Form-E
Re-Diversion i) Land Use Change ii) Laying of OFC/ UG drinking water pipeline/ slurry
pipeline/ electric cable/ CNG/PNG/ Petroleum and Crude Oil within RoW
Sl. No. 1 to 13 is covered in CAF
14 State #Auto Populate#
15 Application for [1. Land Use Change 2. Re-Diversion] Drop Down
If Re-Diversion is selected, then
15.1 [1. Laying of UG OFC 2. Laying of above ground OFC 3. UG Drop Down
drinking water pipeline 4. UG Slurry pipeline 5. UG Electric
cable 6. UG CNG/PNG 7. UG Petroleum and Crude Oil]
16 Re-diversion/ Change in land use is sought by [Primary Agency/ : Drop Down
Secondary Agency] *
17 Purpose of Re-diversion/ Change in land use* #Free Text#
17.1 Whether the re-diversion/ Change in land use is proposed Drop Down
within the Right of Way of road [Yes/ No]*
17.2 Justification* #Free Text#
17.3 Division Drop Down
PARIVESH Division Names.pdf
17.4 Upload single KML of all the patches/ segments for the Upload
selected division (KML of area propose for re-diversion should
be clearly shown)
17.5 Area for which re-diversion/ Change in land use is applied,
detail of approval obtained under the FC Act, 1980
Area approved (Earlier) Area Proposed for Re-diversion/ Change in
land use*
Compone Non-Forest Forest Land Component Non-Forest Land Forest Land
nt Land (Ha) (Ha) (Ha) (Ha)
#Free #Number# #Number# #Free #Number# #Number#
Text# Text#
+Add Rows
from Sl. No.
17.3
18 Project affected tress to be felled [Yes/No]* If Yes then Drop Down
18.1 No. of trees proposed to be felled*
Comp As per original layout plan As per changed layout plan (B) Net change (B-A)
onent/ of proposal (A)
patch
#Free #Number# #Number# #Auto Calculate#
Text#
19 Details of approvals under the Forest (Conservation) Act , 1980
accorded in the past (Auto Fetch) (non mandatory)
If Proposal No. exists in the database, then auto fetch below mentioned
details
1
Else all the details need to be fed
19.1 Proposal No. Search/ #Free Text#
19.2 MoEF File No. Auto Fetch/ #Free Text#
19.3 Area of forest land diverted (ha) Auto Fetch/ #Number#
19.4 Period of diversion (Years) Auto Fetch/ #Number#
19.5 Date of approval Auto Fetch/ #Date#
+ Add Rows
20 Upload NOC from primary agency (applicable for secondary agency Upload
only)
In case of Secondary agency, form submits here (with undertaking)
21 Status of compliance to conditions stipulated in the previous approvals
21.1 Proposal No. Search/ #Free Text#
21.2 MoEF File No. Auto Fetch/ #Free Text#
21.3 Conditions stipulated by the MoEF Auto Fetch/ #Free Text#
21.4 Details of the compliance Auto Fetch/ #Free Text#
+ Add Rows
22 Details of the forest land returned back to the State Forest Department
or any other Authority from the forest land diverted in favour of the
user agency (Auto Fetch in Approved case)
22.1 Whether a part of the forest land diverted in favour of the user Drop Down
agency has been returned to the State Forest Department or any
other Authority? [Yes/ No] If Yes, then
22.1. No. of patches of the forest land returned /surrendered #Number#
1
22.1. Area of the forest land returned/surrendered (ha) #Number#
2
22.1. Patch wise details
3
22.1.3.1 Area of patch (ha) #Number#
22.1.3.2 Copy of the map of the patch (KML) Upload
22.1.3.3 Copy of the map of the patch prepared by Upload
using GPS or Total Station
22.1.3.4 Date of return #Date#
22.1.3.5 Authority to whom the forest land has Drop Down
been returned [State Forest Department/
Other] If Other, then
22.1.3.5.1 Please specify #Free Text#
22.1.3.6 Status of reclamation of land proposed to Drop Down
be returned /surrendered [Technical
Reclamation/ Biological Reclamation]
22.1.3.7 Copy of documentary proof in support of Upload
the return/surrender of the forest land
+ Add Rows
2
23 Whether the Project or a part thereof is located in any Protected Area Drop Down
or their Eco sensitive zone? [Yes/No] (Auto Fetch if available else user
need to feed it)
If Yes
23.1 Whether Project or a part thereof is located within a Drop Down
Protected Area / Eco sensitive zone?
