FORM D

Form of Tradiog Licence

PAN: AMVPS.!3-1n
[See Rule - g (1) and Rule 7] TIN : 21AMVPS063: 31:-.)

. Licence No. EL-P1?!_?9! ?pl

-e_
Date -2_7-Fe_b--2_01 ;s-

1. Name of the licencee (in full) : Rajashree Minorals Chemicals

2. Fult Address : Prop.Ashok Kumar Singh, AI-B/S2/190, New lnduslrlal Estatr:, ..Ja1:r:: (' :,jc

3. Father's Name ln full (in case of tirm, give names : Rajashree Minerals Chemicals
and address of partners and person holding powers
of attorney to act on behalf of the firm)

4. Profession of thctlicencee
, t{.r,i r:t
: Business

5. . €pecifrc place or places of business jurisdiction of B/S2190, New lndustrial Estate, Jagatpur, Cuttack
_ ,_ ,;Authoritv
- ::_;_-.--,
the ComD.lenl
- it, ' r -
, _ :

6. Sirecific purpose for which liccnce is grantcd P1-Processing ,end-use and sale of residuals With in Slate
(Procuremsnt, storing I Processing / Selling /
Trading)

7. Name of mineral/ore covered under the licence : Bauxite, Bentonite, Fireclay

8. Particulars of payment of application fee

Challan No Bank Transaction No Challan Date Challan Ar
. IKOOWWWSVO 2C44083D8D 22-Jan-2Q19 75000
,: i:r ii. " ..r
Late Fine: 25000

9. Particulars of payment of securitydeposit

10. Name and Address of persons/firms from whom ths

mineraUores will be purchased/procured

Mineral iProcurementSource
Jharkharld

' .r. r. '. i'''

11. Period of License From 23-Mar-2019 To 22-Mat-2024

12. License Code 050702129442

{3. lf it is a caso of renewal the number and date of 0-

grant of the orlginal licence

14. No. and date of application for thls licence. z RL411242912019 22-Jan-2o19

. i.{ ..

Date rif Grant : 27-Feb-2019 Signaturc of fi',.I

Mining l.l.,c

Memo No: R1A112429/2019.1.1 Mines, Dt: 27.Feb.2019

Copy forwarded to the Director of Mines, ODISHA, Bhubaneswar for favour of information.

i:

Signatur'; ci