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 | |
| 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) | 06733.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) | 06732.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) | 02192.pdf |
| Bonding Evaluation Factor Sheet (R-102) (read-only) | 20069.pdf |
| Plan of Reclamation (R-101) (read-only) | 02191.pdf |
| Plan of Revegetation (R-301) (read-only) | 02190.pdf |
| Report of Affected Area (R-200) (read-only) | 02193.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 |
Stay Connected
You are leaving the IN.gov website. By clicking OK, you will be taken to a website that is not affiliated with the State of Indiana and may have different privacy and security policies. The State of Indiana is not responsible for, and does not endorse, guarantee, or monitor content, availability, viewpoints, products, or services that are offered or expressed on this non IN.gov portal website.
