Information Collection

SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire

IC 35613 under ICR 202602-3245-005 · OMB 3245-0062.

Documents and Forms

Document Name Document Type
Form SBA Form 2181 Pre-Screen SBIC MAQ Short Form SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Pre-Screen SBIC MAQ Short Form SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 SBIC MAQ SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 SBIC MAQ SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 SBIC Subsequent Fund MAQ SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 SBIC Subsequent Fund MAQ SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit A Activities Relationship Certification SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit A Activities Relationship Certification SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit B Individual Declarations SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit B Individual Declarations SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit C Significant Investor Declarations SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit C Significant Investor Declarations SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit D Individual Legal Questionnaire SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit D Individual Legal Questionnaire SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit E Legal Document Certification SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit E Legal Document Certification SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit F Capital Certificate SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit F Capital Certificate SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit Transferors Liability Contract SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form SBA Form 2181 Exhi SBIC MAQ Exhibit Transferors Liability Contract SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form
Form 2181 SBIC Application Instructions v3.1.pdf www.sba.gov/inv Instruction
Form 2181 SBIC Application Instructions v3.1.pdf www.sba.gov/inv Instruction
SBA Form 2181 Pre-Screen SBIC MAQ Short Form SBA Form 2181 Prescreen MAQ v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Pre-Screen SBIC MAQ Short Form SBA Form 2181 Prescreen MAQ v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC MAQ SBA Form 2181 SBIC MAQ v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC MAQ SBA Form 2181 SBIC MAQ v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC Subsequent Fund MAQ SBA Form 2181, Sub-Fund MAQ v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC Subsequent Fund MAQ SBA Form 2181, Sub-Fund MAQ v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit A Activities Relationship Certification SBA Form 2181 Exhibit A Activities Relationships Certification v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit A Activities Relationship Certification SBA Form 2181 Exhibit A Activities Relationships Certification v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit B Individual Declarations SBA Form 2181 Exhibit B Individual Declarations v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit B Individual Declarations SBA Form 2181 Exhibit B Individual Declarations v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit C Significant Investor Declarations SBA Form 2181 Exhibit C Significant Investor Declarations v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit C Significant Investor Declarations SBA Form 2181 Exhibit C Significant Investor Declarations v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit D Individual Legal Questionnaire SBA Form 2181 Exhibit D Individual Legal Questionnaire v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit D Individual Legal Questionnaire SBA Form 2181 Exhibit D Individual Legal Questionnaire v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit E Legal Document Certification SBA Form 2181 Exhibit E Legal Document Certification v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit E Legal Document Certification SBA Form 2181 Exhibit E Legal Document Certification v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit F Capital Certificate SBA Form 2181 Exhibit F Capital Certificate v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit F Capital Certificate SBA Form 2181 Exhibit F Capital Certificate v3.1.xlsx www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit Transferors Liability Contract SBA Form 2181 Exhibit G Transferors Liability Contract v3.1.pdf www.sba.gov/inv Form
SBA Form 2181 Exhi SBIC MAQ Exhibit Transferors Liability Contract SBA Form 2181 Exhibit G Transferors Liability Contract v3.1.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: Required to Obtain or Retain Benefits

CFR Citation: 13 CFR 107

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Form 2181 SBIC Application Instructions v3.1.pdf	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181	Pre-Screen SBIC MAQ Short Form	SBA Form 2181 Prescreen MAQ v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181	SBIC MAQ	SBA Form 2181 SBIC MAQ v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181	SBIC Subsequent Fund MAQ	SBA Form 2181, Sub-Fund MAQ v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit A	SBIC MAQ Exhibit A Activities Relationship Certification	SBA Form 2181 Exhibit A Activities Relationships Certification v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit B	SBIC MAQ Exhibit B Individual Declarations	SBA Form 2181 Exhibit B Individual Declarations v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit C	SBIC MAQ Exhibit C Significant Investor Declarations	SBA Form 2181 Exhibit C Significant Investor Declarations v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit D	SBIC MAQ Exhibit D Individual Legal Questionnaire	SBA Form 2181 Exhibit D Individual Legal Questionnaire v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit E	SBIC MAQ Exhibit E Legal Document Certification	SBA Form 2181 Exhibit E Legal Document Certification v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit F	SBIC MAQ Exhibit F Capital Certificate	SBA Form 2181 Exhibit F Capital Certificate v3.1.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Exhibit G	SBIC MAQ Exhibit Transferors Liability Contract	SBA Form 2181 Exhibit G Transferors Liability Contract v3.1.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: Small Business Investment Company Information System (SBA SBICIS 40)	FR Citation: 90 FR 41467

Number of Respondents: 325	Number of Respondents for Small Entity: 309

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	325	0	325
Annual IC Time Burden (Hours)	21,749	0	21,749
Annual IC Cost Burden (Dollars)	9,228,290	-1	9,228,291

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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