OMB control number

Statement of Personal History

OMB 3245-0178 · SBA.

OMB 3245-0178

SBA collects this information to assess eligibility for participation in its programs. Specifically, SBA uses the information to make a character or criminal history determination about individuals associated with an application for financial assistance or other SBA program benefits.

The latest form for Statement of Personal History expires 2029-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form SBA Form 912 Statement of Personal History Form and Instruction
3245-0178 Regulations Pertinent Statutes Dec 2025.docx Supplementary Document
3245-0178 Regulations Pertinent Statutes Dec 2025.docx Supplementary Document
3245-0178 -- Supporting Statement sba form 912 Dec 2025 Updated.docx Supporting Statement A
Statement of Personal History Form and Instruction
Statement of Personal History Form and Instruction

All Historical Document Collections

202512-3245-003 Approved with change	Revision of a currently approved collection	2025-12-15
202210-3245-001 Approved without change	Extension without change of a currently approved collection	2022-10-25
201905-3245-005 Approved without change	Revision of a currently approved collection	2019-05-29
201604-3245-001 Approved without change	Revision of a currently approved collection	2016-04-06
201302-3245-005 Approved with change	Revision of a currently approved collection	2013-02-20
200912-3245-004 Approved with change	Revision of a currently approved collection	2009-12-18
200609-3245-008 Approved without change	Extension without change of a currently approved collection	2006-09-29
200306-3245-001 Approved without change	Revision of a currently approved collection	2003-06-17
200006-3245-004 Approved without change	Revision of a currently approved collection	2000-06-28
199705-3245-001 Approved without change	Reinstatement without change of a previously approved collection	1997-05-14
199312-3245-001 Approved without change	Revision of a currently approved collection	1993-12-06
199304-3245-004 Approved without change	Revision of a currently approved collection	1993-04-16
199003-3245-004 Approved without change	Revision of a currently approved collection	1990-03-21
198703-3245-007 Approved without change	Extension without change of a currently approved collection	1987-03-26
198408-3245-033 Approved with change	No material or nonsubstantive change to a currently approved collection	1984-08-01
198401-3245-013 Approved without change	New collection (Request for a new OMB Control Number)	1984-01-03