Information Collection

Statement of Personal History

IC 35635 under ICR 202602-3245-004 · OMB 3245-0080.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 1081 Statement of Personal History Statement of Personal History	Form and Instruction
Form 1081 Statement of Personal History Form 1081 - Statement of Personal History (FINAL 2-13-26).docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 1081				Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title: SBA 21 â Loan System

FR Citation: 86 FR 23026

Number of Respondents: 146

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	146	-4	150
Annual IC Time Burden (Hours)	73	-2	75
Annual IC Cost Burden (Dollars)	2,959	919	2,040

Documents for IC

table that charts IC Documents
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.

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