Names and addresses of owners and occupiers of the land covered by the application.

Question 5: Native Title

If the application includes Crown land, indicate which of the following options will be utilised to comply with the Commonwealth Native Title Act 1993 (NTA) or the Traditional Owners Settlement Act 2010 (TOSA).

You must answer this question now if the application includes Crown land (refer to Application Kit)

Question 6: Does the application area lie within a granted Exploration Licence (EL), Prospecting Licence (PL) or Retention Licence (RL)?

(1) Provide the relevant licence number

 

Please tick the appropriate box below:
(The application is invalid if you cannot tick one of these questions below)

I/We are the holder(s) of the EL/PL/RL
or
A letter of consent from the EL/PL/RL holder is attached

Question 7: Licence term required

A mining licence may be granted for a term not exceeding twenty years unless the Minister decides otherwise.

Question 8: Estimated expenditure for the first 5 years of the licence
Question 9: Evidence of financial capacity to fund the estimated expenditure

1. Company (with audited financial report):

Assets: $
Liabilities:
Net Financial Position:

Note: All companies must attach their most recent audited financial report. All fields must be completed. Insert N/A if not applicable.

2. Individual/Company (without audited financial report):

Assets:
Liabilities:
Net Financial Position:

Note: All applicants must provide a current bank statement.

List of plant and equipment can only be included provided it is owned by the applicant and it is to be used for activities on this application.

All fields must be completed. Insert N/A if not applicable.

Question 10: Expertise of person(s), including the applicant, undertaking the mining program
Name Qualifications Employee of applicant?
1. Yes No
2. Yes No

If the person is not an employee of the applicant you must attach evidence that he/she has agreed to assist in the work program

Question 11. Indicate your experience in mining

I/We currently or have previously held a minerals tenement in Victoria (within last 5 years) under the name given in Question 1 (No further details are required).

I/We have previously held a minerals tenement in Victoria (within last 5 years), under another name (Attach details).

I/We have previously held a minerals tenement outside Victoria (within last 5 years) (Attach details of location and type of most recently held tenements and describe operation).

I/We have not previously held a minerals tenement within last 5 years (Attach details of your knowledge and relevant mining/exploration experience).

Question 12: Indicate with a tick whether any of the following apply to the applicant or an associate of the applicant

Has failed to undertake rehabilitation required under the MRSDA and the Minister has taken action to rehabilitate the land under section 83 of the MRSDA

Has had a licence cancelled under the MRSDA;

Has been convicted of an offence against the MRSDA;

Has been convicted of an offence involving fraud or dishonesty; or

Is insolvent under administration.

If one or more of the above are applicable to either the applicant or an associate of the applicant attach details outlining -

  • the name of the party and their relationship to the applicant; and
  • the nature of the offence; and
  • when the offence was committed; and
  • the penalty imposed (if applicable).

Note - an Associate is defined as a director, partner, trustee, executive officer, secretary or any other officer or person associated or connected with the ownership, administration or management of the applicant's business.

Question 13: Mineralisation Report

If the mineral resource described in Question 17 (below) is not already being mined, a mineralisation report must be submitted with the application (Note - if the application is for an Infrastructure Mining Licence, you do not need to identify a mineral resource or submit a mineralisation report, for the purposes of this application).

If the application is for an Infrastructure Mining Licence please tick the box below and indicate the associated Mining Licence number in the relevant box below.

Infrastructure Mining Licence

MIN

If you have ticked both boxes proceed to question 14.

The mineralisation report must be in accordance with section 15(1BE) and (1BF) of the MRSDA. The mineralisation report must include the exploration results in relation to the described mineral resource, including the exploration results which detail:

Types of minerals identified;

Location, depth, quantity and extent of the minerals;

Method by which that extent has been determined; and

Analytic results obtained from samples of those minerals

The mineralisation report must also include, in accordance with the Ministerial guidelines, information that:

Where pre-feasibility or other relevant studies, plans and analyses demonstrating economic viability have been undertaken, includes a description and summary of the findings of those studies with independent verification by a suitably qualified person; or

Where pre-feasibility or other relevant studies, plans and analyses demonstrating economic viability have been undertaken, includes a full copy of the relevant study for analysis by the Department; or

Where pre-feasibility or other relevant studies, plans and analyses demonstrating economic viability have not been undertaken, demonstrates a commitment to mining.

