BAS-2 BAS 2 - Counties Form

FORM

BAS-2 (05-2021)

OMB Control No.: 0607-0151 Expiration Date: xx-xx-2024

U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU

BOUNDARY AND ANNEXATION SURVEY (BAS)
COUNTIES AND EQUIVALENT AREAS
Boundaries as of —

To report changes for your county, parish, borough or equivalent area, please complete this form.
GENERAL
INSTRUCTIONS

● Answer all questions on the form completely.
● If there are no boundary changes to report, please email , call 1–800–972–5651, or
respond electronically at .
● Please do not return all of the maps. Return only the maps with changes.
● Return the completed form(s) and updated map(s) using the provided envelope and return label.
Type

County, parish, borough or equivalent area

STATE CODE

BAS ID

State

COUNTY CODE

IMPORTANT – ANNOTATE EACH CHANGE ON THE MAP(S) WITH THE APPROPRIATE DOCUMENTATION ACCORDING TO THE
INSTRUCTIONS PROVIDED IN THE BAS RESPONDENT GUIDE. Please update the map(s) USING THE APPROPRIATE COLORED PENCILS.

Question 1

LEGAL COUNTY BOUNDARY CHANGES DURING THIS PERIOD

Please mark (X) the appropriate boxes.
1a. Have there been any legal boundary changes to this county, parish, borough or equivalent area during the time period shown above?
Yes – Please record all legal changes (annexations, deannexations, and other actions) in the Documentation of Changes
section of this form and update the map(s) USING THE ENCLOSED RED PENCIL. Continue with question 1b.
No – Continue with question 1b.
1b. Are there any legal boundary changes to the county, parish, borough or equivalent area that occurred prior to the time period shown
for question 1, but do not appear on the enclosed maps?
Yes – Please update the map(s) with the RED PENCIL. Continue with question 1c.
No – Continue with question 1c.
1c. Besides legal changes, are there any boundary corrections that need to be made to your boundary on the map(s)?
Yes – Correct the map(s) USING THE RED PENCIL and the letters "BC" to indicate a boundary correction.
Enter the total number of boundary corrections that were
made to the county or equivalent area’s boundary.

Continue with question 1d.

No – Continue with question 1d.
1d. Is your county a consolidated BAS respondent? If you are unfamiliar with this approach, please consult your BAS Respondent Guide.
Yes – Continue with question 2.
No – Please encourage the MCD and/or incorporated place BAS respondents in your county, parish, borough or equivalent area to
report their changes. Continue with question 2d.
Question 2

OTHER CHANGES – Mark (X) applicable box(es).

2a. Have there been any legal boundary changes to the minor civil divisions or incorporated places (if any) within this county,
parish, borough or equivalent area during the time period shown for question 1, above?
Yes – Please update the map(s) with the RED PENCIL. Continue with question 2b.
No – Continue with question 2b.
2b. Are there any legal boundary changes to the minor civil divisions or incorporated places (if any) that occurred prior to the
time period shown for question 1, but do not appear on the enclosed maps?
Yes – Please update the map(s) with the RED PENCIL. Continue with question 2c.
No – Continue with question 2c.
2c. Are there any corrections that should be made to the boundaries shown on the map(s) of your minor civil divisions (MCDs) or
incorporated places?
Yes – Please update the map(s) with the RED PENCIL and the letters "BC" to indicate a boundary correction.
Enter the total number of boundary corrections that
were made to MCDs and incorporated places.

Continue with question 2d.

No – Continue with question 2d.
2d. Do you wish to report any additions, deletions or other changes to the features (other than boundaries) shown on the map(s)?
Yes – Please update the map(s) with the PURPLE PENCIL. Continue with question 3.

No – Continue with question 3.

We estimate that participating in the Boundary and Annexation Survey will take 7.5 hours on average. Send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, using Paperwork Reduction Project 0607-0151 as the subject, to
. This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number that
appears at the upper right of the form confirms this approval. If this number were not displayed, we could not conduct this survey. The Census Bureau conducts
this survey under the legal authority of the Title 13 United States Code, Section 6.

Question 3

CONTACT INFORMATION – Please fill in your contact information in the space provided below.
BAS Respondent

Mailing
Address

Mark (X) one government type for the BAS Respondent.

(The BAS respondent is the person filling out this form.)

Local

County/equivalent

Regional

Name
Address
Position
Department

City

Telephone

(

)

Fax

(

)

Ext.

State
E-mail

Mark (X) this box if the BAS Respondent
is the same as the BAS Mailing Contact.

Question 4

Mark (X) this box if the BAS Respondent is
the same as the Highest Elected Official.

CONTACT INFORMATION – Please fill in or correct the contact information below.
Mark (X) one government type for the BAS Mailing Contact.

BAS Mailing Contact

Mailing
Address

ZIP code

(Provide address where BAS materials should be sent.)

Local

County/equivalent

Regional

Name
Address
Position
Department

City

Telephone

(

)

Fax

(

)

Ext.

State

ZIP code

E-mail

Highest Elected Official

Mailing
Address

(for county, parish, borough or equivalent area)

Name
Address
Position
Department

City

Telephone

(

)

Fax

(

)

RETURN FORMS TO:

U.S. Census Bureau
National Processing Center
ATTN: BAS RETURNS, BLDG 63E
1201 East 10th Street
Jeffersonville, IN 47132

Ext.

