Information Collection

Help America Vote Act (HAVA)

IC 9761 under ICR 202012-0960-003 · OMB 0960-0706.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0706 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HAVA Screenshots.pdf	Other-Sample Internet Screens
HAVA Screenshots.pdf	Other-Sample Internet Screens
HAVA MOU Template.pdf	Other-Memorandum of Understanding Te
HAVA MOU Template.pdf	Other-Memorandum of Understanding Te
Revised PA & PRA Statements.pdf	Other-Revised PA & PRA Statements
Revised PA & PRA Statements.pdf	Other-Revised PA & PRA Statements

IC Title:

Help America Vote Act (HAVA)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample Internet Screens	Yes	Yes	Fillable Fileable Signable
Other-Memorandum of Understanding Template	No		Paper Only
Other-Revised PA & PRA Statements	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,191,936	-746,160	4,938,096
Annual IC Time Burden (Hours)	139,731	-24,872	164,603
Annual IC Cost Burden (Dollars)	420,797	129,449	291,348

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.

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