Annexure-I

ANNUAL RETURN OF COAL MINE FOR THE YEAR ENDING ON THE 31ST DECEMBER,20__
(Under the Mines Act, 1952 and allied legislations framed thereunder)
PART-A

: The Coal Mines Regulations, 1957 (See Regulation 5):

1.
2.

Name of mine
Postal address of mine

3.
4.
5.

Date of opening
Labour Identification No. (LIN)
Name of Owner
(a) Contact details of Owner
(b) e-mail Id of Owner
(c) Postal address of Owner

6.

Name of Agent (if any) as

defined in section 2(c) of the
Mines Act, 1952
(a) Contact details of Agent
(b) e-mail Id of Agent
(c) Postal address of Agent

7.

Name of Manager

:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
:____________________________________________
:____________________________________________
:____________________________________________
: Tel. No. - ____________ Mobile No. - ____________
:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
:____________________________________________

: Tel. No. - ____________ Mobile No. - ____________

:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
:____________________________________________

(a) Contact details of Manager

(b) e-mail Id of Manager
(c) Postal address of Manager

8.

9.

Tel. No. - ____________ Mobile No. - ____________

:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
Statutory personnel employed in the mine
Sl. No.
Designation
No. required
No. available
Shortage/surplus

No. of contractors
engaged

:____________________________________________

10. EMPLOYMENT
(1) Number of persons employed on roll in the mine :
Classification
Male
Belowground
Opencast
Aboveground

Departmental
Female

Total

Male

Contractual
Female

Total

(2) Maximum number of persons employed on any one day during the year 20_____
(i) in workings belowground on ____________ (specific day) : __________
(ii) in all in the mine on ____________ (specific day) : ____________
(3) Details of mandays worked and average employment:
Classification

Departmental
Total mandays
Average daily number
worked
of persons employed
Male Female Total Male Female Total

Contractual
Total mandays
Average daily number
worked
of persons employed
Male Female Total Male Female Total

(a) Belowground
(b) Opencast
(c) Aboveground

11. No. of days worked

No. of shift worked
12

:_____________________________________________
:_____________________________________________

DETAILS OF COAL RAISED, MATERIAL HANDLED, ETC.

(a)

COAL RAISED ETC. (for all mines) :

All figures in Tonnes

Grade

(1)

(b)

Opening
stock on
1st
January,
20___

Coal raised during the year

Belowground
Opencast
Bord & Pillar
Method other
Method
than Bord &
Pillar {____
(Specify
Method)}
Dev.

Depillar.

Dev.

Extraction

(3)

(4)

(5)

(6)

(2)

(8)

Coal
Dispatched

Closing
stock
on 31st
December
20___
{Diff. of
Column
(9) &
(10)}

(9)

(10)

(11)

MATERIAL HANDLED (for Opencast mines only) :

Coal raised during the year

{Column (7) of 12(a) converted in
cubic metre}
(1)

13.

(7)

SubTotal
of
(3)
to
(7)

Total of
Columns
(2) and
(7)

Stone, debris, etc. handled

during the year (cubic metre)
(2)

Total material handled during the

calendar year (cubic metre)
{Col.(1)+(2)}
(3)

(a) AGGREGATE HORSE-POWER OF MACHINERY AND EQUIPMENT USED/INSTALLED IN

THE MINE
Place

Electrical

Oil/natural gas/steam

Compressed air

(a) Underground
(b) Opencast
(c) Aboveground
Total

(b) Voltage(s) at which current is used:

(i)
(ii)

Lighting
Power

:____________________________________________
:____________________________________________

14.

ACCIDENT STATISTICS (during last three years)

Year

Fatal accident
Number Number of
person(s)
killed

Serious accident

Number of
person(s)
seriously
injured

Number

Number of
person(s)
seriously
injured

Reportable accident
Number

Minor accident

Number Number Number

of
of
person(s)
person(s)
injured
injured

20____
20____
20____

PART-B
1.

