Information Collection

Help America Vote Act (HAVA)

IC 9761 under ICR 202402-0960-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Sample HAVA Screenshots.pdf	Other-Sample Internet Screens
Sample HAVA Screenshots.pdf	Other-Sample Internet Screens
HAVA MOU Template - 0706.pdf	Other-Memorandum of Understanding Te
HAVA MOU Template - 0706.pdf	Other-Memorandum of Understanding Te
AAMVA HAVV Agreement template.pdf	Other- AAMVA HAVV Agreement template
AAMVA HAVV Agreement template.pdf	Other- AAMVA HAVV Agreement template

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample Internet Screens	Sample HAVA Screenshots.pdf	Yes	Yes	Fillable Fileable Signable
Other-Memorandum of Understanding Template	HAVA MOU Template - 0706.pdf	No		Paper Only
Other- AAMVA HAVV Agreement template	AAMVA HAVV Agreement template.pdf	No		Paper Only

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	4,905,600	713,664	4,191,936
Annual IC Time Burden (Hours)	163,520	23,789	139,731
Annual IC Cost Burden (Dollars)	63,459	-357,338	420,797

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.