Information Collection

SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire

IC 35613 under ICR 201612-3245-003 · OMB 3245-0062.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3245-0062 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SBA Form 2182 EXD SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form and Instruction
3245-0062 SBIC Application Instructions 12-21-16.pdf	Instruction
SBA Form 2181 Applicant Narrative 3245-0062 SBA Form 2181 - Narrative (Applicant Name) 12-21-16.pdf	Form and Instruction
SBA Form 2182 Principal Exhibits 3245-0062 SBA Form 2182 - (Principal Name) 12-21-16.docx	Form and Instruction
SBA Form 2182 EXD Exhibit D 3245-0062 2162 Exhibit D - (Applicant Name) 12-21-16.xlsx	Form and Instruction
SBA Form 2182 Exce Excel Supplement 3245-0062 Form 2181 - Supplement (Applicant Name)_final.xlsx	Form and Instruction
SBA Form 2183 Funds Exhibits 3245-0062 SBA Form 2183 - (Applicant Name) 12-21-16.pdf	Form and Instruction
SBA Form 2182 Exhi Exhibit E1 3245-0062 Exhibit E1 - (YYYY Portfolio Name)_final.xlsx	Form and Instruction

IC Title:

SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 13 CFR 107.410

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 and Instruction	SBA Form 2182 EXD	Exhibit D	3245-0062 2162 Exhibit D - (Applicant Name) 12-21-16.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Instruction			3245-0062 SBIC Application Instructions 12-21-16.pdf	www.sba.gov/inv	Yes	No	Paper Only
Form and Instruction	SBA Form 2182 Excel Supplement	Excel Supplement	3245-0062 Form 2181 - Supplement (Applicant Name)_final.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form and Instruction	SBA Form 2183	Funds Exhibits	3245-0062 SBA Form 2183 - (Applicant Name) 12-21-16.pdf	www.sba.gov/inv	Yes	Yes	Paper Only
Form and Instruction	SBA Form 2181	Applicant Narrative	3245-0062 SBA Form 2181 - Narrative (Applicant Name) 12-21-16.pdf	www.sba.gov/inv	Yes	Yes	Paper Only
Form and Instruction	SBA Form 2182	Principal Exhibits	3245-0062 SBA Form 2182 - (Principal Name) 12-21-16.docx	www.sba.gov/inv	Yes	Yes	Paper Only
Form and Instruction	SBA Form 2182 Exhibit E1	Exhibit E1	3245-0062 Exhibit E1 - (YYYY Portfolio Name)_final.xlsx	www.sba.gov/inv	Yes	No	Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 375

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 67 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	375	-15	390
Annual IC Time Burden (Hours)	24,625	17,255	7,370
Annual IC Cost Burden (Dollars)	2,360,294	-94,412	2,454,706

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.