: The Mines Rules, 1955:

INITIAL/PERIODICAL MEDICAL EXAMINATION (IME/PME) CONDUCTED DURING THE

YEAR
{Rules 29B and 29P(1) of the Mines Rules, 1955}
Number of persons
employed

Departmental

Contractual

Number of persons required

to undergo IME/PME

Departmental

Contractual

Number of persons actually

undergone IME/PME

Departmental

No. of
persons
declared
medically
unfit

Contractual

Initial Medical Examination (IME)

Periodical Medical Examination (PME)

2.

APPOINTMENT OF WORKMENS INSPECTORS

{Rules 29Q of the Mines Rules, 1955}
(i) No. of Workmens Inspector required
(ii) No. of Workmens Inspector provided

3.

Number of Safety Committee meeting conducted

during the year {Rule 29V of the Mines Rules, 1955}
: __________________________

PART-C
1.

: __________________________
: __________________________

: Mines Vocational Training Rules, 1966

VOCATIONAL TRAINING
Number of persons employed
Departmental

Contractual

Number of persons required to

undergo vocational training
Departmental
Contractual

Number of persons actually

undergone vocational training
Departmental
Contractual

Basic Vocational Training (under Rule 6)

Refresher Training (under Rule 8)

Certified that the information submitted in the Annual Return (in page 1, 2 and 3) is correct to
the best of my knowledge.
Signature (with date and official seal) ______________

Designation : Owner/Agent/Manager

Annexure-II
ANNUAL RETURN OF METALLIFERROUS MINE FOR THE YEAR ENDING ON THE
31ST DECEMBER, 20____
(Under the Mines Act, 1952 and allied legislations framed thereunder)
PART-A

: The Metalliferous Mines Regulations, 1957 (See Regulation 5):

1.
2.

Name of mine
Postal address of mine

3.
4.
5.

Date of opening
Labour Identification No. (LIN)
Name of Owner
(d) Contact details of Owner
(e) e-mail Id of Owner
(f) Postal address of Owner

6.

Name of Agent (if any) as

defined in section 2(c) of the
Mines Act, 1952
(d) Contact details of Agent
(e) e-mail Id of Agent
(f) Postal address of Agent

7.

Name of Manager
(d) Contact details of Manager
(e) e-mail Id of Manager
(f) Postal address of Manager

8.

9.

:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
:____________________________________________
:____________________________________________
:____________________________________________
: Tel. No. - ____________ Mobile No. - ____________
:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
:____________________________________________

: Tel. No. - ____________ Mobile No. - ____________

:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
:____________________________________________
: Tel. No. - ____________ Mobile No. - ____________
:____________________________________________
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________

Statutory personnel employed in the mine

Sl. No.
Designation
No. required

No. of contractors
engaged

No. available

Shortage/surplus

:____________________________________________

10. EMPLOYMENT
(1) Number of persons employed on roll in the mine :
Classification

Departmental
Male

Belowground
Opencast
Aboveground

Female

Contractual
Total

Male

Female

Total

(2) Maximum number of persons employed on any one day during the year 20__
(iii) in workings below ground on ____________ (specific day) :
(iv) in all in the mine on ____________ (specific day) :
(3) Details of mandays worked and average employment:
Classification

Departmental
Total mandays
Average daily number
worked
of persons employed
Male Female Total Male Female Total

Contractual
Total mandays
Average daily number
worked
of persons employed
Male Female Total Male Female Total

(d) Belowground
(e) Opencast
(f) Aboveground

11. No. of days worked

No. of shift worked
12

:_____________________________________________
:_____________________________________________

DETAILS OF OUTPUT, MATERIAL HANDLED, ETC.

(c)

OUTPUT (for all mines) :

Name
of
mineral
raised

(1)

(d)

Opening stock
Output of the Mineral
Despatches
on 1st January,
during the year
20___
Run- Processed
ROM
Processed ROM Processed
off
Mineral
Mineral
Mineral
Below- OpenMine
ground cast
(ROM)
(2)

(3)

(4)

(5)

(6)

(7)

(8)

Closing stock
on 31st December
20___
ROM
Processed
{Col.2+4 Mineral
+5-7}
{Col.3+68}
(9)

(10)

Metal Extracted,
if any
Name

Quantity

(11)

(12)

MATERIAL HANDLED (for Opencast mines only) :

ROM raised during the year

{Column (5) of 12(a) converted in
cubic metre}
(1)

Stone, debris, etc. handled

during the year (cubic metre)
(2)

Total material handled during the

calendar year (cubic metre)
{Col.(1)+(2)}
(3)

13.

