Fillable Sba Form 912 - Statement Of Personal History (Page 2 of 2) in pdf

NOTICES REQUIRED BY LAW

The following is a brief summary of the laws applicable to this solicitation of information.

Paperwork Reduction Act (44 U.S.C. Chapter 35)

SBA is collecting the information on this form to make a character and credit eligibility decision to fund or deny you

a loan or other form of assistance. The information is required in order for SBA to have sufficient information to

determine whether to provide you with the requested assistance. The information collected may be checked

against criminal history indices of the Federal Bureau of Investigation.

Privacy Act (5 U.S.C. § 552a)

Any person can request to see or get copies of any personal information that SBA has in his or her file, when that

file is retrieved by individual identifiers, such as name or social security numbers. Requests for information about

another party may be denied unless SBA has the written permission of the individual to release the information to

the requestor or unless the information is subject to disclosure under the Freedom of Information Act.

Under the provisions of the Privacy Act, you are not required to provide your social security number. Failure to

provide your social security number may not affect any right, benefit or privilege to which you are entitled.

Disclosures of name and other personal identifiers are, however, required for a benefit, as SBA requires an

individual seeking assistance from SBA to provide it with sufficient information for it to make a character

determination. In determining whether an individual is of good character, SBA considers the person's integrity,

candor, and disposition toward criminal actions. In making loans pursuant to section 7(a)(6) the Small Business

Act (the Act), 15 USC § 636 (a)(6), SBA is required to have reasonable assurance that the loan is of sound value

and will be repaid or that it is in the best interest of the Government to grant the assistance requested.

Additionally, SBA is specifically authorized to verify your criminal history, or lack thereof, pursuant to section

7(a)(1)(B), 15 USC § 636(a)(1)(B). Further, for all forms of assistance, SBA is authorized to make all

investigations necessary to ensure that a person has not engaged in acts that violate or will violate the Act or the

Small Business Investment Act,15 USC §§ 634(b)(11) and 687b(a). For these purposes, you are asked to

voluntarily provide your social security number to assist SBA in making a character determination and to

distinguish you from other individuals with the same or similar name or other personal identifier.

When the information collected on this form indicates a violation or potential violation of law, whether civil,

criminal, or administrative in nature, SBA may refer it to the appropriate agency, whether Federal, State, local, or

foreign, charged with responsibility for or otherwise involved in investigation, prosecution, enforcement or

prevention of such violations. See 74 Fed. Reg. 14890 (2009) for other published routine uses.

Sba Form 912 - Statement Of Personal History Page 2