OMB
Number: 0607-0988
Expiration
Date:
XX-XX-2024
VERIFICATION FORM FOR ________________________
(state name)
I have reviewed the 118th congressional district boundaries and identifying numbers, and I certify that the boundaries and numbers are correct as shown.
I have reviewed the 118th congressional district boundaries and identifying numbers, and I certify that the boundaries are correct as shown, except for the following block assignments specified below:
I have reviewed the 118th congressional district boundaries and identifying numbers. I verify that the boundaries are correct as shown, except for the identified block assignments. In lieu of specifying the incorrect block assignments and/or codes, we are providing corrections by sending a new block equivalency file via e-mail to rdo@census.gov.
Date ___________ Signature ____________________________________
Name ___________________________________________________________
Title ___________________________________________________________
Address ___________________________________________________________
City _______________________ State ___________ Zip Code __________
E-mail ___________________________________________________________
Fax ___________________________________________________________
County (code) |
Census Tract |
Census Block |
Incorrect CD |
Correct CD |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Please return this form by e-mail to rdo@census.gov or by FAX at 301-763-4348.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | 108th CONGRESSIONAL DISTRICT BOUNDARY |
Author | byle0001 |
File Modified | 0000-00-00 |
File Created | 2024-10-07 |