Materials Checklist (Indicate materials submitted with an “X”)
7 copies of the following (5 copies in electronic format and 2 hard copies):
Completed application Forms 100 and Form 101
If applicable, attach Form 100 - Schedule A, listing recommendations/issues made from previous Texas
examination. List how they have been corrected or addressed. If the have not, explain why.
If component has been modified, include log detailing changes from the previously Texas certified version
Nationally accredited voting system test laboratory reports of all tests (including summary) conducted on
items submitted
Operating Manual(s)
Maintenance Manual(s)
Training Manual(s)
Technical Specifications
Operational Specifications
List all COTS hardware/software used with the system and their version numbers – If listed in a nationally
accredited test laboratory reports, state where
List all configurations that will be marketed and sold in Texas
- indicate if the optical scan will be used as a precinct count, central count, or both
Provide complete step-by-step installation instructions for all software installs and configurations specific to
Texas
List of other election jurisdictions where system is in use or has been in use
Acknowledge which voting system test laboratory has bee
n notified to send a copy of the software and
source code and expected delivery date to our office.
Nationally
accredited voting system test laboratory
Name
Delivery Date
Signature of Person Making Request Title Date
Please submit the certification fee and all relevant materials to:
Irene Diaz
Elections Division
P.O. Box 12060
Austin, Texas 78711-2060
