Phase 4 Certificat Phase 4 Certification Form (States with Multiple Congres

OMB Control No.: 0607-0988
Expiration Date: 11/30/2024
Form: Phase 4 Certification Form
Multiple CD States
(2026)

120

th

Phase 4 Certification Form (States with Multiple Congressional Districts)

Congressional District (CD) Boundaries and State Legislative District (SLD) Boundaries

I certify there have been no changes to the geographic areas selected below since they were last
submitted and/or verified through the Redistricting Data Program in 2024.
120th CD

SLDU (Upper House)

SLDL (Lower House)

There have been changes to the CD and/or SLD boundaries selected 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.
120th CD Whole Block

SLDU (Upper House) Whole Block

SLDL (Lower House) Whole Block

120th CD Split Block

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 .
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)).