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Annex III

INFORMATION’S OF GIS

[Mark ( ) if applicable]

1. Geo-Code (BBS):

(2001) Division District Thana Union Mauza Institution Code

2. Name of Institution :---------------------------------------------------------------------------
3. Location Information :
(A) Village/Holding No./Road : ---------------------------- -----------------------------
(B) Dag No.(CS)
(C) Published year of the Mauza Map (CS) (SA) (SA) (RS) (RS)
(D) Sheet No. (if any) (CS) (SA) (RS)
(E) Name of the Mauza (CS) (SA) (RS)
(F) Jl No. of the Mauza (CS) (SA) (RS)

4. Road/ River Information :
(A) Nearest Pucca Road : ------------- Distance of the Road: K.M. M.
(B) Location of the Road: East/West/North/South/Northeast/Southeast/Northwest/Southwest
(C) Location of the River: -------------------- Nearest River: K.M. M.
(D) Location of River: East/West/North/South/Northeast/Southeast/Northwest/Southwest

5. Identification in the Map:
(A) Identified in the Map ? Yes No
(B) If answer is ‘A’ no then write the cause:

6. Nearest Important Infrastructure:
(A) Distance of the Thana Police Station: K.M. M.
(B) Location of the Police Station: East/West/North/South/Northeast/Southeast/Northwest/Southwest
(C) Distance of the Union Council: K.M. M.
(D) Location of the Council: East/West/North/South/Northeast/Southeast/Northwest/Southwest
(E) Name of a Nearest Important Infrastructure: Bazar/Rail Station/Bus Station/Bandor/Lunchghat:
(F) Distance of the Infrastructure: K.M. M.
(G) Location of the Infrastructure: East/West/North/South/Northeast/Southeast/Northwest/Southwest

Enumerating Officer Signature and Seal
Signature and Date: (Head of the Institution)

Seal:

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