State

ZIP code

E-mail

Thank you for your participation and timely response.
Questions?

Telephone: 1-800-972-5651
Email:
Website:

CENSUS USE ONLY

SPECIAL INSTRUCTIONS (If any)

FORM BAS-2 (05-2021)

Date
processed

Clerk ID
processed

Date
verified

Clerk ID
verified

Date form
keyed

Date GPP
updated

S/S change

Map received

Map
change

S/S no
change

Other map

Map no
change

PLAT/
Description

Map
signed

Letter

GOVERNMENT NAMES AND STATUS DOCUMENTATION
COUNTIES AND EQUIVALENT AREAS
County, parish, borough or equivalent area

BAS ID

Type

State

STATE CODE

COUNTY CODE

SPECIAL INSTRUCTIONS (If any)

FORM BAS-2 (05-2021)

(2)

Other (merger,
consolidation, etc.)

(1)

Inactive entity
became active

● Correct the spelling only
● Do not enter a date in column (9).

EFFECTIVE
DATE OF
CHANGE
Month, day,
year

Active entity
became inactive

If the name shown is misspelled —

● Draw a line through it,
● Print the correct type
above it, and
● Enter the date the change
was effective in column (9).

Incorporated place or
MCD never existed

● Draw a line through it,
● Print the correct type above it, and
● Enter the date the change was effective in column (9).

If the type shown is
incorrect —

STATUS CHANGES
If changes in status have
occurred — Please mark (X) in
the appropriate column and
enter the date the change was
effective in (9).

Disincorporated place
or disorganized MCD

If the name shown has changed —

TYPE

New incorporated place
or organized MCD

NAME OF INCORPORATED PLACE OR
MINOR CIVIL DIVISION (MCD)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

GOVERNMENT NAMES AND STATUS DOCUMENTATION – Continued
COUNTIES AND EQUIVALENT AREAS
County or
equivalent
area
any)
County,
parish,
borough
or(ifequivalent
area

BAS ID

State

STATE CODE

(2)

Other (merger,
consolidation, etc.)

(1)

Inactive entity
became active

● Correct the spelling only
● Do not enter a date in column (9).

Active entity
became inactive

If the name shown is misspelled —

EFFECTIVE
DATE OF
CHANGE
Month, day, year

Incorporated place or
MCD never existed

● Draw a line through it,
● Print the correct name above it, and
● Enter the date the change was effective in column (9).

If the type shown is
incorrect —
● Draw a line through it,
● Print the correct type
above it, and
● Enter the date the change
was effective in column (9).

STATUS CHANGES
If changes in status have
occurred — Please mark (X) in
the appropriate column and
enter the date the change was
effective in (9).

Disincorporated place
or disorganized MCD

If the name shown has changed —

TYPE

COUNTY CODE

New incorporated place
or organized MCD

NAME OF INCORPORATED PLACE OR
MINOR CIVIL DIVISION

FORM BAS-2 (05-2021)

Type

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Documentation of Changes
COUNTIES AND EQUIVALENT AREAS
County, parish, borough or equivalent area

Type

BAS ID

STATE CODE

State

COUNTY CODE

SPECIAL INSTRUCTIONS (If any)

Please follow the instructions below and review the preprinted entries for correctness and completeness and make changes as necessary.
For new legal changes, use the provided spaces to print the requested information for all annexations, deannexations and other changes that
have occurred during the previous year(s).
Instructions for Entering Data in Columns
(1) Change – Enter A for annexations, D for deannexations, B for boundary corrections, or O for other changes.
(2) Authorization – Enter the authorization type. (O = Ordinance, R = Resolution, L = Local Law, S = State-level action, and X = Other)
(3) Authorization – Enter the authorization number for the change you are reporting.
(4) Date – Enter the effective date of the change. (Month, day, year)
(5) Entity – Enter the name of the entity (i.e. name of MCD, place, or county) where the change occurred.
(6) County/Equivalent – Enter the name of the county or equivalent area in which the change occurred.
(7) Minor Civil Division (MCD) – Enter the name of the minor civil division (if any) in which the change occurred.
(8) Area – Enter the estimated size (in tenths of acres) of the annexation, deannexation or other change.

Change
Type
A/D/O
(1)

Authorization
Type
O/R/L/S/X
(2)

FORM BAS-2 (05-2021)

Authorization Number

Date
Month/Day,
Year

Entity
Name

County/
Equivalent
Name

(3)

(4)

(5)

(6)

Minor Civil Division
Name (if any)
(7)

Area
Acres
(tenths)
(8)

Documentation of Changes – Continued
COUNTIES AND EQUIVALENT AREAS
County, parish, borough or equivalent area

Type

BAS ID
Change
Type
A/D/O
(1)

FORM BAS-2 (05-2021)

COUNTY CODE

STATE CODE
Authorization

Type
O/R/L/S/X
(2)

Authorization Number
(3)

State

Date
Month/Day,
Year

Entity
Name

County/
Equivalent
Name

(4)

(5)

(6)

Minor Civil Division
Name (if any)
(7)

Area
Acres
(tenths)
(8)