Information Collection

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

IC 35671 under ICR 201505-3245-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 3245-0118 SBA Form 856 (5-20-15).docx Form and Instruction
SBA Form 856 A Disclosure Sstatement Non-LEVERAGED Licensees 3245-0118 SBA Form 856A 5-20-15.docx 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	3245-0118 SBA Form 856 (5-20-15).docx		No		Paper Only
Form and Instruction	SBA Form 856 A	Disclosure Sstatement Non-LEVERAGED Licensees	3245-0118 SBA Form 856A 5-20-15.docx		No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 298	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	Previously Approved
Annual Number of Responses for this IC	298	-2	300
Annual IC Time Burden (Hours)	138	0	138
Annual IC Cost Burden (Dollars)	0	0	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.