Information Collection

Anomaly Reporting Form

IC 216195 under ICR 201504-3265-003 · OMB 3265-0019.

Documents and Forms

Document Name Document Type
Form EAC 003C Anomaly Reporting Form Form
EAC 003C Anomaly Reporting Form Voting System Anomaly Reporting Form.EAC 003C.pdf www.eac.gov/testing_and_certification/anomaly_reporting_form.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Anomaly Reporting Form	Agency IC Tracking Number:	EAC 003C

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	EAC 003C	Anomaly Reporting Form	Voting System Anomaly Reporting Form.EAC 003C.pdf	http://www.eac.gov/testing_and_certification/anomaly_reporting_form.aspx	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: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	41	41
Annual IC Time Burden (Hours)	82	82
Annual IC Cost Burden (Dollars)	1,025	1,025

Documents for IC

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.