Information Collection

Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees

IC 35671 under ICR 202204-3245-002 · OMB 3245-0118.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3245-0118 can be found here:

Documents and Forms

Document Name Document Type
Form SBA Form 856 Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees Form and Instruction
SBA Form 856 DISCLOSURE STATEMENT LEVERAGED LICENSEES SBA Form 856 FINAL 2022 4-05-2022.docx www.sba.gov Form and Instruction
SBA Form 856 DISCLOSURE STATEMENT LEVERAGED LICENSEES SBA Form 856 FINAL 2022 4-05-2022.docx www.sba.gov Form and Instruction
SBA Form 856A DISCLOSURE STATEMENT NON-LEVERAGED LICENSEES 3245-0118 SBA Form 856A 3-23-2022.docx www.sba.gov Form and Instruction
SBA Form 856A DISCLOSURE STATEMENT NON-LEVERAGED LICENSEES 3245-0118 SBA Form 856A 3-23-2022.docx www.sba.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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 856	DISCLOSURE STATEMENT LEVERAGED LICENSEES	SBA Form 856 FINAL 2022 4-05-2022.docx	www.sba.gov	Yes	Yes	Paper Only
Form and Instruction	SBA Form 856A	DISCLOSURE STATEMENT NON-LEVERAGED LICENSEES	3245-0118 SBA Form 856A 3-23-2022.docx	www.sba.gov	Yes	Yes	Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 271	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	271	0	271
Annual IC Time Burden (Hours)	252	-3	255
Annual IC Cost Burden (Dollars)	6,935	6,935	0

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.