SBA 2246 RBIC Amendment to Application

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OMB No: 0570-0051

URAL BUSINESS INVESTMENT PROGRAM
U.S. DEPARTMENT OF AGRICULTURE
U. S. SMALL BUSINESS ADMINISTRATION
409 Third Street, S.W. Washington, DC 20416 Tel: (202) 205-6510; Fax: (202) 205-6959

AMENDMENT

TO

RBIC APPLICATION (SBA Forms 2241 and 2242)

Instructions: Rural Business Investment Companies (RBICs) must submit all amendments to RBIC Application (SBA Forms 2241 and 2242) on this Amendment form. RBICs must reference the Question on SBA Form 2241 Part I, Questionnaire, or the Exhibit letter on SBA Form 2242 Part II, Exhibits, that it is amending by the submission of this Amendment Form. Send the original and one copy of each Amendment and all pages attached to it, to SBA at the address shown above.

RBIC Name
RBIC Number
Date of this Amendment
Date of last Amendment submitted
Captions of items being amended (use additional pages as needed)
Number of pages attached

RBIC hereby certifies that all information submitted in this Amendment to RBIC Application, and in the pages attached to it, is true and correct; is being submitted for the purpose of obtaining SBA approval of amendments to RBIC's Application (SBA Forms 2241 and 2242); and will become part of RBIC 's Participation Agreement with SBA. RBIC represents that its undersigned representative has the authority to make such certifications and to bind the RBIC by signing below.

Typed Name
Title: (President/General Partner/Manager)
Signature		Date

SBA is collecting the information on this form for the purpose of determining, based on the application as amended, whether the RBIC should remain a RBIC. SBA may use the collected information in performing background investigations of the key personnel of the RBIC. The information collected on this form is required in order for the RBIC to continue to receive SBA assistance. SBA is collecting this information on behalf of the U.S. Department of Agriculture (USDA) pursuant to a delegation of authority by USDA to SBA (7 CFR 4290.45.)

Please note: The estimated burden for completing this form is 1 hour per response. You are not required to respond to this form unless it displays a current Office of Management and Budget (OMB) approval number. The information collected on this form will be kept confidential to the extent permitted by law. If you have questions or comments concerning this estimate or other aspects of this information collection, please contact the U.S. Small Business Administration, Chief, Administrative Information Branch, Washington, DC 20416 and/or Office of Management and Budget, SBA Desk Officer, Washington, D.C. 20503. OMB Approval 0570-0051. Please do not send forms to OMB.

SBA Form 2246 (5/04) Previous edition is obsolete