NMVC Program Application, Funding and Reporting

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SBA FORM 468.1 CORPORATE SBIC'S	Form and Instruction	Removed	Available
Form SBA FORM 1031 PORTFOLIO FINANCING REPORT	Form and Instruction	Removed	Repair queued
Form BA FORM 2219 OPERATIONAL ASSISTANCE (OA) GRANT PERFORMACE REPORT	Form and Instruction	Removed	Available
Form SBA FORM 34 INSTRUCTIONS FOR BANK IDENTIFICATION FORM (SBA FORM 34) (FUNDING NET PROCEEDS)	Form and Instruction	Removed	Repair queued
Form SBA FORM 480 SIZE STATUS DECLARATION	Form and Instruction	Removed	Repair queued
Form SF-270 REQUEST FOR ADVANCE OR REIMBURSEMENT	Form and Instruction	Removed	Repair queued
Form SF-269 FINANCIAL STATUS REPORT	Form and Instruction	Removed	Available
Form SBA FORM 2217 REQUEST FOR SBA APPROVAL OF MANAGEMENT SERVICES FEES AND OTHER FEES	Form and Instruction	Removed	Available
Form SBA FORM 2210 INSTRUCTIONS FOR NMVC DEBENTURE DRAW APPLICATION	Form and Instruction	Removed	Repair queued
Form SBA FORM 2208 NMVCC APPLICATION (SBA FORMS 2184 AND 2185)	Form and Instruction	Removed	Available
Form SBA FORM 468 SCHED LOW-INCOME INVESTMENTS	Form and Instruction	Removed	Available
Form SBA FORM 468 SCHED SOCIAL ECONOMIC OR COMMUNITY ECNOMIC DEVELOPMENT IMPACT ASSESSMENT	Form and Instruction	Removed	Repair queued
Form SBA FORM 468 SCHED LOW INCOME ENTERPRISE FINANCING IMPACT ASSESEMENT	Form and Instruction	Removed	Available
SPECIALIZED SMALL BUSINESS INVESTMENT COMPANY (SSBIC) FOR OPERATIONAL ASSISTANCE (OA) GRAT UNDER THE NEW MARKETS VENTURE CAPITAL (NMVC) PROGRAM	Form and Instruction	Removed	Repair queued
Form SBA FORM 2216 SSBIC INTERVIEW QUESTIONS	Form and Instruction	Removed	Available
Form SBA FORM 2185 NEW MARKETS VENTURE CAPITAL PROGRAM APPLICATION PART II, EXHIBTS	Form	Removed	Available
Form SBA FORM 2184 NEW MARKETS VENTURE CAPITAL PROGRAM APPLICATION	Form and Instruction	Removed	Repair queued
Form SBA FORM 468 SCHEDULES	Form and Instruction	New	Repair queued
Form SBA FORM 2184 NMVC PART I APPLICATION	Form and Instruction	New	Available
Form SBA FORM 1031 PORTFOLIO FINANCING REPORT	Form and Instruction	New	Available
Form SBA FORM 2219 OPERATIONAL ASSISTANCE GRANT PERFORMANCE REPORT	Form and Instruction	New	Repair queued
Form SBA FORM 2217 REQUEST FOR SBA APPROVAL OF MANAGMENT SERVICES FEES	Form and Instruction	New	Repair queued
Form SBA FORM 2216 NMVC PROGRAM APPLICANT INTERVIEW QUESTIONS	Form and Instruction	New	Available
Form SBA FORM 2211 INSTRUCTIONS APPLICATION FOR SBA COMMITMENT OF LEVERAGE	Form and Instruction	New	Repair queued
Form SBA FORM 2210 NMVC INSTRUCTIONS	Form and Instruction	New	Repair queued
Form SBA FORM 2208 AMENDMENT TO NMVC APPLICATION	Form and Instruction	New	Repair queued
Form SBA FORM 2204 NMVC PARTICIPATION AGREEMENT	Form and Instruction	New	Available
Form SBA FORM 2185 NMVC EXHIBTS TO NMVC APPLICATION	Form and Instruction	New	Available
Form SBA FORM 468 SCH 9 ANNUAL FINANCIAL REPORT	Form and Instruction	New	Available
Form SBA FORM 34 BANK IDENTIFICATION FORM	Form and Instruction	New	Repair queued
Form SBA FORM 468 SCH 1 ANNUAL FINANCIAL REPORT - SHORT FORM	Form and Instruction	New	Available
