Statement of Personal History

Documents and Forms

Document Name Document Type
Form SBA Form 912 Statement of Personal History Form and Instruction
SBA Form 912 Statement of Personal History 3245-0178 SBA Form 912 10-25-2022.pdf www.sba.gov Form and Instruction
SBA Form 912 Statement of Personal History 3245-0178 SBA Form 912 10-25-2022.pdf www.sba.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement of Personal History	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SBA Form 912	Statement of Personal History	3245-0178 SBA Form 912 10-25-2022.pdf	www.sba.gov	Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 142,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	142,000	0	142,000
Annual IC Time Burden (Hours)	35,500	0	35,500
Annual IC Cost Burden (Dollars)	284,000	-14,200	298,200

Documents for IC

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.