EAC-ESTEP-001A Application for ESTEP Participation

U.S. Election Assistance Commission

OMB Control # XXXX-XXXX
Expires: XX/XX/XXXX

Application for Participation in the
Election-Supporting Technology
Evaluation Program (ESTEP)
1. Participant Organization:

2. Manufacturer Code (if applicable):

5. System Development:

D
D
D

Commercial
In-House
Blended/Other
Please describe in section 9 of this form.

6. System Name:
3. Technology for Evaluation:

D
D

Electronic Poll Books (EPBs)

D
D

Election Night Reporting Databases

Voter Registration Portals and Databases

7. System Model/Version Number:

CJ Electronic Ballot Delivery Systems

Other Emerging Technology
Please describe in section 9 of this form.

4. Version of Requirements to be Used for Testing:

8. Technical Data Package (TDP)

CJ Supporting Documentation Attached

D

No Documentation Available

9. Brief Description of System:

Signature

Date

Printed Name

Designation

Form EAC-ESTEP-001A

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Instructions
This form provides participants with the means to apply for evaluation of an election-supporting technology system to
requirements designed by the EAC. Completion of this application is a required step in the EAC Election Supporting Technology
Evaluation Program (ESTEP).
This form is generally self-explanatory, however, the numbers and the instructions below correspond to the numbered sections of the
form.

1. Participant Organization: Full legal name of the organization that has elected to submit this application. Participants may include
manufacturers or state and local jurisdictions.

2. Manufacturer Code: The three-letter identification code provided by the EAC upon manufacturer registration. If a code has not yet been
assigned at the time of application, please respond with “N/A.”

3. Technology for Evaluation: Identify the technology submitted for evaluation.
4. Version of Standards to be Used for Testing: Select the version of the EAC-approved requirements to which the candidate
election-supporting technology is to be tested.
5-7. System Identification: Provide information as requested.

8. Technical Data Package (TDP): Identify whether the technical data package has been included with your application as an

attachment. The EAC reserves the right to reject a participant’s application, should they fail to include the following documents in their
TDP submission.
a. List of accessibility capabilities
b. Device capabilities and limits
c. Coding convention
d. Functional diagrams
e. List of client jurisdictions, if applicable
f. Training materials

9. Brief Description of the System: Describe the system, carefully listing all components submitted for evaluation. This information will be
used to describe the system in ESTEP’s final report.

If there are any questions regarding this form, please contact ESTEP via [email protected].
This information will be used solely to administer the EAC Election Supporting Technology Evaluation Program. This program is
voluntary, however, individuals who wish to participate must meet the requirements of the Program. This information will be made
public consistent with the requirements of the Freedom of Information Act, the Trade Secrets Act, and any other applicable Federal
law or regulation. Public reporting burden for this collection of information is estimated to average about 27 hours for completion of
this form. This estimate includes the time for reviewing the instructions, gathering information and completing the form. Send
comments regarding this burden estimate to the Election Supporting Technology Evaluation Program Director, U.S. Election
Assistance Commission, 633 3rd Street N.W., Suite 200, Washington, DC 20001. Notwithstanding any other provision of law, no
person is required to respond to, nor shall any person be subject to a penalty for failure to respond to, or comply with, a collection of
information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently
valid 0MB Control Number.

Form EAC-ESTEP-001A

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U.S. Election Assistance Commission

Application for Testing in the Election-Supporting
Technology Evaluation Program (ESTEP)
(To be completed by an EAC representative)

1. Application Number

Supplemental Comments (optional):

2. Participant Application Package
Received
Date/Time
Accepted
Date/Time
If not accepted, include attachment for written
notice of rejection.

3. Lead Technical Reviewer

4. VSTL Test Plan
Received
Date/Time
Accepted
Date/Time
If not accepted, include attachment for written
notice of rejection.

5. VSTL Test Report
Received
Date/Time
Accepted
Date/Time
If not accepted, include attachment for written
notice of rejection.

Form EAC-ESTEP-001A

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