Whether Explosive(s) used in the mine (Yes/No):

14.

(I) AGGREGATE HORSE-POWER OF MACHINERY AND EQUIPMENT USED/INSTALLED IN

THE MINE
Place

Electrical

Oil/natural gas/steam

Compressed air

(d) Underground
(e) Opencast
(f) Aboveground
Total

(II) Voltage(s) at which current is used:

(i)
Lighting
:____________________________________________
(ii)
Power
:____________________________________________

15.

ACCIDENT STATISTICS (during last three years)

Year

Fatal accident
Number Number of
person(s)
killed

Serious accident

Number of
person(s)
seriously
injured

Numbe
r

Number of
person(s)
seriously
injured

Reportable accident

Minor accident

Number Number Number Number

of
of
person(s
person(s)
) injured
injured

20____
20____
20____

PART-B
1.

: The Mines Rules, 1955:

INITIAL/PERIODICAL MEDICAL EXAMINATION (IME/PME) CONDUCTED DURING THE

YEAR
{Rules 29B and 29P(1) of the Mines Rules, 1955}
Number of persons
employed

Number of persons required

to undergo IME/PME

Departmental

Contractu
Departmental
al
Initial Medical Examination (IME)

Contractual

Number of persons actually

undergone IME/PME

Departmental

No. of
persons
declared
medically
unfit

Contractual

Periodical Medical Examination (PME)

2.

APPOINTMENT OF WORKMENS INSPECTORS

{Rules 29Q of the Mines Rules, 1955}
(j) No. of Workmens Inspector required
(iii) No. of Workmens Inspector provided

3.

Number of Safety Committee meeting conducted

during the year {Rule 29V of the Mines Rules, 1955}
: __________________________

PART-C
1.

: __________________________
: __________________________

: Mines Vocational Training Rules, 1966

VOCATIONAL TRAINING
Number of persons employed
Departmental

Contractual

Number of persons required to

undergo vocational training
Departmental
Contractual

Number of persons actually

undergone vocational training
Departmental
Contractual

Basic Vocational Training (under Rule 6)

Refresher Training (under Rule 8)

Certified that the information submitted in the Annual Return (in page 1, 2 and 3) is correct to
the best of my knowledge.

Signature (with date and official seal) ______________

Designation : Owner/Agent/Manager

Annexure-III
ANNUAL RETURN OF OIL MINE FOR THE YEAR ENDING ON THE 31ST DECEMBER,20__
(Under the Mines Act, 1952 and allied legislations framed thereunder)

1.
2.

3.
4.
5.

6.

7.

8.

PART-A
: The Oil Mines Regulations, 1984 (See Regulation 5):
Name of mine
:____________________________________________
Postal address of mine
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
Date of opening
:____________________________________________
Labour Identification No. (LIN)
:____________________________________________
Name of Owner
:____________________________________________
(a) Contact details of Owner
: Tel. No. - ____________ Mobile No. - ____________
(b) e-mail Id of Owner
:____________________________________________
(c) Postal address of Owner
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
Name of Agent (if any) as
:____________________________________________
defined in Section 2(c)of the
Mines Act, 1952
(a)
Contact details of Agent
: Tel. No. - ____________ Mobile No. - ____________
(b) e-mail Id of Agent
:____________________________________________
(c) Postal address of Agent
: Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
Name of Manager
:____________________________________________
(a) Contact details of Manager : Tel. No. - ____________ Mobile No. - ____________
(b) e-mail Id of Manager
:____________________________________________
(c) Postal address of Manager : Village/Area/Road ____________________________
Tehsil/Taluka/Sub-division______________________
District______________ PIN____________________
State_______________________________________
Statutory personnel employed in the mine
Sl.No.

