Financing Eligibility Statement - Social Disadvantage/Economic Disadvantage

Forms and Documents

Document Name	Status
Form SBA 1941A Financing Eligibility Statement - Social Disadvantage/Economic Disadvantage Form and Instruction	Modified
1941 Investment Act Form 1941-NOV 24.pdf Supplementary Document	2010-11-24
1941appendix.NOV 24.doc Supplementary Document	2010-11-24
1941 Supporting Statement omb83-1941_NOV-24.docx Supporting Statement A	2010-11-24

IC Document Collections

IC ID	Document Title	Status
35752	Financing Eligibility Statement - Social Disadvantage/Economic Disadvantage Form and Instruction	Modified

ICR Details

OMB Control No: 3245-0301	ICR Reference No: 201011-3245-003
Status: Historical Active	Previous ICR Reference No: 200709-3245-001
Agency/Subagency: SBA	Agency Tracking No:
Title: Financing Eligibility Statement - Social Disadvantage/Economic Disadvantage
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/03/2011
	Date Received in OIRA: 11/24/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2014	36 Months From Approved	12/31/2010
Responses	50	0	80
Time Burden (Hours)	100	0	160
Cost Burden (Dollars)	0	0	0

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Abstract: Small businesses seeking financing from specialized small business investment companies (SSBICs) will complete this form for the purpose of demonstrating their eligibility for such financing based on their ownership by individuals who are either socially or economically disadvantaged. Written certification of eligibility is required by the Small Business Investment Act of 1958.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 26295	05/11/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 47034	08/04/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Financing Eligibility Statement - Social Disadvantage/Economic Disadvantage	SBA FORM 1941C , SBA 1941A , SBA FORM 1941 B	Financing Eligbility Statement Social Disadvantage ,   Financing Eligibilty Statement ,   Financing Eligibility Statement

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	50	80	0	-30	0	0
Annual Time Burden (Hours)	100	160	0	-60	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Cutting Redundancy

Short Statement: As a result of the repeal of section 301(d) of the Small Business Investment Act, no new SSBIC'S have been licensed since 1996.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/24/2010

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