Information Collection

Statement of Personal History

IC 35707 under ICR 201604-3245-001 · OMB 3245-0178.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3245-0178 can be found here:

Documents and Forms

Document Name Document Type
Form SBA Form 912 Statement of Personal History Form and Instruction
SBA Form 912 Statement of Personal History 3245-0178 SBA Form revised 912 4-5-16.pdf www.sba.gov/library Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement of Personal History	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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 912	Statement of Personal History	3245-0178 SBA Form revised 912 4-5-16.pdf	www.sba.gov/library	Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 142,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	142,000	142,000
Annual IC Time Burden (Hours)	35,500	35,500
Annual IC Cost Burden (Dollars)	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.