Person filling out this Checklist:

Component/Agency:
Name:
Title:
Telephone number:
Fax number:
E-mail address:

Equipment under review:

Type (choose one):

(a) printer
(b) fax machine
(c) copier
(d) other -- describe:

Manufacturer:
Model:
Number of units of this model operated or used by component:

Used by approximately [blank] members of the public on a weekly basis.
Used by approximately [blank] Federal employees on a weekly basis.

Hours of availability (choose the most appropriate):
(a) 24 hours a day, seven days a week
(b) normal business hours, weekdays only
(c) normal business hours, 7 days a week
(d) extended business hours, weekdays only
(e) extended business hours, weekdays and some weekend hours

Question	Y	N	N/A
1. Can the user change sound settings, such as volume?
2. Are any displays -- including liquid crystal displays -- readable by persons who are in a seated position, such as those who use wheelchairs?
3. For free-standing equipment, is the highest operable part of controls, dispensers, receptacles, and other operable equipment placed within at least one of the following reach ranges? (a) If a forward approach is required, the maximum high forward reach is 48 inches. (b) If a side approach is allowed, and the reach is not over an obstruction, the maximum high side reach is 54 inches; if it is over an obstruction which is no more than 24 inches wide and 34 inches high, the maximum high side reach is 46 inches.
4. Are status information and cues that are provided in a visual manner also available in an audible manner for persons with visual impairments?
5. For fax machines, does the machine provide line status information (such as notifying the user of a "busy" fax line) in a visual manner (either text display or status lights) for users who are deaf or hard of hearing?
6. Is the force required to operate or active controls no greater than 5 lbf?
7. Can users confirm their selections? For instance, if a person has limited fine motor control, such as a person who has a palsy, it is helpful for him or her to have the opportunity to confirm selections -- such as "number of copies" selected -- before the operation begins.
8. Are controls and operating mechanisms operable with one hand and operable without tight grasping, pinching, or twisting of the wrist?
9. Is there a headphone jack for accessing information by users of assistive listening systems?
10. Are instructions and all information for use accessible to and independently usable by persons with vision impairments, such as with recorded information or Braille labels and directions?
11. Are there alternate operating mechanisms for persons who cannot use push-style controls? Ex. For instance, are there alternative methods of control -- such as voice activation -- for routine tasks?

12. After you have evaluated this equipment using the Checklist, have users with a wide variety of disabilities test it for accessibility. Describe the accessibility successes and problems they encountered during these exercises, including your plans for addressing any problems: [space provided for answer]

1. For persons with disabilities, additional copies of this document are available on computer disk and in alternate formats including large print, Braille, and audio cassette, by calling the U.S. Department of Justice at the following numbers:

Section 508 Coordinators:
1-202-305-8304 (voice)
1-202-353-8944 (TTY)

ADA Information Line:
1-800-514-0301 (voice)
1-800-514-0383 (TTY)

Alternate format copies for persons with disabilities may also be requested via e-mail to:

sec508.questions@usdoj.gov

This document is available on the Section 508 Home Page of the Civil Rights Division, U.S. Department of Justice: http://www.usdoj.gov/crt/508