Form 429 "Voting Equipment Purchased With Hava Funds Disposal Form" - Ohio

Form 429 is a Ohio Secretary of State form also known as the "Voting Equipment Purchased With Hava Funds Disposal Form". The latest edition of the form was released in September 1, 2017 and is available for digital filing.

Download a PDF version of the Form 429 down below or find it on Ohio Secretary of State Forms website.

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Download Form 429 "Voting Equipment Purchased With Hava Funds Disposal Form" - Ohio

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Form No. 429 Prescribed by the Secretary of State (09-17)
Voting Equipment Purchased with HAVA Funds
Disposal Form
The Ohio Secretary of State’s Office has adopted a policy on transfer or disposal of voting
equipment purchased with Help America Vote Act (HAVA) funds. This form is to be used for the
proper disposal of voting equipment.
The
County Board of Elections has voting equipment that is no longer
county
in working condition due to age, malfunction, or damage and will therefore dispose of the
equipment in accordance with the aforementioned policy listed below as of this
day of
, 20
.
year
month
Please list the quantity of equipment, a brief description of the equipment and the
estimated value of the equipment being transferred.
Quantity
Item Description
Estimated Value
If you need more space, please attach a list of items, quantity and their estimated value.
The Board of Elections shall maintain accurate records of all equipment disposed of in the event of
relevant audits, claims, litigation, negotiations or other proceedings regarding the disposal of voting
equipment originally purchased with Help America Vote Act (HAVA) funding.
Board of Elections Director's Signature
Date (MM/DD/YYYY)
Board of Elections Chair's Signature
Date (MM/DD/YYYY)
SOS USE ONLY
The Secretary of State’s office has approved the disposal of the above list of voting equipment.
Director of Elections’ Signature of Approval
Date (MM/DD/YYYY)
Form No. 429 Prescribed by the Secretary of State (09-17)
Voting Equipment Purchased with HAVA Funds
Disposal Form
The Ohio Secretary of State’s Office has adopted a policy on transfer or disposal of voting
equipment purchased with Help America Vote Act (HAVA) funds. This form is to be used for the
proper disposal of voting equipment.
The
County Board of Elections has voting equipment that is no longer
county
in working condition due to age, malfunction, or damage and will therefore dispose of the
equipment in accordance with the aforementioned policy listed below as of this
day of
, 20
.
year
month
Please list the quantity of equipment, a brief description of the equipment and the
estimated value of the equipment being transferred.
Quantity
Item Description
Estimated Value
If you need more space, please attach a list of items, quantity and their estimated value.
The Board of Elections shall maintain accurate records of all equipment disposed of in the event of
relevant audits, claims, litigation, negotiations or other proceedings regarding the disposal of voting
equipment originally purchased with Help America Vote Act (HAVA) funding.
Board of Elections Director's Signature
Date (MM/DD/YYYY)
Board of Elections Chair's Signature
Date (MM/DD/YYYY)
SOS USE ONLY
The Secretary of State’s office has approved the disposal of the above list of voting equipment.
Director of Elections’ Signature of Approval
Date (MM/DD/YYYY)
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