Information Collection

SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire

IC 35613 under ICR 200704-3245-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 2181 SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form
3245-0062 F1-Template.xls	Instruction
3245-0062 F2-Template.xls	Instruction
3245-0062 F3-Template.xls	Instruction
3245-0062 F4-Template.xls	Instruction
3245-0062 F5-Template.xls	Instruction
2181 SBIC MANAGEMENT ASSESSMENT QUESTIONNAIRE/SBIC LICENSE AP SBA Form2181 01-04.doc WWW.SBA.GOV/INV	Form
2182 PART II EXHIBITS TO SMALL BUSINESS INVESTMENT COMPANY LI SBA Form2182 03-07.doc WWW.SBA.GOV/INV	Form
2183 PART III EXHIBITSS TO SMALL BUSINESS INVESTMET COMPANY M SBA Form2183 03-07.doc WWW.SBA.GOV/INV	Form

IC Title:

SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 13 CFR 107.410

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	2181	SBIC MANAGEMENT ASSESSMENT QUESTIONNAIRE/SBIC LICENSE APPLICATION PART 1	SBA Form2181 01-04.doc	WWW.SBA.GOV/INV	Yes	Yes	Fillable Fileable Signable
Form	2182	PART II EXHIBITS TO SMALL BUSINESS INVESTMENT COMPANY LICENSE APPLICATION	SBA Form2182 03-07.doc	WWW.SBA.GOV/INV	Yes	Yes	Fillable Fileable Signable
Form	2183	PART III EXHIBITSS TO SMALL BUSINESS INVESTMET COMPANY MANAGEMENT ASSESSMENT QUESTIONNAIRE	SBA Form2183 03-07.doc	WWW.SBA.GOV/INV	Yes	Yes	Fillable Fileable Signable
Instruction			3245-0062 F1-Template.xls		No		Paper Only
Instruction			3245-0062 F2-Template.xls		No		Paper Only
Instruction			3245-0062 F3-Template.xls		No		Paper Only
Instruction			3245-0062 F4-Template.xls		No		Paper Only
Instruction			3245-0062 F5-Template.xls		No		Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 20 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	255	-425	680
Annual IC Time Burden (Hours)	4,300	-6,580	10,880
Annual IC Cost Burden (Dollars)	1,605,000	-2,675,000	4,280,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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