Information Collection

License Application, Statement Of Personal History, And Qualification Of Management

IC 160001 under ICR 199308-3245-003 · OMB 3245-0062.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3245-0062 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

LICENSE APPLICATION, STATEMENT OF PERSONAL HISTORY, AND QUALIFICATION OF MANAGEMENT

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SBA 415				No	No
Form	415A				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 41

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	41	-1,764	1,722	83
Annual IC Time Burden (Hours)	3,280	-1,680	1,640	3,320
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.