Paycheck Protection Program Affiliation Worksheet

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SBA Form 3511 Paycheck Protection Program_Affiliation Worksheet	Form and Instruction	Modified	Repair queued
3245-0416 Supporting Statement SBA Form 3511 PPP_Affliation Worksheet 1-31-2022.docx	Supporting Statement A	Uploaded 2022-01-31	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244786	Paycheck Protection Program_Affiliation Worksheet	Form and Instruction	Modified

ICR Details

OMB Control No: 3245-0416	ICR Reference No: 202201-3245-005
Status: Received in OIRA	Previous ICR Reference No: 202106-3245-003
Agency/Subagency: SBA	Agency Tracking No:
Title: Paycheck Protection Program Affiliation Worksheet
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/31/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2022
Responses	37,500	37,500
Time Burden (Hours)	37,500	37,500
Cost Burden (Dollars)	1,706,250	949,500

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Abstract: During SBA’s review of loans made under the Paycheck Protection Program, SBA will collect information from those Borrowers that have known Affiliates or believed to have Affiliates as defined in 13 CFR 121.301(f). SBA will use the information to review the borrowers' eligibility certifications and compliance with SBA's size and affiliation requirements.

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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:
	86 FR 35144	07/01/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 4702	01/28/2022
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
Paycheck Protection Program_Affiliation Worksheet	SBA Form 3511	PPP Affiliation Worksheet

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	37,500	37,500	0	0	0	0
Annual Time Burden (Hours)	37,500	37,500	0	0	0	0
Annual Cost Burden (Dollars)	1,706,250	949,500	0	756,750	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $4,024,500

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.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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? No

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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: 01/31/2022

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