Information Collection

Referendum Ballot

IC 203658 under ICR 201208-0581-002 · OMB 0581-0286.

Documents and Forms

Document Name Document Type
Form HWL-ORB Referendum Ballot Form
HWL-ORB Official Referendum Ballot Referendum Ballot (HWL-ORB).doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Referendum Ballot	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HWL-ORB	Official Referendum Ballot	Referendum Ballot (HWL-ORB).doc		No		Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,350	Number of Respondents for Small Entity: 1,200

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	270	270
Annual IC Time Burden (Hours)	68	68
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.