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Statement of Personal History
Statement of Personal History
OMB: 3245-0178
IC ID: 35707
OMB.report
SBA
OMB 3245-0178
ICR 202512-3245-003
IC 35707
( )
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
Form 912 12.2025.pdf
www.sba.gov
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
Form 912 12.2025.pdf
www.sba.gov
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
SBA 20 – Disaster Loan Case File
FR Citation:
86 FR 64979
Number of Respondents:
10,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
10,000
0
0
-132,000
0
142,000
Annual IC Time Burden (Hours)
2,500
0
0
-33,000
0
35,500
Annual IC Cost Burden (Dollars)
75,000
0
0
-209,000
0
284,000
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.