Information Collection

Statement of Personal History

IC 35635 under ICR 202602-3245-004 · OMB 3245-0080.

Documents and Forms

Document Name Document Type
Form Form 1081 Statement of Personal History Statement of Personal History Form and Instruction
Form 1081 Statement of Personal History Form 1081 - Statement of Personal History (FINAL 2-13-26).docx 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: Required to Obtain or Retain Benefits

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	Form 1081	Statement of Personal History	Form 1081 - Statement of Personal History (FINAL 2-13-26).docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title: SBA 21 â Loan System	FR Citation: 86 FR 23026

Number of Respondents: 146	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	146	-4	150
Annual IC Time Burden (Hours)	73	-2	75
Annual IC Cost Burden (Dollars)	2,959	919	2,040

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.

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