(a) Information about the applicant, including name, standing to present application, entity type, principle address, mailing address, telephone number, fax number and email, if applicable.

(b) Identification of the specific electronic poll book to be evaluated for certification. Each electronic poll book or version of an electronic poll book requires a separate request for certification. Each component of the hardware, firmware, and software must be identified by version number.

(c) A signed confidentiality agreement providing the Secretary of State, upon demand, source code for all software and firmware and a working model of the electronic poll book.

(d) All the documentation necessary for the identification of the full system configuration submitted for evaluation and for the development of an appropriate test plan for conducting system certification testing, collectively referred to as the Technical Data Package (TDP) as described in section 20153.

(e) Documentation and description of any known anomalies, including a description of the root cause and resolution.

(f) Documentation from election jurisdictions that have certified the proposed electronic poll book.

(g) Whether the proposed electronic poll book has ever been denied certification or had certification withdrawn in any other state.

(h) A list of election jurisdictions using or previously having used the proposed electronic poll book.