1.	Project Details

   Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? : Yes    Type of Violation : Other    Details of Violation : All the relevant documentation regarding the project has been enclosed along with minutes of SEAC and SEIAA Uttar Pradesh meetings   Upload document of Damage Assessment Report : Annexure-Damage Assessment Report   Upload document of Remediation Plan and Natural & Community augmentation plan : Annexure-Damage Assessment Report   Upload TOR Letter(if issued earlier) : None   Upload EC Letter(if issued earlier) : None

1.	Project Details

   i. Proposal No. : IA/UP/MIS/64056/2014    ii. MoEFCC File No. : 1803    iii.Short narrative of the project: Residential Colony Ansal Basera at Jhansi Uttar Pradesh    iv. Project Sector : Infrastructure and Miscellaneous Projects  +  CRZ    v. Company/Proponent : MS BASERA BUILDERS AND MS MADAKINEE ESTATE PVT LTD

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Uttar Pradesh	Jhansi	Jhansi

   vii.Date of TOR Granted 27 Jun 2015 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 19 Apr 2017 x.Project Type: New

2.	Uploaded Documents of EIA/EMP,Risk Assessment,Public Hearing etc.

i.EIA/EMP: Annexure-EIA/EMP ii.Risk Assessment: Annexure-Risk Assessment iii.Public Hearing: Annexure-Public Hearing    iv. Date of Public Hearing: 19 Apr 2017   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: Annexure-Additional Report/Study/Document   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: As per Gazette Notification dated 24 February 2014 SEAC and SEIAA UP have completed their tenure of 3 years We are now requesting transfer of our project from SEIAA UP to MoEFCC for appraisal

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 62    iii. Name of Consultant: ENVIRTA Sustainable Solutions India Pvt. Ltd.   iv. Address : 2412 4th floor express trade tower 2 b 36 sector 132 noida up   v. Mobile No.: 9910037943   vi. Landline No.: 01204974242   vii. Email Id: msbaserabuilders@gmail.com

5.	Undertaking

I hereby give undertaking that the data and information given in the 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 found to be false or misleading at at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost.

   i. Name of Applicant : OP    ii. Designation : Authorisedsignatory    iii. Name of Company(Applicant Name should not be given here) : MS BASERA BUILDERS AND MS MADAKINEE ESTATE PVT LTD    iv. Address : 118, UFF, Prakashdeep Building 7 Tolstoy Marg, Connaught Place, New Delhi 1 v. Uploaded copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency: Annexure-Uploaded copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency