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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample Internet Screens	HAVA Screenshots.pdf	Yes	Yes	Fillable Fileable Signable
Other-Memorandum of Understanding Template	HAVA MOU Template.pdf	No		Paper Only
Other-Revised PA & PRA Statements	Revised PA & PRA Statements.pdf	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 %

	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

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.