Refer Guidelines for Description of a Mineral Resource in a Mining Licence or a Retention Licence Application.

Question 14: Competent Person

The mineralisation report must be prepared by a competent person.

The following information must also be submitted with the mineralisation report:

Contact details of the person who prepared the report

Relevant professional organisation membership/s of the competent person who prepared the report; and

Relevant experience of the person who prepared the report.

Question 15: Work program details

Attach details of the proposed program of work that include:

A map of the location of the proposed works in relation to the boundaries of the land included in the application; and

A brief description of the proposed type of works including

  1. a description of the mining activities to be undertaken, including the proposed scale of mining;
  2. where relevant, a statement outlining any studies to be undertaken to further establish the economic viability of mining the mineral resource;
  3. where relevant, a description of any further geological work to upgrade the mineral resource;
a proposed schedule for-
  1. obtaining any other necessary permits, approvals or authorisations required before mining can commence;
  2. construction and commissioning for mining;
  3. commencement of mining.

Refer to Mining Licence Application Kit and the Mining Licence guidelines for specific details of the program of work requirements.

Proposed Type of Operation:

Hard Rock Open Cut

Doze and Detect

Bulk sampling/surface/ trenching/exploration

Hard Rock Underground

Alluvial

Shallow excavation (gypsum, kaolin)

Other (specify):

Type of Treatment:

No Treatment

CIL/CIP

Vat Leach

Gravity

Heap Leach

Mercury

Other (specify):

Question 16: Mineral(s) to which the licence will relate

Gold

Silver

Platinum

Coal

Antimony

Diamonds

Mineral sands

Kaolin/Clay

Coal Bed Methane

Base metals (copper, lead, zinc)

Gypsum

Other

If other please specify:

Question 17: Description of mineral resource

Section 15(1BB) of the MRSDA requires that the application describes the mineral resource in accordance with the guidelines issued by the Minister. Attach a description of the mineral resource, in accordance with the Ministerial guidelines and indicate whether that description refers to a:

JORC indicated mineral resource (minimum JORC standard); or JORC measured mineral resource; or Alternative mineral resource standard as provided in the Ministerial guidelines.

Note: The application must be accompanied by the prescribed fee. Refer to Fees and charges

Question 18: Application Fee
Application for Mining Licence fee of $
Note: The application must be accompanied by the prescribed fee. Refer Fees and charges
Question 19: Survey of land applied for

Section 15(1BH) of the MRSDA requires that the application must include a survey of the boundary of the land proposed to be covered by the licence in accordance with Division 3A.

Attach a survey of the land proposed to be covered by the licence:

Applicant's Declaration

I/We declare that to the best of my/our knowledge, all the information I/we have given is true and correct.

Attachments Checklist

Indicate with a tick, the attachments you are submitting with the application:

Privacy Statement

Personal information provided by you for the purpose of your application and any related purpose (including the issue of a licence) is collected, used and stored by DEDJTR to assist in the performance of duties under the MRSDA.

You have the right of access to this information by contacting the Earth Resources Information Centre, Department of Economic Development, Jobs, Transport and Resources, Level 15, 1 Spring Street, Melbourne VIC 3000.

The information may be disclosed to the Victoria Police, the Australian Securities and Investments Commission and other government organisations for the purpose of administering or enforcing the MRSDA or a relevant Act. Limited information may be available to the public for the purpose of land use advice.

Office Use Only

Date received:

Delivered: In person / By post

Checked by:

Mining Licence no:

District:
YOU MUST SUBMIT THIS
APPLICATION TO
THE EARTH RESOURCES
INFORMATION CENTRE,
LEVEL 15, 1 SPRING STREET
MELBOURNE VICTORIA 3000
(GPO BOX 2392,
MELBOURNE VICTORIA 3001)
RANKING IS GIVEN ACCORDING TO
THE DAY THE APPLICATION IS RECEIVED
BY
THE EARTH RESOURCES INFORMATION CENTRE