OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 201206-3245-001 · OMB 3245-0118 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form `SBA FORM 856 Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees Form Modified Available
Form SBA FORM 856 Disclosure Statement Lveraged Licensees Form and Instruction New Available
3245-0118 SBA Form 856 Corresponding Stat~Reg Pro 6-12.docx Supplementary Document Uploaded 2012-06-01 Available
3245-0118 SBA Form 856 Supporting Statement 6-12.doc Supporting Statement A Uploaded 2012-06-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
35671 Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees Form Modified
202552 Disclosure Statement Lveraged Licensees Form and Instruction New
ICR Details
3245-0118 201206-3245-001
Historical Active 200903-3245-001
SBA
Disclosure Statement-Leveraged Licensees; Disclosure Statement Non-leveraged Licensees
Revision of a currently approved collection   No
Regular
Approved without change 07/11/2012
Retrieve Notice of Action (NOA) 06/01/2012
  Inventory as of this Action Requested Previously Approved
07/31/2015 36 Months From Approved 07/31/2012
600 0 350
276 0 162
0 0 0
Small Business Administration (SBA) Forms 856 and 856A are used by SBA examiners as part of their examination of licensed small business investment companies (SBICs). This information collection obtains representations from an SBIC's management regarding certain obligations, transactions and relationships of the SBIC and helps SBA to evaluate the SBIC's financial condition and compliance with applicable laws and regulations.
None
None
Not associated with rulemaking
  76 FR 77298 12/12/2011
77 FR 14583 03/13/2012
No
  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 600 350 0 250 0 0
Annual Time Burden (Hours) 276 162 0 114 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Change in respondents
$0
No
No
No
No
No
Uncollected
Carol Fendler 202 205-7559
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/01/2012