Information Collection

Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees

IC 35671 under ICR 200903-3245-001 · OMB 3245-0118.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3245-0118 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form `SBA FORM 856 Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees	Form
`SBA FORM 856 DISCLOSURE STATEMENT LEVERAGED LICENSEES SBA Form 856.doc	Form
SBA FORM 856A DISCLOSURE STATEMENT NON-LEVERAGED LICENSEES SBA Form 856A.doc	Form

IC Title:

Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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 FORM 856	DISCLOSURE STATEMENT LEVERAGED LICENSEES	SBA Form 856.doc		No		Paper Only
Form	SBA FORM 856A	DISCLOSURE STATEMENT NON-LEVERAGED LICENSEES	SBA Form 856A.doc		No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	162	162
Annual IC Cost Burden (Dollars)	0	0

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.