NIGER STATE GEOGRAPHIC INFORMATION SYSTEM (NIGIS) AGENCY

INTENT TO ERECT TELECOM MAST 

Terms and Conditions.

By submitting Intent to Erect Telecom Mast Form, you are agreeing to be bound by the following terms and conditions.

1. Payment of Annual Ground Rent

2. Completed Form Should be Submitted to Geo-Information unit at NIGIS Agency for Validation.

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DATE & TIME

ID

T&C VALIDATION

Agree Disagree

T&C REMARK

INVALID REGISTRATION

REGISTRANT

COMPANY NAME

COMPANY ADDRESS

COMPANY E-MAIL

COMPANY PHONE

LGA (Optic Fiber)

Please select Bosso Local Government Area Chanchaga Local Government Area Gurara Government Area Munya Local Government Area Paiko Local Government Area Rafi Local Government Area Shiroro Local Government Area Suleja Local Government Area Tafa Local Government Area Agaie Local Government Area Bida Local Government Area Edatti Local Government Area Gbako Local Government Area Katcha Local Government Area Lapai Local Government Area Lavun Local Government Area Mokwa Local Government Area Agwara Local Government Area Borgu Local Government Area Kontagora Local Government Area Magama Local Government Area Mariga Local Government Area Mashegu Local Government Area Rijau Local Government Area Wushishi Local Government Area

TOWN (Optic Fiber)

LENGHT (In meters)

SUITABILITY TEST

Please select Residential Non-Residential

STATUS

Please select Development Undevelop

Add a new option to those above

Value Label

ROUTE COORDINATES (Lat/Lon)

QR ID

Submit

3. By Submitting this form, you Must Agree to the T&C Above Otherwise, Your Registration is Invalid.

Validation: _____________________________________

Sign / Date & Stamp

Head of Geo-Information

NIGIS Agency.

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