FORM 31 / Mining Act 1971 (“the Act”) - Part 12, s76 /
TENEMENT RETURNS e-LODGEMENT (TReL) APPLICATION
USE THIS FORM TO: / Apply for a new user account for the TReL application, or modify/delete an existing account.

Section A: Account User (must be an individual)

Title / Name / Account user must be an individual, but a business postal address may be supplied.
Position may be holder, operator, director, accountant etc.
Email address is required for a TReL account.
Postal address
Suburb/Locality
State / Postcode
Position
Email address
Telephone / Mobile
Do you consent to receiving electronic correspondence from the Department regarding tenement matters? / /

SECURITY QUESTIONS

Place of birth
(City, state, country) / Required for account validation, if password is forgotten.
Date of birth (dd/mm/yyyy)
Mother’s maiden name

ACCOUNT REQUEST

/ Tick one box only.

/ Existing
Username: …….…………………………

Section B: Client Details

Individual / / Tick one box only.
*Strike out any that do not apply.
Provide the business’s Registered Address if different to postal address given above.
OR Company /
Business name
Address Line 1
Address Line 2
Suburb/Locality
State / Postcode
ABN / ACN

COMPANY AUTHORISED OFFICER

I certify that the individual named as the Account User in Section A above is authorised to represent this company for matters relating to Mining Returns with DSD.

Print name / Ensure that the named officer has appropriate authority to certify this application.
Position
Date signed
Signature

Section C: Tenements

Specify the mining tenements that you wish to assign to your TReL account. You may specify tenements held by other parties if a tenement operator/manager arrangement exists. DSD may seek authorisation from the holder before assigning the tenement/s to your account.

Tenement number/s / Please specify each tenement, do not write “all tenements”.

Section D: Account user certification

I certify that I am aware of my obligations under the Act regarding the submission of mining returns and royalty payments to DSD for the tenements listed on the attached page.

I acknowledge that I must read and accept the terms and conditions set out in the TReL application in order to use it.

Print name / Ensure the account user named in Section A completes this section.
Date signed
Signature

Under the Act, penalties apply for the late submission of a mining return (including a nil return), and also for the late payment of royalty owed.

Return the completed form:

FORM 31 / MINING ACT 1971 / Version 1.3 – January 2018 / Page 1 of 2

via Post to:

DSD

Resource Royalties Team

GPO Box 320

ADELAIDE SA 5001

via Email to:

FORM 31 / MINING ACT 1971 / Version 1.3 – January 2018 / Page 1 of 2

Ph: (08) 8463 3095

Fax: (08) 8463 3229

ACCOUNT APPROVED

Name / OFFICE USE ONLY
Position
Date
Signature
FORM 31 / MINING ACT 1971 / Version 1.3 – January 2018 / Page 1 of 2