Section 4, "Act" Deaos The Gr$otnay Lsnd Rigbts Act, 2022

FanilyVillage:Chiefdom:Date: Witness; Name B SCTIEDUIT4 Land t'ansaction record fomtat FmitilVillase:Chiefdom:Date: Land trairsaction type: -sale Transaction date: Na,re, addresses and contacts ofparties: Location ofland (name of sheet, road or area and name oftown orvillage urbere IaDd is located): -lease -tenancy -piedge (S€tect one) Briefdescription ofland and is location: Size oflan* Surv€y plao available? YesYNo Is transaction docunented? Yestilo PrlI,'r@ ^,\D PLrBLrvrD eY fiE CxrvEnt.ac.r PRDrrolc Drr,rxrrctvr, Snre Leoxe SCHEDULE-< Free, Prior and Informed Consent Forn ior Investnent-lnduced DisPlacement and Resenlement Famih:village;Chiefdont:Date: Wq the adult male and female members ofthis town/village (delete one)' names appear beloq teely give our consent to & reseftl€d to anothcr by [imert name of company] in accordance with the provisions of the Act' RegulatioDs oD investsnent-ioduced displacement and resettlement and Nationat Investsnent Induced Resettlement Act 2023' We were infonned of the likelihood of rcsettlement during negotiations [insert name of company] and have be€n provided with sardics' sc€narios assessments in our local language showing that disptacement and are unavoidable. We have also been provided with the baseline studics assessmentsandresettlementactionplanrequiredbytheAcgtheregulation investuent-induced displacement and resettlement and the National Inve hduc€d Resettl.mentAct 2023 in our local language, rvhich we have discussed Aeely, aad approvd in oPen nrcetings oflhe comr unity' After consideration ofthe infomation provided to us, we, comtitufing at l€ast 60plo ofthe male and female adult memb€rs ofthis villager'toum inilpen rneaing collectiyely agree to be resettled in accordance with the above-mentioned laws and affix our mark toAign this document to sho* our Aee, prior ad infonned consent to the resefilement after the content ofthis form was read and explaired to us in our local language, rdrich we fully undcrstoo4 Thmrbprintlsignatue ContactName t. 4.