NMVC Supporting Statement #3245-0332 (12-16-11).docx	Supporting Statement A	Uploaded 2011-12-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	CORPORATE SBIC'S
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	PORTFOLIO FINANCING REPORT
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	OPERATIONAL ASSISTANCE (OA) GRANT PERFORMACE REPORT
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	INSTRUCTIONS FOR BANK IDENTIFICATION FORM (SBA FORM 34) (FUNDING NET PROCEEDS)
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	SIZE STATUS DECLARATION
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	REQUEST FOR ADVANCE OR REIMBURSEMENT
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	FINANCIAL STATUS REPORT
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	REQUEST FOR SBA APPROVAL OF MANAGEMENT SERVICES FEES AND OTHER FEES
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	INSTRUCTIONS FOR NMVC DEBENTURE DRAW APPLICATION
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	NMVCC APPLICATION (SBA FORMS 2184 AND 2185)
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	LOW-INCOME INVESTMENTS
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	SOCIAL ECONOMIC OR COMMUNITY ECNOMIC DEVELOPMENT IMPACT ASSESSMENT
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	LOW INCOME ENTERPRISE FINANCING IMPACT ASSESEMENT
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	SPECIALIZED SMALL BUSINESS INVESTMENT COMPANY (SSBIC) FOR OPERATIONAL ASSISTANCE (OA) GRAT UNDER THE NEW MARKETS VENTURE CAPITAL (NMVC) PROGRAM
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	SSBIC INTERVIEW QUESTIONS
35801	NMVC Program Application, Funding and Reporting	Form	Removed	NEW MARKETS VENTURE CAPITAL PROGRAM APPLICATION PART II, EXHIBTS
35801	NMVC Program Application, Funding and Reporting	Form and Instruction	Removed	NEW MARKETS VENTURE CAPITAL PROGRAM APPLICATION
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	SCHEDULES
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	NMVC PART I APPLICATION
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	PORTFOLIO FINANCING REPORT
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	OPERATIONAL ASSISTANCE GRANT PERFORMANCE REPORT
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	REQUEST FOR SBA APPROVAL OF MANAGMENT SERVICES FEES
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	NMVC PROGRAM APPLICANT INTERVIEW QUESTIONS
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	INSTRUCTIONS APPLICATION FOR SBA COMMITMENT OF LEVERAGE
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	NMVC INSTRUCTIONS
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	AMENDMENT TO NMVC APPLICATION
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	NMVC PARTICIPATION AGREEMENT
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	NMVC EXHIBTS TO NMVC APPLICATION
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	ANNUAL FINANCIAL REPORT
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	BANK IDENTIFICATION FORM
200539	NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	Form and Instruction	New	ANNUAL FINANCIAL REPORT - SHORT FORM

