"Form-11 [See rule 4(6) (2)] APPLICATION FOR OBTAINING LOCAL TRANSIT PASS FOR TRANSPORTATION OF MINERALS FROM RAILWAY SIDINGS
1. (i)
(ii) Name of the applicant Designation (in case of Company or Firm) Mobile Number
2. Name of the mineral 3 . Quantity of the mineral to be brought by way of Railway transportation : .. ..... .... ............................... (cubic meter/ ton) s.
No.
(1) 368 (9 )
4. Name of the Railway siding ........................................ . ...... .. ......... .. ............ ..
(from where the mineral is to be transported)
5. (i) Name of the recipient of the mineral and
6.
7.
(ii) Address
(iii) Name of the Railway siding where the mineral is to be u nloaded
(iv) Purpose (private plant/processing plant/ licensed place/ other)
(v) Complete address of the destination
(vi) Transportation route via (In case of more than one route, the route which is to be used for transport must be clearly mentioned) Required number of local transit pass :
Other details : (1) ......... ... . ........ . (2) ................... .
Signature ............... . .................. .. . .. .. ...... . . .
Name ....... .. . ... .... .. ... ...................... . .. .. ... .. . .
Designation .... ...... .. ................... . .. .......... ..
(Seal in case of company or firm)"