Information Collection

Field Anomaly Reporting

IC 45347 under ICR 201405-3265-001 · OMB 3265-0004.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EAC 003C Field Anomaly Reporting	Form and Instruction
EAC 003C Voting System Anomaly Reporting Form Voluntary Anomaly Reporting Form 1.1.pdf www.eac.gov	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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 and Instruction	EAC 003C	Voting System Anomaly Reporting Form	Voluntary Anomaly Reporting Form 1.1.pdf	www.eac.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 41

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	41	41
Annual IC Time Burden (Hours)	82	82
Annual IC Cost Burden (Dollars)	2,050	2,050

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.