25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 25 PCGP Model - Corporate General Partner Resolution for SBA Commitment	Form	Removed	Available
Form 25 PC Corporate Resolution for SBA Commitment	Form	Removed	Available
Form 1065 Applicant Licensee's Assurance of Compliance	Form	Removed	Available
Form 34 Bank Identification Form for Disbursement of Licensee's Amount of Net Proceeds	Form and Instruction	Removed	Available
Form 33 Model Letter to Selling Agent (Form and Instructions)	Form and Instruction	Removed	Available
Form 25 PIGP Individual General Partner Certificate for SBA Commitment	Form	Removed	Available
Form SBA FORM 1065 Applicant Licensee's Assurance of Compliance	Form and Instruction	Unchanged	Available
Form SBA FORM 34 Bank Indentification FORM	Form and Instruction	Unchanged	Available
Form SBA FORM 33 Model Letter to Selling Agent	Form and Instruction	Unchanged	Available
Form SBA FORM 25 PIGP Individual General Partner Certificate for SBA Commitment Certificater of General Partner	Form and Instruction	Unchanged	Available
Form SBA FORM 25 PCGP Corporate Genral Partner Resolution for SBA Commitment Certificate	Form and Instruction	Unchanged	Repair queued
Form SBA FORM 25 PC Corporate Resolution for SBA Commitment	Form and Instruction	Unchanged	Available
SBIC Supporting Statement 11-15-11.doc	Supporting Statement A	Uploaded 2012-01-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
35639	25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	Form	Removed	Model - Corporate General Partner Resolution for SBA Commitment
35639	25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	Form	Removed	Corporate Resolution for SBA Commitment
35639	25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	Form	Removed	Applicant Licensee's Assurance of Compliance
35639	25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	Form and Instruction	Removed	Bank Identification Form for Disbursement of Licensee's Amount of Net Proceeds
35639	25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	Form and Instruction	Removed	Model Letter to Selling Agent (Form and Instructions)
35639	25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	Form	Removed	Individual General Partner Certificate for SBA Commitment
200165	25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	Form and Instruction	Unchanged	Applicant Licensee's Assurance of Compliance
200165	25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	Form and Instruction	Unchanged	Bank Indentification FORM
200165	25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	Form and Instruction	Unchanged	Model Letter to Selling Agent
200165	25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	Form and Instruction	Unchanged	Individual General Partner Certificate for SBA Commitment Certificater of General Partner
200165	25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	Form and Instruction	Unchanged	Corporate Genral Partner Resolution for SBA Commitment Certificate
200165	25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	Form and Instruction	Unchanged	Corporate Resolution for SBA Commitment

ICR Details

OMB Control No: 3245-0081	ICR Reference No: 201201-3245-001
Status: Historical Active	Previous ICR Reference No: 201111-3245-001
Agency/Subagency: SBA	Agency Tracking No:
Title: 25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance
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: 02/14/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/10/2012
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	48	0	48
Time Burden (Hours)	42	0	43
Cost Burden (Dollars)	0	0	720

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Abstract: Applicants for SBA-guaranteed commitment must complete these forms as part of the application process. SBA uses the information to make informed and proper credit decisions and to establish the SBIC's eligibility for leverage and need for funds.

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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
25-Model Corp. Resol. or GP Certif., 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appl. Lic. Assure. of Compliance	25 PIGP, 25 PC, 33, 34, 1065, 25 PCGP	Individual General Partner Certificate for SBA Commitment ,   Model Letter to Selling Agent (Form and Instructions) ,   Bank Identification Form for Disbursement of Licensee's Amount of Net Proceeds ,   Applicant Licensee's Assurance of Compliance ,   Corporate Resolution for SBA Commitment ,   Model - Corporate General Partner Resolution for SBA Commitment
25-Model Corp.. Resol, or GP Certif, 33-Model Letter to Selling Agent, 34-Bank ID, 1065-Appli.Lic. Assur. of Compliance	SBA FORM 25 PCGP, SBA FORM 25 PIGP , SBA FORM 33 , SBA FORM 34, SBA FORM 1065 , SBA FORM 25 PC	Corporate Resolution for SBA Commitment ,   Corporate Genral Partner Resolution for SBA Commitment Certificate ,   Individual General Partner Certificate for SBA Commitment Certificater of General Partner ,   Model Letter to Selling Agent ,   Bank Indentification FORM ,   Applicant Licensee's Assurance of Compliance

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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	48	48	0	0	0	0
Annual Time Burden (Hours)	42	43	0	-1	0	0
Annual Cost Burden (Dollars)	0	720	0	-720	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The number of applications for refunding maturing debentures has declined during this time and thus the estimated aggregate annual hours for completion has been reduced by 1 hour.

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Annual Cost to Federal Government: $702

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: 01/10/2012

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