miKvix cÖv_wgK we`¨vj‡q mnKvix wk¶K wb‡qvM-2012Õ-Gi Av‡e`b dig

eiveit †Rjv cÖv_wgK wk¶v Awdmvi,wm‡jU †Rjv|

(1) c‡`i bvgt- mnKvix wk¶K

(2) cÖv_x©i c~Y© bvg(GmGmwm mb` Abyhvqx)t

(K) evsjvqt- Lv‡j`v †eMg cwc

(L) Bs‡iRx‡Z(eo A¶‡i)t KHALEDA BEGUM POPY

(3) wcZv/¯^vgxi bvgt- ‡gvt wmivR DwÏb

(4) gvZvi bvgt- †di‡`Šmx †eMg

(5) cÖv_x©i ¯’vqx wVKvbvt MÖvg/gnj­v/evox bs/moKt †gvj­vcyi

WvKNit wb`bcyi †cvó †KvWt 3170

Dc‡Rjv/_vbvt- weqvbxevRvi †Rjvt wm‡jU

(6) cÎ †hvMv‡hv‡Mi wVKvbvt- MÖvg-‡gvj­vcyi, WvKNi-wb`bcyi, Dc‡Rjv-weqvbxevRvi,†Rjv-wm‡jU

(7) Rb¥ ZvwiL(GmGmwm mb` Abyhvqx)t 01-01-1991 Bs

(8) ( 31 A‡±vei 2012Bs ZvwiL Abyhvqx) eqm.....20...... ermit...... 06...... gvmt...... 00...... w`b

(9) gwnjv/cyi“lt(wjLyb)t gwnjv

(10) ˆeevwnK Ae¯’v (cÖ‡hvR¨ †¶‡Î wVK wPý w`b)weevwnZv/AweevwnZv/weaev/ZvjvKcÖvßv/wecZœxK

(11) we‡kl †KvUv(cÖ‡hvR¨ †¶‡Î wVK wPý w`b)t‡cvl¨/gyw³‡hvØvi mš—vb/Avbmvi-wfwWwc m`m¨/GwZg cÖwZe›`x/DcRvwZ

(12) cÖv_x †cvl¨ n‡jÑ

(K)miKvix cÖv_wgK we`¨vj‡q †h wk¶‡Ki †cvl¨ Zuvi bvg:......

(L) D³ wk¶‡Ki me© †kl Kg©¯’j:......

(M) cÖv_©xi mv‡_ D³ wk¶‡Ki m¤ú©K:......

(13) cÖv_©x gyw³‡hv×vi mš—vb n‡j-......

(K) gyw³‡hv×vi bvg:......

(L) gyw³‡hv×vi mv‡_ cÖv_x©i m¤úK©......

(M) gyw³‡hv×vi c~Y© wUKvbv:......

(14) wk¶vMZ †hvM¨Zv ( GmGmwm /mggvb I ZrcieZ©x mKj cix¶v cvk msµvš— ):......

µwgK bs / cix¶vi bvg / wefvM/wRwcG / cv‡ki eQi / ‡evW©/wek¦we`¨vjq
1 / Gm Gm wm / 2.50 / 2008 / wm‡jU
2 / GBP Gm wm / 3.50 / 2010 / wm‡jU
3
4

(15)  cÖwk¶‡bi bvg I weeib ( hw` _v‡K) : ......

(16)  ‡UªRvwi Pvjvb I bs :...... ZvwiLt-......

e¨vs‡Ki bvg I wUKvbv : ‡mvbvjx e¨vsK,weqvbxevRvi kvLv

GZØviv Avwg kc_ cye©K †Nvlbv KiwQ †h, G Av‡e`b c‡Îi mKj weeiY Avgvi Ávb I wek¦vl g‡Z mZ¨

cÖv_©xi ¯^v¶i :......

cÖv_©xi cyY©bvg : Lv‡j`v †eMg cwc

ZvwiL : ......

Av‡e`b c‡Îi mv‡_ †cÖwiZ KvMRcÎvw`i weeib:

1| wk¶vMZ †hvM¨Zvi mZ¨vwqZ gyj mb` c‡Îi Kwc

2| RvZxqZv mb` cÎ

3| †UªRvix Pvjvb bs-

‡Rjv cÖv_wgK wk¶v Awdm

‡Rjv-wm‡jU|

cÖ‡ekcÎ (g~j)

miKvwi cÖv_wgK we`¨vj‡q mnKvix wk¶K wb‡qvM-2012-Gi wbe©vPbx cix¶v

(Awdm KZ…©K c~iYxq)

1. c‡`i bvgt mnKvix wk¶K †ivj bst ......

2. (K) cix¶vi ZvwiLt...... mgqt......

(L) †K›`ªt ......

( cÖv_x© KZ…©K c~iYxq)

3. (K) cÖv_xi bvgt Lv‡j`v †eMg cwc

(L) wcZvi/¯^vgxi bvgt †gvt wmivR DwÏb

4. cÖv_x©i †hvMv‡hv‡Mi wVKvbvt MÖvg/gnj­v/evox bs/moKt †gvj­vcyi ‡nvwìs bs-011

WvKNit wb`bcyi †cvó‡KvWt 3170

Dc‡Rjv/_vbvt weqvbxevRvi †Rjvt wm‡jU

5.cÖv_x©i ¯’vqx Dc‡Rjv/_vbvi bvgt weqvbxevRvi †Rjvt wm‡jU

......

Av‡e`bKvixi ¯^v¶i †Rjv cix¶v cwiPvjbv KwgwUi c‡¶

†Rjv cÖv_wgK wk¶v Awcmv‡ii ¯^v¶i I mxj

wet`ªt cÖ‡ekcÎ e¨ZxZ †Kvb cÖv_x©‡K wjwLZ cix¶vq AskMÖnb Ki‡Z †`qv n‡e bv|GB cix¶vq AskMÖn‡bi Rb¨ †Kvb cÖKvi wUG-wWG cÖ`vb Kiv n‡e bv| cix¶vi wb‡`©kvejx mshy³ Kiv n‡j|

......

‡Rjv cÖv_wgK wk¶v Awdm

‡Rjv-wm‡jU|

cÖ‡ekcÎ (Wywc­‡KU)

miKvwi cÖv_wgK we`¨vj‡q mnKvix wk¶K wb‡qvM-2012-Gi wbe©vPbx cix¶v

(Awdm KZ…©K c~iYxq)

1. c‡`i bvgt mnKvix wk¶K †ivj bst ......

2. (K) cix¶vi ZvwiLt...... mgqt......

(L) †K›`ªt ......

( cÖv_x© KZ…©K c~iYxq)

3. (K) cÖv_xi bvgt Lv‡j`v †eMg cwc

(L) wcZvi/¯^vgxi bvgt †gvt wmivR DwÏb

4. cÖv_x©i †hvMv‡hv‡Mi wVKvbvt MÖvg/gnj­v/evox bs/moKt †gvj­vcyi †nvwìs bs-011

WvKNit wb`bcyi †cvó‡KvWt 3170

Dc‡Rjv/_vbvt weqvbxevRvi †Rjvt wm‡jU

5.cÖv_x©i ¯’vqx Dc‡Rjv/_vbvi bvgt weqvbxevRvi †Rjvt wm‡jU

......

Av‡e`bKvixi ¯^v¶i †Rjv cix¶v cwiPvjbv KwgwUi c‡¶

†Rjv cÖv_wgK wk¶v Awdmv‡ii ¯^v¶i I mxj