SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessment Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SBA Form 2181 SBIC SBIC MAQ Exhibit Transferors Liability Contract	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC MAQ Exhibit F Capital Certificate	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC MAQ Exhibit E Legal Document Certification	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC MAQ Exhibit D Individual Legal Questionnaire	Form	Modified	Available
Form SBA Form 2181 MAQ SBIC MAQ Exhibit C Significant Investor Declarations	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC MAQ Exhibit B Individual Declarations	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC MAQ Exhibit A Relationship Certification	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC Subsequent Fund MAQ	Form	Modified	Available
Form SBA Form 2181 SBIC SBIC MAQ Long Form	Form	Modified	Available
Form SBA Form 2181 Pre- Pre-Screen SBIC MAQ Short Form	Form	Modified	Available
Form SBA Form 2181 SBIC Program Application Instructions	Form and Instruction	Modified	Available
Form SBA Form 2181 SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form and Instruction	Modified	Repair queued
3245-0062 SBA Form 2181 Corresponding Stat~Regs 1-16-2024.docx	Supplementary Document	Uploaded 2024-01-16	Repair queued
3245-0062 MAQ Supporting Statement 1-16-2024 OMB Submission.docx	Supporting Statement A	Uploaded 2024-01-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit Transferors Liability Contract
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit F Capital Certificate
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit E Legal Document Certification
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit D Individual Legal Questionnaire
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit C Significant Investor Declarations
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit B Individual Declarations
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Exhibit A Relationship Certification
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC Subsequent Fund MAQ
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	SBIC MAQ Long Form
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form	Modified	Pre-Screen SBIC MAQ Short Form
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form and Instruction	Modified	SBIC Program Application Instructions
35613	SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	Form and Instruction	Modified

ICR Details

OMB Control No: 3245-0062	ICR Reference No: 202401-3245-001
Status: Historical Active	Previous ICR Reference No: 202308-3245-001
Agency/Subagency: SBA	Agency Tracking No:
Title: SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessment Questionnaire
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: 03/11/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/19/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2027	36 Months From Approved	03/31/2024
Responses	275	0	275
Time Burden (Hours)	17,750	0	17,750
Cost Burden (Dollars)	6,502,073	0	6,502,073

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Abstract: SBA Forms 2181, 2182 and 2183 provide SBA with the necessary information to make decisions regarding the approval or denial of an applicant for a small business investment company (SBIC) license. SBA uses this information to assess an applicant's ability to successfully operate an SBIC within the scope of the Small Business Investment Act of 1958, as amended.

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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:
	87 FR 73062	11/28/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 3702	01/19/2024
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
SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire	SBA Form 2181 , SBA Form 2181 Pre-Screen , SBA Form 2181 SBIC MAQ Long Form , SBA Form 2181 SBIC Subsequent Fund, SBA Form 2181 SBIC Exhibit A , SBA Form 2181 SBIC MAQ Exhibit B, SBA Form 2181 MAQ Exhibit C , SBA Form 2181 SBIC MAQ Exhibit D , SBA Form 2181 SBIC MAQ Exhibit E, SBA Form 2181 SBIC MAQ Exhibit F , SBA Form 2181 SBIC MAQ Exhibit G	SBIC Program Application Instructions ,   Pre-Screen SBIC MAQ Short Form ,   SBIC MAQ Long Form ,   SBIC Subsequent Fund MAQ ,   SBIC MAQ Exhibit A Relationship Certification ,   SBIC MAQ Exhibit B Individual Declarations ,   SBIC MAQ Exhibit C Significant Investor Declarations ,   SBIC MAQ Exhibit D Individual Legal Questionnaire ,   SBIC MAQ Exhibit E Legal Document Certification ,   SBIC MAQ Exhibit F Capital Certificate ,   SBIC MAQ Exhibit Transferors Liability Contract

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ICR Summary of Burden

table that charts list 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	275	275	0	0	0	0
Annual Time Burden (Hours)	17,750	17,750	0	0	0	0
Annual Cost Burden (Dollars)	6,502,073	6,502,073	0	0	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: $705,042

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]? 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? 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: 01/19/2024

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