Form SBA FORM 2461 SBA FORM 2461 Quarterly Contract Completion Report

OMB Control NO: 3245-0395
Expiration Date:
Instructions: Each Surety Company participating in SBA’s Surety Bond Guarantee Program is required to use this form to report on all contracts that were successfully completed during the fiscal quarter. The information is due to
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SBA within 45 days after the close of each fiscal year quarter that ends on December 31 , March 31 , June 30 and September 30 . Submission of this information is required to obtain or retain a benefit. The information may be
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submitted via email to SBA at @sba.gov or via mail/courier to U.S. Small Business Administration, Office of Surety Guarantees, 409 3 Street, SW, Washington, DC, 20416. If additional space is needed, attach additional pages.
Clearly identify the information using the same headings for each reporting column.

U.S. SMALL BUSINESS ADMINISTRATION
SURETY BOND GUARANTEE PROGRAM
QUARTERLY CONTRACT COMPLETION REPORT

SURETY NAME: ______________________________________ QUARTER ENDED: ___________________________________

SBG/PSB
NUMBER

CONTRACTOR
NAME

ORIGINAL CONTRACT
AMOUNT (AS OF BOND
EXECUTION)

REVISED CONTRACT
AMOUNT

CONTRACT COMPLETION
DATE

OUTSTANDING CONTRACTOR FEE DUE TO
SBA OR TO BE REFUNDED TO THE
CONTRACTOR

OUTSTANDING SURETY
FEE DUE TO SBA OR TO
BE REBATED TO THE
SURETY

I certify that all information provided is true, correct and complete to the best of my knowledge. I understand that knowingly making a false statement or submitting false information is a
violation of Federal law and could result in criminal prosecution or civil penalties under 18 U.S.C §287,371,1001, 15 U.S.C. §645, or 31 U.S.C. §3729

__________________________________________________
Name and Title of Surety’s Certifying Official
____________________________
Signature

__________________
Date

SBA Form 2461

PLEASE NOTE: The estimated burden for completing this form, including time to read instructions and compile the information needed to respond, is 1 hour. You are not required to
respond to any collection of information unless it displays a currently valid OMB approval number. Comments on the burden or any other aspect of this request for contract information
should be sent to: U.S. Small Business Administration, Chief, AIB, 409 3rd Street, SW, Washington, DC 20416, and Desk Officer for the Small Business Administration, Office of
Management and Budget, New Executive Office Building, Room 10202, Washington, D.C., 20503. OMB Approval (3245- ).
PLEASE DO NOT SEND FORMS TO OMB.