ELECT-633 Voting Equipment L&A Testing Certification

Before You Start
This survey replaces the paper version of ELECT-633/SBE-633. Please do not mail, fax, or email these forms to the Department as they will not be accepted.
The survey cannot be saved; once you start, if you time out or close before submitting, you will have to start over.

General Information

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           for which you are completing this survey.
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Locality Representative

Position *


This L&A testing certification applies to: *
I, the undersigned, certify to the Department of Elections that:
  • I personally witnessed the final testing of the voting equipment used in each precinct;
  • The equipment was properly programmed for this election; and
  • The testing and programming was conducted as required by Va. Code ยงยง 24.2-632 and 24.2-633.
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