The Division of Mine Reclamation and Enforcement utilizes a variety of forms in its day-to-day operations. Many of these have been converted to electronic format and are available for download.
Electronic forms on this page are self-extracting compressed files. The forms will be automatically placed into Word format once they are downloaded and executed. Opening the forms in Microsoft Word will allow the user to complete the forms and to include additional sections and attachments where appropriate.
Click here to view instructions for downloading electronic forms.
The Attach Tools Microsoft Word template allows you to add attachments to your forms.
Download Attach Tools in the same way you download an electronic form.
NCR2 - Application for Surface Disturbance Noncoal Mining Permit
NCR9 - Noncoal Performance Bond
NCR10 - Noncoal Letter of Credit
NCR11 - Noncoal Escrow Agreement
NCR12 - Noncoal Request for Bond Release
NCR14 - Noncoal Citizen's Request for Inspection
NCR15 - Noncoal Request for Reclamation Deferral
NCR18 - Noncoal Planting Report
SME05 - Citizen's Request for Inspection
SME09 - Deferment of Reclamation (Due to adverse conditions beyond the operator's control)
SME21 - Certification of Construction
SME22 - Certification of Maintenance on Impoundments
SME23 - Planting Report
SME29 - Certificate of Liability Insurance
SME30 - Notice of Cancellation (Nonrenewal or change of liability insurance)
SME42 - Performance Bond
SME42F- Performance Bond on Federal Land
SME42SA - Supplemental Assurance
SME64 - Escrow Agreement
SME72 - Irrevocable Standby Letter of Credit
SME72A - Confirmation of Irrevocable Standby Letter of Credit
SME80 - Minor Field Revision Application
SME87A - Application for Permanent Program Bond Release
SMP04 - Notice of Coal Exploration (not a permit)
Presubsidence - Presubsidence Survey Form
Application for Blaster Certification - Application for Blaster Certification Form
Letter of Reference for Blaster Certification - Letter of Reference for Blaster Certification Form
Application for Renewal of Blaster Certification - Application for Blaster Certification Renewal Form
For technical assistance in downloading electronic forms, contact Jim Adamson at 502-564-6940
or by e-mail at Jim.Adamson@ky.gov .
To request a copy of an electronic form, contact Jill Bruckner at 502-564-2340 or by e-mail at Jill.Bruckner@ky.gov .
