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Phase 4 Certification Form (Single CD States)
ICR 202608-0607-005 · OMB 0607-0988 · Object 172047100.
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Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | Phase 4 Certification Form (Single CD States) |
| Author | U.S. Census Bureau |
| Last Modified By | Acrobat PDFMaker 24 for Word |
| File Modified | 2024-08-26 |
| File Created | 2024-08-16 |
| Conversion State | complete |
Extracted Text
OMB Control No.: 0607-0988 Expiration Date: 11/30/2024 Form: Phase 4 Certification Form Single CD States (2026) Phase 4 Certification Form (States with a Single Congressional District) (Alaska, Delaware, North Dakota, South Dakota, Vermont, and Wyoming) I certify there have been no changes to the state legislative districts (SLDs) checked below since they were last submitted and/or verified through the Redistricting Data Program in 2024. SLDU (Upper House) SLDL (Lower House) There have been changes to the state legislative district boundaries checked below since they were last submitted and/or verified through the Redistricting Data Program in 2024. Select the option(s) below that identify the district type and whether the changes involve whole or split blocks. SLDU (Upper House) Whole Blocks SLDL (Lower House) Whole Blocks SLDU (Upper House) Split Blocks SLDL (Lower House) Split Blocks Name: _______________________________________________________________________________ Title: ________________________________________________________________________________ Address: _____________________________________________________________________________ Email: _______________________________________________________________________________ Phone: _______________________________________________________________________________ Fax: _________________________________________________________________________________ Signature: _____________________________________________ Date: __________________________ For questions about completing this form or any other questions on the redistricting topic, contact the Redistricting & Voting rights Data Office at 301-763-4039 or at <[email protected]>. We estimate that participating in the Redistricting Data Program will take eight hours on average. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to <[email protected]>. This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number that appears on this form confirms this approval. If this number were not displayed, we could not conduct this program. The Census Bureau conducts this program under the legal authority of Public Law 94-171, as amended (Title 13 United States Code (U.S.C.), Section 141(c)).