[Protected Area / Eco sensitive zone]
If located in Project or a part thereof is located within the Protected
Area,
23.2 Distance from the nearest Protected Area (km) (non #Number#
mandatory)
23.3 Distance from the nearest Eco-Sensitive Zone (km) (non #Number#
mandatory)
23.4 Status of approval of NBWL [Approval obtained / under Drop Down
consideration / Application yet to be submitted]
If Project ID / Proposal No. exists, then auto fetch below
mentioned details
Else all the details need to be fed
If Approval obtained
23.2.1 Project ID/ Proposal No. #Search#/ #Free Text#
23.2.2 Date of approval Auto Fetch/ #Date
Stamp#
23.2.3 Reference No. Auto Fetch/ #Free Text#
23.2.4 Upload copy of approval Auto Fetch/ Upload
If application is under consideration
23.2.1 Project ID/ Proposal No.
23.2.2 Date of application Auto Fetch/ #Date
Stamp#
23.2.3 Reference No. Auto Fetch/ #Free Text#
23.2.4 Upload copy of application Auto Fetch/ Upload
If application yet to be submitted
23.2.1 Reasons thereof #Free Text#
If located in Eco sensitive zone
23.2 Whether approval of the Standing Committee of National Drop Down
Board for the Wildlife (NBWL) required? [Yes/ No]
If yes, then please provide details
23.2.1 Status of approval of the Standing Drop Down
Committee of National Board for the
Wildlife (NBWL) to the Project [Approval
obtained / under consideration / Application yet to
be submitted]
If Project ID / Proposal No. exists, then auto fetch below
mentioned details
Else all the details need to be fed
If Approval obtained
3
23.3.1.1 Project ID/ Proposal No. #Search#/ #Free Text#
23.3.1.2 Date of approval Auto Fetch/ #Date
Stamp#
23.3.1.3 Reference No. Auto Fetch/ #Free Text#
23.3.1.4 Upload copy of approval Auto Fetch/ Upload
If application is under consideration
23.3.1.1 Project ID/ Proposal No. #Search#/ #Free Text#
23.3.1.2 Date of application Auto Fetch/ #Date
Stamp#
23.3.1.3 Reference No. Auto Fetch/ #Free Text#
23.3.1.4 Upload copy of application Auto Fetch/ Upload
If application yet to be submitted
23.3.1.1 Reasons thereof #Free Text#
If No,
23.2 Reasons thereof #Free Text#
24 Sector Specific Details (Same as FC Form-A except for Airport as this is not required)
25 An undertaking to abide by the conditions stipulated in the approval Upload
granted under the FC Act, 1980
26 Undertaking
I hereby give undertaking that the data and information given in the #Check Box#
application and enclosures are true to be best of my knowledge and belief
and I am aware that if any part of the data and information is found to be
false or misleading at any stage, the project will be rejected and clearance
given if any to the project will be revoked at our risk and cost. In addition to
the above, I hereby give undertaking that no activity/ construction/ expansion
has since been taken up
26.1 Name : KYC
26.2 Designation : KYC
26.3 Company : KYC
26.4 Address : KYC
26.5 AADHAR Based e-Signature : eSign
26.6 Date : #System Generated#
Note:
In the case of primary agency all the fields are mandatory (except those where if any is
mentioned), sl. no. 20 is not required.
In the case of secondary agency Sl. No. 16, 17, 17.1, 17.2, 17.4 (Area Proposed for Re-diversion/
Change in land use*), 18, 18.1, 20 is mandatory
