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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 202401-3245-001
IC 35613
( )
Documents and Forms
Document Name
Document Type
Form SBA Form 2181
SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire
Form and Instruction
SBA Form 2181 SBIC Program Application Instructions
3245-0062 SBA Form 2181 SBIC Program Application Instructions OMB Submission 1-16-2024.docx
www.sba.gov/inv
Form and Instruction
SBA Form 2181 SBIC Program Application Instructions
3245-0062 SBA Form 2181 SBIC Program Application Instructions OMB Submission 1-16-2024.docx
www.sba.gov/inv
Form and Instruction
SBA Form 2181 Pre- Pre-Screen SBIC MAQ Short Form
3245-0062 SBA Form 2181 Pre-Screen SBIC MAQ (Short Form) 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 Pre- Pre-Screen SBIC MAQ Short Form
3245-0062 SBA Form 2181 Pre-Screen SBIC MAQ (Short Form) 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Long Form
3245-0062 SBA Form 2181 SBIC MAQ (Long Form) 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Long Form
3245-0062 SBA Form 2181 SBIC MAQ (Long Form) 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC Subsequent Fund MAQ
3245-0062 SBA Form 2181 SBIC Subsequent Fund MAQ 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC Subsequent Fund MAQ
3245-0062 SBA Form 2181 SBIC Subsequent Fund MAQ 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit A Relationship Certification
3245-0062 SBA Form 2181 SBIC MAQ Exhibit A Activities Relationship Certification 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit A Relationship Certification
3245-0062 SBA Form 2181 SBIC MAQ Exhibit A Activities Relationship Certification 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit B Individual Declarations
3245-0062 SBA Form 2181 SBIC MAQ Exhibit B Individual Declarations 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit B Individual Declarations
3245-0062 SBA Form 2181 SBIC MAQ Exhibit B Individual Declarations 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 MAQ SBIC MAQ Exhibit C Significant Investor Declarations
3245-0062 SBA Form 2181 SBIC MAQ Exhibit C Significant Investor Declarations 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 MAQ SBIC MAQ Exhibit C Significant Investor Declarations
3245-0062 SBA Form 2181 SBIC MAQ Exhibit C Significant Investor Declarations 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit D Individual Legal Questionnaire
3245-0062 SBA Form 2181 SBIC MAQ Exhibit D Individual Legal Questionnaire 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit D Individual Legal Questionnaire
3245-0062 SBA Form 2181 SBIC MAQ Exhibit D Individual Legal Questionnaire 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit E Legal Document Certification
3245-0062 SBA Form 2181 SBIC MAQ Exhibit E Legal Document Certification 1-16-2023 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit E Legal Document Certification
3245-0062 SBA Form 2181 SBIC MAQ Exhibit E Legal Document Certification 1-16-2023 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit F Capital Certificate
3245-0062 SBA Form 2181 SBIC MAQ Exhibit F Capital Certificate 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit F Capital Certificate
3245-0062 SBA Form 2181 SBIC MAQ Exhibit F Capital Certificate 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit Transferors Liability Contract
3245-0062 SBA Form 2181 SBIC MAQ Exhibit G Transferors Liability Contract 1-16-2024 OMB Submission.pdf
www.sba.gov/inv
Form
SBA Form 2181 SBIC SBIC MAQ Exhibit Transferors Liability Contract
3245-0062 SBA Form 2181 SBIC MAQ Exhibit G Transferors Liability Contract 1-16-2024 OMB Submission.pdf
www.sba.gov/inv
Form
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:
Voluntary
CFR Citation:
13 CFR 107.410
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 2181
SBIC Program Application Instructions
3245-0062 SBA Form 2181 SBIC Program Application Instructions OMB Submission 1-16-2024.docx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 Pre-Screen
Pre-Screen SBIC MAQ Short Form
3245-0062 SBA Form 2181 Pre-Screen SBIC MAQ (Short Form) 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC MAQ Long Form
SBIC MAQ Long Form
3245-0062 SBA Form 2181 SBIC MAQ (Long Form) 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC Subsequent Fund
SBIC Subsequent Fund MAQ
3245-0062 SBA Form 2181 SBIC Subsequent Fund MAQ 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC Exhibit A
SBIC MAQ Exhibit A Relationship Certification
3245-0062 SBA Form 2181 SBIC MAQ Exhibit A Activities Relationship Certification 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC MAQ Exhibit B
SBIC MAQ Exhibit B Individual Declarations
3245-0062 SBA Form 2181 SBIC MAQ Exhibit B Individual Declarations 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 MAQ Exhibit C
SBIC MAQ Exhibit C Significant Investor Declarations
3245-0062 SBA Form 2181 SBIC MAQ Exhibit C Significant Investor Declarations 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC MAQ Exhibit D
SBIC MAQ Exhibit D Individual Legal Questionnaire
3245-0062 SBA Form 2181 SBIC MAQ Exhibit D Individual Legal Questionnaire 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC MAQ Exhibit E
SBIC MAQ Exhibit E Legal Document Certification
3245-0062 SBA Form 2181 SBIC MAQ Exhibit E Legal Document Certification 1-16-2023 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC MAQ Exhibit F
SBIC MAQ Exhibit F Capital Certificate
3245-0062 SBA Form 2181 SBIC MAQ Exhibit F Capital Certificate 1-16-2024 OMB Submission.xlsx
www.sba.gov/inv
Yes
Yes
Paper Only
Form
SBA Form 2181 SBIC MAQ Exhibit G
SBIC MAQ Exhibit Transferors Liability Contract
3245-0062 SBA Form 2181 SBIC MAQ Exhibit G Transferors Liability Contract 1-16-2024 OMB Submission.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:
FR Citation:
Number of Respondents:
275
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
67 %
Approved
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
275
0
0
0
0
275
Annual IC Time Burden (Hours)
17,750
0
0
0
0
17,750
Annual IC Cost Burden (Dollars)
6,502,073
0
0
0
0
6,502,073
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.