Personal Financial Statement - Women Owned Small Business (Wosb) Program (Page 4 of 4) in pdf

Personal Financial Statement - Women Owned Small Business (Wosb) Program Page 4

PLEASE READ, DETACH, AND RETAIN FOR YOUR RECORDS

STATEMENTS REQUIRED BY LAW AND EXECUTIVE ORDER

Privacy Act (5 U.S.C. 552a)

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

use is the disclosure of information maintained in SBA’s investigative files system of records when this information

indicates a violation or potential violation of law, whether civil, criminal, or administrative in nature. Specifically, SBA

may refer the information 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. Another routine use

is disclosure to other Federal agencies conducting background checks; only to the extent the information is relevant to the

requesting agencies' function. See, 74 F.R. 14890 (2009), and as amended from time to time for additional background

and other routine uses.

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. Proprietary data on a small business 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.

Executive Order 12549, Debarment and Suspension (2 CFR 2700)

The small business certifies, by submission of this form for program participation or contract award that neither it nor its

principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from

participation in this transaction by any Federal department or agency.

Where the small business is unable to certify to any of the statements in this certification, such participants shall attach an

explanation.

SBA Form 413 (WOSB) (09-14) Previous Editions Obsolete

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Personal Financial Statement - Women Owned Small Business (Wosb) Program Page 4