Information Collection

Referendum Ballot

IC 203658 under ICR 201208-0581-002 · OMB 0581-0286.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HWL-ORB Referendum Ballot	Form
HWL-ORB Official Referendum Ballot Referendum Ballot (HWL-ORB).doc	Form

IC Title:

Referendum Ballot

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HWL-ORB	Official Referendum Ballot	Referendum Ballot (HWL-ORB).doc		No		Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,350

Number of Respondents for Small Entity: 1,200

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	270	270
Annual IC Time Burden (Hours)	68	68
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.