SBIC License Application; Statement of Personal History and Qualification of Management

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
35610	SBIC License Application; Statement of Personal History and Qualification of Management Form	Migrated

ICR Details

OMB Control No: 3245-0062	ICR Reference No: 199909-3245-005
Status: Historical Active	Previous ICR Reference No: 199607-3245-004
Agency/Subagency: SBA	Agency Tracking No:
Title: SBIC License Application; Statement of Personal History and Qualification of Management
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/01/2000
	Date Received in OIRA: 09/29/1999
Terms of Clearance: Section 7 of Pub. L. 93-579 provided that: (a)(1) It shall be unlawful for any Federal, State or local government agency to deny to any individual any right, benefit, or privilege provided by law because of such individual's refusal to disclose his social security account number. (2) The provisions of paragraph (1) of this subsection shall not apply with respect to - (A) any disclosure which is required by Federal statute, or (B) the disclosure of a social security number to any Federal, State, or local agency maintaining a system of records in existence and operating before January 1, 1975, if such disclosure was required under statute or regulation adopted prior to such date to verify the identity of an individual. (b) Any Federal, State, or local government agency which requests an individual to disclose his social security account number shall inform that individual whether that disclosure is mandatory or voluntary, by what statutory or other authority such number is solicited, and what uses will be made of it. SBA should reexamine these forms to ensure its compliance with this provision of the Privacy Act. In addition, since SBA disseminates Form 415a withour Form 415 and instructions, SBA should include with the Form 415a clear instructions as to where the completed forms should be sent and include a disclaimer that completed forms should not be sent to the addresses given in the Paperwork Reduction Act statement.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2002	02/28/2002	02/29/2000
Responses	90	0	40
Time Burden (Hours)	14,400	0	3,260
Cost Burden (Dollars)	7,020,000	0	2,320,000

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Abstract: SBA forms 415 and 415A provide SBA with the necessary information to make informed and proper 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 sucessfully 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:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
SBIC License Application; Statement of Personal History and Qualification of Management	SBA-FORM-415, SBA-FORM-415A

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ICR Summary 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	90	40	0	0	50	0
Annual Time Burden (Hours)	14,400	3,260	0	0	11,140	0
Annual Cost Burden (Dollars)	7,020,000	2,320,000	0	0	4,700,000	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: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 09/29/1999

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