ICR Details

OMB Control No: 3245-0332	ICR Reference No: 201112-3245-001
Status: Historical Active	Previous ICR Reference No: 200810-3245-002
Agency/Subagency: SBA	Agency Tracking No:
Title: NMVC Program Application, Funding and Reporting
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/02/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/21/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2015	36 Months From Approved	02/29/2012
Responses	378	0	1,151
Time Burden (Hours)	1,818	0	14,012
Cost Burden (Dollars)	0	0	4,550,999

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Abstract: SBA uses this information collection for proper oversight within the scope of the Small Business Act to assess NMVC Program participants. Only the six NMVC Companies in the NMVC program will be required to submit the forms in this information collection. Although no new NMVCCs are anticipated, the information collected in the application forms in part of the contractual obligation of each NMVCC, and therefore must be used for any legal or other structural changes.

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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:
	76 FR 36163	06/21/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 70527	11/14/2011
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
NMVC PROGRAM APPLICATION, FUNDING AND REPORTING	SBA FORM 468 SCH 9, SBA FORM 468 SCH 10 , SBA FORM 2185, SBA FORM 2204 , SBA FORM 2184 , SBA FORM 2216 , SBA FORM 1031 , SBA FORM 2219 , SBA FORM 2210, SBA FORM 2211 , SBA FORM 468 , SBA FORM 2217 , SBA FORM 2208 , SBA FORM 34	BANK IDENTIFICATION FORM ,   ANNUAL FINANCIAL REPORT ,   ANNUAL FINANCIAL REPORT - SHORT FORM ,   NMVC EXHIBTS TO NMVC APPLICATION ,   NMVC PARTICIPATION AGREEMENT ,   AMENDMENT TO NMVC APPLICATION ,   NMVC INSTRUCTIONS ,   INSTRUCTIONS APPLICATION FOR SBA COMMITMENT OF LEVERAGE ,   NMVC PROGRAM APPLICANT INTERVIEW QUESTIONS ,   REQUEST FOR SBA APPROVAL OF MANAGMENT SERVICES FEES ,   OPERATIONAL ASSISTANCE GRANT PERFORMANCE REPORT ,   PORTFOLIO FINANCING REPORT ,   NMVC PART I APPLICATION ,   SCHEDULES
NMVC Program Application, Funding and Reporting	SBA FORM 468.1, SBA FORM 2184 , SBA FORM 2208 , SBA FORM 468 SCHEDULE 9 , SBA FORM 468 SCHEDULE 11, SBA FORM 2216 , N/A, SBA FORM 1031 , SBA FORM 2185 , BA FORM 2219 , SBA FORM 34 , SF-269, SBA FORM 2210 , SBA FORM 2217, SBA FORM 468 SCHEDULE 10 , SF-270, SBA FORM 480	NEW MARKETS VENTURE CAPITAL PROGRAM APPLICATION ,   NEW MARKETS VENTURE CAPITAL PROGRAM APPLICATION PART II, EXHIBTS ,   SSBIC INTERVIEW QUESTIONS ,   SPECIALIZED SMALL BUSINESS INVESTMENT COMPANY (SSBIC) FOR OPERATIONAL ASSISTANCE (OA) GRAT UNDER THE NEW MARKETS VENTURE CAPITAL (NMVC) PROGRAM ,   LOW INCOME ENTERPRISE FINANCING IMPACT ASSESEMENT ,   SOCIAL ECONOMIC OR COMMUNITY ECNOMIC DEVELOPMENT IMPACT ASSESSMENT ,   LOW-INCOME INVESTMENTS ,   NMVCC APPLICATION (SBA FORMS 2184 AND 2185) ,   INSTRUCTIONS FOR NMVC DEBENTURE DRAW APPLICATION ,   REQUEST FOR SBA APPROVAL OF MANAGEMENT SERVICES FEES AND OTHER FEES ,   FINANCIAL STATUS REPORT ,   REQUEST FOR ADVANCE OR REIMBURSEMENT ,   SIZE STATUS DECLARATION ,   INSTRUCTIONS FOR BANK IDENTIFICATION FORM (SBA FORM 34) (FUNDING NET PROCEEDS) ,   OPERATIONAL ASSISTANCE (OA) GRANT PERFORMACE REPORT ,   PORTFOLIO FINANCING REPORT ,   CORPORATE SBIC'S

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ICR Summary of Burden

table that charts list 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	378	1,151	-1,151	378	0	0
Annual Time Burden (Hours)	1,818	14,012	-14,012	1,818	0	0
Annual Cost Burden (Dollars)	0	4,550,999	-4,550,999	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: THE IS DUE TO FINITE NUMBER OF NMVC PROGRAM PARTICIPANTS AND THE ASSOCIATED VOERSIGHT AND ADMINISTRATIVE COST TO THE GOVERNMENT.

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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: 12/21/2011

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