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Reclamation > Mine Regulation > Forms Forms

Title Form Number Electronic Format
Coal Exploration
Application for Approval to Conduct Coal Exploration Activities under 250 Tons(read-only) 50616.pdf
Coal Mining Permitting
Request For Renewal Of Blaster Certification 54002.pdf
54002.doc
Application For Blaster Certification 54003.pdf
54003.doc
Application for an Incidental Boundary Revision to a Previously Approved Permit (read-only) 50617.pdf
Certificate of Liability Insurance (read-only) 50613.pdf
Report of Coal Production & Reclamation Fee (read-only) 44984.pdf
Request For Exemption For Coal Extraction Incidental to the Extraction of Other Minerals (read-only) 50614.pdf
Semi-Annual Seeding Report (B-601) (read-only) 50619.pdf
Coal Mine Bond
Bond Pool Application (read-only) 51507.pdf
Collateral Assignment of Certificate of Deposit (CA-1) (read-only) 50625.pdf
Collateral Assignment of Deposit Account (DA-1) (read-only) 50624.pdf
Irrevocable Letter of Credit (LC-1) (read-only) 6733.pdf
Irrevocable Letter of Credit Amendment (LC-2) (read-only) 50622.pdf
Self-Bond Application (read-only) 51895.pdf
Self-Bond Indemnity Agreement and Absolute Corporate Guaranty (read-only) 51892.pdf
Approval for Self-Bonding (read-only) 51893.pdf
Self-Bond Indemnity Agreement and Absolute Corporate Guaranty Rider (SE-1) (read-only) 51894.pdf
Self-Bond Indemnity Agreement and Absolute Corporate Guaranty Rider with Guarantor (SE-2) (read-only) 51951.pdf
Surety Bond (SB-1) (read-only) 50621.pdf
Surety Bond Rider (SB-2) (read-only) 6732.pdf
Surface Coal Mine Reclamation Bond Pool Fund, New Acres (BP-1) (read-only) 51509.pdf
Surface Coal Mine Reclamation Bond Pool Fund (BP-2) (read-only) 51510.pdf
Clay and Shale Mining
Application for a Permit (R-100) (read only) 2192.pdf
Bonding Evaluation Factor Sheet (R-102) (read-only) 20069.pdf
Plan of Reclamation (R-101) (read-only) 2191.pdf
Plan of Revegetation (R-301) (read-only) 2190.pdf
Report of Affected Area (R-200) (read-only) 2193.pdf
Report of Grading - Maps (R-300) (read-only) 20065.pdf
Report of Vegetation (R-302) (read-only) 20063.pdf
Misc Forms
Citizen Complaint and State Inspection Request (read-only) 50419.pdf

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