P4-04 2022 SLD Verification Form (DC)

The Redistricting Data Program

P4-04_SLD_Verification_Form_Phase4_DC

Phase 4: Collection of Post Census Redistricting Data Plans

OMB: 0607-0988

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OMB Number: 0607-0988
Expiration Date: XX-XX-2024

PHASE 4 (POST 2020 CENSUS) CITY WARD BOUNDARY VERIFICATION FORM FOR THE DISTRICT OF COLUMBIA


I have reviewed the city ward boundaries, identifying numbers (and names if applicable). I certify that the boundaries, numbers, and names are correct as shown.



City Ward – (SLDU)


I have reviewed the city ward boundaries, identifying numbers (and names if applicable). I certify that the boundaries are correct as shown, except for the following block assignments specified below:



City Ward – (SLDU)


I have reviewed the city ward boundaries, identifying numbers (and names if applicable). I verify that the boundaries are correct as shown, except for the identified block assignments. In lieu of specifying the incorrect block assignments, codes, or names, we are providing corrections by sending a new block equivalency file via e-mail to [email protected].



City Ward – (SLDU)



Date ___________ Signature ____________________________________


Name ___________________________________________________________


Title ___________________________________________________________


Address ___________________________________________________________


City _______________________ State ___________ Zip Code __________


E-mail ___________________________________________________________


Fax ___________________________________________________________


County (code)

Census Tract

Census Block

Incorrect District #

Correct District #


 

 

 

 


 

 

 

 


 

 

 

 


 

 

 

 


 

 

 

 


 

 

 

 


 

 

 

 


Please return this form by e-mail to [email protected] or by FAX at 301-763-4348.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title108th CONGRESSIONAL DISTRICT BOUNDARY
Authorbyle0001
File Modified0000-00-00
File Created2021-10-04

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