Phase 4 Certificat Phase 4 Certification Form (District of Columbia)

OMB Control No.: 0607-0988
Expiration Date: 11/30/2024
Form: Phase 4 Certification Form
District of Columbia
(2026)

Phase 4 Certification Form (District of Columbia)
Ward Boundaries

I certify there have been no changes to the ward boundaries since they were last submitted and/or
verified through the Redistricting Data Program in 2024.
No Changes
There have been changes to the ward boundaries since they were last submitted and/or verified through
the Redistricting Data Program in 2024. Select the option below that indicates whether the changes
involve whole blocks or split blocks.
Whole Blocks

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 .
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 . 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)).