Designation

No. required

No. available

Shortage/surplus

9. No. of contractors engaged

: ____________________________________________
10. EMPLOYMENT
(1) Number of persons employed on roll in the mine:
Classification
Male

Departmental
Female

Total

Male

Contractual
Female

Total

(2) Maximum number of persons employed on any one day during the year 20__ in all in the
mine on ____________ (specific day):___________________________________
(3) Details of mandays worked and average employment:
Classification

Departmental
Total mandays worked Average daily number
of persons employed
Male Female Total Male Female Total

Contractual
Total mandays
Average daily number
worked
of persons employed
Male Female Total Male Female Total

11. No. of days worked

:____________________________________________
No. of shifts worked
:____________________________________________
12. (I) AGGREGATE HORSE-POWER OF MACHINERY AND EQUIPMENT USED/INSTALLED IN THE
MINE
Place

Electrical

Oil/natural gas/steam

Compressed air

Total

(II)Voltage(s) at which current is used:

(i)
Lighting
:____________________________________________
(ii)
Power
:____________________________________________
13. Drilling and other rigs, oil wells and gas wells and pipelines
Item No.
(1)
1
1.1
1.2
1.3
2
2.1
2.2
2.3
2.4
2.5
2.6
2.7
3
3.1
3.2
3.3

Classification

Type of Rig

(2)
Drilling, Workover and other rigs
Drilling
Workover
Other Rigs
Oil, gas and other wells
Wells drilled
Wells abandoned
Gas wells completed
Oil wells completed
Gas wells on production
Oil wells on production
Oil wells where production discontinued
Pipelines
Flow lines laid from wells to gathering
station
Pipelines laid from gathering station to
central storage tanks
Others (Specify)

Total No. of
units in use
(4)

(3)

Length in metres

Diameter in metres

14. Details of production:

Item
No.

Type of
Product

(1)
1

(2)
Oil (in Metric
Tonnes)

Gas (in M3)

Opening
stock as
on 1st
January
(3)

Production

(4)

Value
(in
Rs.)
(5)

Despatches
To
refinery

To
market

For house
consumption

(6)

(7)

(8)

Closing
stock as
on 31st
December
(9)

15. ACCIDENT STATISTICS (During last three years)

Year

Fatal accident
Number of
Number of
person(s)
person(s)
killed
seriously
injured

Number

Serious accident
Number
Number of
person(s)
seriously
injured

Reportable accident
Minor accident
Number Number Number Number of
of
person(s)
person(s)
injured
injured

20____
20____
20____

PART-B
1.

: The Mines Rules, 1955:

INITIAL/PERIODICAL MEDICAL EXAMINATION (IME/PME) CONDUCTED DURING THE

YEAR {Rules 29B and 29P(1) of the Mines Rules, 1955}
Number of persons employed

Number of persons required

to undergo IME/PME

Departmental

Contractu
Departmental
al
Initial Medical Examination (IME)

Contractual

Number of persons actually

undergone IME/PME
Departmental

No. of persons
declared
medically unfit

Contractual

Periodical Medical Examination (PME)

2.

APPOINTMENT OF WORKMENS INSPECTORS

{Rules 29Q of the Mines Rules, 1955}
(k) No. of Workmens Inspector required
(iv) No. of Workmens Inspector provided

3.

Number of Safety Committee meeting conducted

during the year {Rule 29V of the Mines Rules, 1955}
: __________________________

PART-C
1.

: __________________________
: __________________________

: Mines Vocational Training Rules, 1966

VOCATIONAL TRAINING
Number of persons employed
Departmental

Contractual

Number of persons required to

undergo vocational training
Departmental
Contractual

Number of persons actually

undergone vocational training
Departmental
Contractual

Basic Vocational Training (under Rule 6)

Refresher Training (under Rule 8)

Certified that the information submitted in the Annual Return (in page 1, page 2, and page 3) is
correct to the best of my knowledge.

Signature (with date and official seal) _________________________

Designation: Owner/Agent/Manager