Settlement Sheet

Forms and Documents

Document Name	Status
Form SBA Form 1050 Settlement Sheet Form and Instruction	Modified
3245-0200 Regs 13 CFR 120 520 11-27-18.pdf Supplementary Document	2018-11-27
3245-0200 SBA Form 1050 Justification 11-27-18.docx Supporting Statement A	2018-11-27

IC Document Collections

IC ID	Document Title	Status
186934	Settlement Sheet Form and Instruction	Modified

ICR Details

OMB Control No: 3245-0200	ICR Reference No: 201811-3245-002
Status: Active	Previous ICR Reference No: 201804-3245-001
Agency/Subagency: SBA	Agency Tracking No:
Title: Settlement Sheet
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: 04/22/2019
	Date Received in OIRA: 11/27/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	36 Months From Approved	05/31/2021
Responses	28,224	0	28,224
Time Burden (Hours)	14,112	0	4,800
Cost Burden (Dollars)	0	0	0

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Abstract: This form is required to be completed at the time of first disbursement by lenders and small business owners for all 7(a) loans that are closed and disbursed with the exception of 7(a) Small, Community Advantage, SBA Express and Export Express loans. SBA uses the information to help determine whether loans were disbursed in compliance with SBA requirements, to obtain certifications to such compliance. The form also notifies lenders of their obligation to retain completed forms.

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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:
	83 FR 37878	08/02/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 60936	11/27/2018
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Settlement Sheet	SBA Form 1050	Settlement Sheet

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ICR Summary 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	28,224	28,224	0	0	0	0
Annual Time Burden (Hours)	14,112	4,800	0	9,312	0	0
Annual Cost Burden (Dollars)	0	0	0	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 burden hours for SBA Form 1050 have increased based on the estimated time spent for each response on the revised form. The old form was estimated to take 10 minutes to complete, while this revised form is estimated to take 30 minutes to complete. Loan volume is expected to be about the same for FY 2019 and 2020.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 11/27/2018

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