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Variation of access of Mining claim,
Mineral Development licence and
Mining Lease
No. (Office Use Only)
MINES ABN 59 020 847 551
Mineral Resource Act 1989
Form MMOL-26 Version 1
You may make an application for a variation of access electronically using the MyMinesOnline system. Alternatively you may complete
the original of this application and submit the application, any attachments and the prescribed fee at a Mines lodgement office.
Note: A document containing information that is false or misleading may attract a maximum penalty of 200 penalty units.
Please use a pen, and write neatly using BLOCK LETTERS Cross where applicable
Question 1 – Permit and holder details
Permit number (eg ML01234):
Current expiry date:
Detail the current holder(s)
Holder 1
Holder 2
Holder 3
Company
Name/surname:
Given name (if
individual):
ACN/ARBN
% Holding:
Question 2 – Access description
2.1 What is the width of access:
Metres (two decimals)
2.2 Provide any relevant information about the access including start and end points:
OFFICE USE ONLY
Fees paid:
Payment Method:
Received at: ________________
Total $ _______
Cash
Received by:
DNRM
Credit Card
Receipt No.
EFTPOS
Receiving officer
I confirm that:
•
the details on application form have been checked;
•
all attachments have been submitted;
•
correct application fees have been submitted for the
relevant application type
Name: ___________________________
______________
Cheque
Signed:___________________________ Date:
Date:
Time:
/
/
AM/PM
/
/
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
2.3 Which datum have you used:

GDA 94 (lat, long)
MGA94 (easting, northing, zone)
3.9 - Access description - by providing details below (Attach as a separate list if insufficient space)
Commencing from the start point, thence along the centreline at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
thence at a bearing of
for a distance of
m,
to the end point.
*Attach as a separate list if insufficient space
Attachments required:
• Map of proposed permit area access

Question 4 – Land information
Land parcel details
4.1 Provide property details for all land parcels covered by the access (add a separate page if insufficient space).
Lot
Plan
Tenure
Land Parcel name
Current usage
Proposed
usage
Landowner name
Landowner address
Eg. 1
RP123123
FH
Smith road
Grazing
Mining or
Access
J Smith
123 Brisbane Rd,
Brisbane
Is
compensation
required?
Yes or No
Question 5 – Consent from landowner
5.1 Do you have written consent of the owner(s) of the land subject to the variation of access?

Yes

No
5.2 If no, what action has been taken to obtain such written consent?
If yes - Attachments required:
•
Consent from the owner

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Question 6 –Obligations and declaration
WARNING: Giving false or misleading information is a serious offence.
•
•
•
•
I have read and understood the resource guides and resources legislation.
I understand my obligations as an applicant/holder.
I have truthfully declared all relevant details requested of me in this application.
If any part of this form has been completed with the assistance of another person, I declare that the information as set
down is true and correct and has been included with my full knowledge, consent and understanding.
Note: if this form is being signed by a person other than the current registered holder, a letter of authority or power of
attorney documents must be provided with this application.
Print name:
Signature:
Position:
Date:
Company:
Print name:
Signature:
Position:
Date:
Company:
Print name:
Signature:
Position:
Date:
Company:
Print name:
Signature:
Position:
Date:
Company:
Question 7 – Payment
Application
Variation of access fee

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OFFICE USE ONLY CHECKLIST -
YES/NO/NA
Has consent been provided if holder has obtained consent?
YES/NO/NA
Has a description of the access been provided?
YES/NO/NA
Has maps, graphical presentations been provided?
YES/NO/NA
Application fee has been lodged with application?
Receiving officer
I confirm that:
I recommend that the application should / should not be received.
•
•
•
•
Name: ___________________________
the details on this form have been checked
the checklist above are complete
attachments required are correct
correct fees have been submitted.
Signed:___________________________
Date:
/
/
The application for variation of access has / has not provided all the
information required by the legislation to be assessed.
Departmental Officer
Reasons for refused to receive:
_______________________________________________________
_______________________________________________________
The application for variation of access to the permit is received and
can be recorded on the register or refused to be received under the
MRA.
Name: ________________________________________
Signed:___________________________
Date:
/
/
Disclaimer
The Queensland Government is collecting information provided on and with this form to assess the suitability of the application under the Mineral
Resources Act 1989 (the Act). This information is authorised by sections 125, 231, 317, 387 of the Act. Some or all of this information may be provided
to other agencies of the Queensland Government for issuing an environmental authority, to make register searches, extracts or copies under section
387B of the Act or to make other approvals as required under the Act. Your personal information will not otherwise be disclosed to any other third party
without your consent, unless authorised or required by law.
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