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SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire
SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessment Questionnaire
OMB: 3245-0062
IC ID: 35613
OMB.report
SBA
OMB 3245-0062
ICR 202602-3245-005
IC 35613
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
13 CFR 107
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Form 2181 SBIC Application Instructions v3.1.pdf
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181
Pre-Screen SBIC MAQ Short Form
SBA Form 2181 Prescreen MAQ v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181
SBIC MAQ
SBA Form 2181 SBIC MAQ v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181
SBIC Subsequent Fund MAQ
SBA Form 2181, Sub-Fund MAQ v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit A
SBIC MAQ Exhibit A Activities Relationship Certification
SBA Form 2181 Exhibit A Activities Relationships Certification v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit B
SBIC MAQ Exhibit B Individual Declarations
SBA Form 2181 Exhibit B Individual Declarations v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit C
SBIC MAQ Exhibit C Significant Investor Declarations
SBA Form 2181 Exhibit C Significant Investor Declarations v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit D
SBIC MAQ Exhibit D Individual Legal Questionnaire
SBA Form 2181 Exhibit D Individual Legal Questionnaire v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit E
SBIC MAQ Exhibit E Legal Document Certification
SBA Form 2181 Exhibit E Legal Document Certification v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit F
SBIC MAQ Exhibit F Capital Certificate
SBA Form 2181 Exhibit F Capital Certificate v3.1.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Exhibit G
SBIC MAQ Exhibit Transferors Liability Contract
SBA Form 2181 Exhibit G Transferors Liability Contract v3.1.pdf
www.sba.gov/inv
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Business and Industry Development
Privacy Act System of Records
Title:
Small Business Investment Company Information System (SBA SBICIS 40)
FR Citation:
90 FR 41467
Number of Respondents:
325
Number of Respondents for Small Entity:
309
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
325
0
0
0
0
325
Annual IC Time Burden (Hours)
21,749
0
0
0
0
21,749
Annual IC Cost Burden (Dollars)
9,228,290
0
-1
0
0
9,228,291
Documents for IC
Title
Document
Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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