Document Name Document Type
Form SBA Form 2181 SBIC Management Assessment Questionnaire & License Application; Exhibits to SBIC License App./Mgmt. Assessement Questionnaire Form and Instruction
SBA Form 2181 SBIC Program Application Instructions Form 2181 SBIC Application Instructions v3.0.pdf www.sba.gov/inv Form and Instruction
SBA Form 2181 Pre- Pre-Screen SBIC MAQ Short Form SBA Form 2181 Prescreen MAQ v3.0.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Long Form SBA Form 2181 SBIC MAQ v3.0.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC Subsequent Fund MAQ SBA Form 2181, Sub-Fund MAQ v3.0.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Exhibit A Relationship Certification 3245-0062 SBA Form 2181 SBIC MAQ Exhibit A Activities Relationship Certification 1-16-2024 OMB Submission.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Exhibit B Individual Declarations 3245-0062 SBA Form 2181 SBIC MAQ Exhibit B Individual Declarations 1-16-2024 OMB Submission.xlsx www.sba.gov/inv Form
SBA Form 2181 MAQ SBIC MAQ Exhibit C Significant Investor Declarations 3245-0062 SBA Form 2181 SBIC MAQ Exhibit C Significant Investor Declarations 1-16-2024 OMB Submission.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Exhibit D Individual Legal Questionnaire 3245-0062 SBA Form 2181 SBIC MAQ Exhibit D Individual Legal Questionnaire 1-16-2024 OMB Submission.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Exhibit E Legal Document Certification 3245-0062 SBA Form 2181 SBIC MAQ Exhibit E Legal Document Certification 1-16-2023 OMB Submission.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Exhibit F Capital Certificate SBA Form 2181 Exhibit F Capital Certificate v3.0.xlsx www.sba.gov/inv Form
SBA Form 2181 SBIC SBIC MAQ Exhibit Transferors Liability Contract 3245-0062 SBA Form 2181 SBIC MAQ Exhibit G Transferors Liability Contract 1-16-2024 OMB Submission.pdf www.sba.gov/inv Form

Information Collection (IC) Details

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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: Voluntary

CFR Citation: 13 CFR 107.410

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 2181	SBIC Program Application Instructions	Form 2181 SBIC Application Instructions v3.0.pdf	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 Pre-Screen	Pre-Screen SBIC MAQ Short Form	SBA Form 2181 Prescreen MAQ v3.0.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC MAQ Long Form	SBIC MAQ Long Form	SBA Form 2181 SBIC MAQ v3.0.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC Subsequent Fund	SBIC Subsequent Fund MAQ	SBA Form 2181, Sub-Fund MAQ v3.0.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC Exhibit A	SBIC MAQ Exhibit A Relationship Certification	3245-0062 SBA Form 2181 SBIC MAQ Exhibit A Activities Relationship Certification 1-16-2024 OMB Submission.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC MAQ Exhibit B	SBIC MAQ Exhibit B Individual Declarations	3245-0062 SBA Form 2181 SBIC MAQ Exhibit B Individual Declarations 1-16-2024 OMB Submission.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 MAQ Exhibit C	SBIC MAQ Exhibit C Significant Investor Declarations	3245-0062 SBA Form 2181 SBIC MAQ Exhibit C Significant Investor Declarations 1-16-2024 OMB Submission.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC MAQ Exhibit D	SBIC MAQ Exhibit D Individual Legal Questionnaire	3245-0062 SBA Form 2181 SBIC MAQ Exhibit D Individual Legal Questionnaire 1-16-2024 OMB Submission.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC MAQ Exhibit E	SBIC MAQ Exhibit E Legal Document Certification	3245-0062 SBA Form 2181 SBIC MAQ Exhibit E Legal Document Certification 1-16-2023 OMB Submission.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC MAQ Exhibit F	SBIC MAQ Exhibit F Capital Certificate	SBA Form 2181 Exhibit F Capital Certificate v3.0.xlsx	www.sba.gov/inv	Yes	Yes	Paper Only
Form	SBA Form 2181 SBIC MAQ Exhibit G	SBIC MAQ Exhibit Transferors Liability Contract	3245-0062 SBA Form 2181 SBIC MAQ Exhibit G Transferors Liability Contract 1-16-2024 OMB Submission.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: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	325	325
Annual IC Time Burden (Hours)	21,749	21,749
Annual IC Cost Burden (Dollars)	9,228,291	9,228,291

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.

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

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

OMB: 3245-0062

IC ID: 35613

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