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Phase 4 Verification Form (CDs)
ICR 202608-0607-005 · OMB 0607-0988 · Object 172047800.
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Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | Phase 4 Verification Form (CDs) |
| 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 Verification Form Congressional Districts (120th) Phase 4 Verification Form Congressional Districts I have reviewed the 120th congressional district (CD) boundaries and associated codes, and I certify that the boundaries and codes correctly represent the districts submitted as part of Phase 4 of the Redistricting Data Program. I have reviewed the 120th CD boundaries and associated codes, and I certify that the boundaries and codes are correct as shown, except for the block assignments specified in the table that appears on the second page of this form. I have reviewed the 120th CD boundaries and associated codes, and I certify that the boundaries and codes are correct as shown, except for the block assignments I am sending in a block equivalency file to <[email protected]> in lieu of specifying the incorrect block assignments and/or codes in the table. Name: _______________________________________________________________________________ Title: ________________________________________________________________________________ Address: _____________________________________________________________________________ Email: _______________________________________________________________________________ Phone: ______________________________________________________________________________ Fax: _________________________________________________________________________________ Signature:____________________________________________ Date:____________________________ 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)). County (code) Census Tract Census Block Incorrect CD Correct CD