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PLEASE READ, DETACH, AND RETAIN FOR YOUR RECORDS

STATEMENTS REQUIRED BY LAW AND EXECUTIVE ORDER

Federal executive agencies, including the Small Business Administration (SBA), are required to withhold or limit

assistance, to impose special conditions on approved guarantee agreements, to provide special notices to applicants and to

require special reports and data from applicants in order to comply with legislation passed by the Congress and Executive

Orders issued by the President and by the provisions of various inter-agency agreements. SBA has issued regulations and

procedures that implement these laws and executive orders, and they are contained in Parts 113 and 117, Title 13, Code of

Federal Regulations Chapter I, or Standard Operating Procedures.

Freedom of Information Act (5 U.S.C. 552)

This law provides, with some exceptions, that SBA must supply information reflected in agency files and records to a person

requesting it. Information about approved SBG guarantee agreements that will be automatically released includes, among other

things, statistics on the SBG programs (individuals are not identified in the statistics) and other information such as the names of

small businesses (and their officers, directors, stockholders or partners) and the amount of the SBG guarantee agreement.

Proprietary data on an applicant would not routinely be made available to third parties. All requests under this Act are to be

addressed to the nearest SBA office and be identified as a Freedom of Information request.

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 retrievable

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. Before any bonds may be guaranteed by

SBA pursuant to Section 411 of the Small Business Investment Act (the Act), 15 USC 694b, SBA is required to have a reasonable

expectation that the applicant will perform the contract for which the bond is sought, and that the terms of and conditions of the

bond are reasonable in the light of the risks involved and the extent of the surety’s participation. 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 Small Business Investment Act, 15 USC Section 687(b)(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.

The Privacy Act authorizes SBA to make certain “routine uses” of information protected by that Act. One such routine use for

SBA’s system of records is that when this information 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, foreign, charged with

responsibility for or otherwise involved in investigation, prosecution, enforcement or prevention of such violations. (See, 74FR

14890 (April 1, 2009) (and as amended from time to time) for additional background and other routine uses.)

Right to Financial Privacy Act of 1978 (12 U.S.C. 3401)

This is notice to you as required by the Right of Financial Privacy of 1978, of SBA’s access rights to financial records

held by

financial institutions that are or have been doing business with you or your business. The law provides that SBA shall have a

right of access to your financial records in connection with its consideration or administration of assistance to you in the form of a

Government SBG guarantee agreement.

The law also authorizes SBA to transfer to another Government authority any financial records included in an application for a

SBG guarantee, or concerning an approved SBG guarantee, as necessary to process or service the guarantee. No other transfer of

your financial records to another Government authority will be permitted by SBA except as required or permitted by law.

SBA Form 994 (1/13) Previous Editions are Obsolete

U.s. Small Business Administration - Application For Surety Bond Guarantee Assistance Form Page 4

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