SBA Form 3313 Jody Raskind Lender of the Year

OMB Control Number 3245-0360
Expiration Date:

National Small Business Week
SBA Form 3313, Jody Raskind Lender of
the Year
Instructions: Refer to the National Small Business Week Award Nominations Guidelines
for detailed instructions for submitting nominations.
This form must be completed by the nominee. The completed form must be submitted with the
nomination package as noted in the award guidelines. Answer each question as fully as possible;
if it is not applicable, state N/A.
1. Lender Information:
a. Name:
b. Address:
c. Phone number:
d. Email address:
e. Website URL:
2. Lender point of contact information:
a. Name:
b. Phone number:
c. Email address:
Answer each of the following questions in 400 words or less.
3. Provide a narrative of your transactions/interactions with small businesses:
4. Provide a summary of the activities and their impacts on the markets they serve:

Caution: Penalties for False Statements
Knowingly making a false statement on this form is a violation of Federal law and could result in
criminal prosecution, significant civil penalties, and a denial of program participation or other
benefits awarded by the agency. A false statement is punishable under 18 U.S.C. §§ 1001 and
SBA Form 3313 (08/2017) (Previous Editions Obsolete)

3571 by imprisonment of not more than five years and/or a fine of not more than $250,000 and
under 15 U.S.C. § 645 by imprisonment of not more than two years and/or a fine of not more
than $5,000.
Paperwork Reduction Act Notice:
SBA will use the information collected on this form, along with other information submitted
by award nominees as part of the nomination package, to determine the nominee's eligibility
for a particular small business award; to identify any actual or apparent conflict of interest
and, to make eventual award determinations. Responding to this request for information is
voluntary. However, failure to provide the requested information may affect SBA’s ability
to make a decision regarding your eligibility for an award.
You are not required to respond to any collection of information unless it displays a currently
valid OMB control number (3245-0360). The estimated burden for completing this form is 1
hour and 15 minutes, including the time for reviewing the instructions, and gathering and
compiling data. Combined with the time for completing the Form 3300, the total estimated time
to prepare and submit the nomination package for each nominee is 90 minutes. Comments on
this burden estimate should be sent to the U.S. Small Business Administration, Chief, AIB 409
3rd St., SW, Washington, DC 20416, and Desk Officer for the U.S. Small Business
Administration, Office of Management and Budget, New Executive Office Building, Room
10202, Washington, DC 20503. DO NOT SEND COMPLETED FORMS TO OMB. Submit
them to the location indicated in the nomination guide.

SBA Form 3313 (08/2017) (Previous Editions Obsolete)