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SBA Form 1623 Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions
What Is SBA Form 1623?
SBA Form 1623, Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions , also known as the SBA 8(a) Form 1623, is a document released by the Small Business Administration (SBA) . The certification is regulated by the 13 CFR Part 145, which states that an individual who is debarred or suspended is to be excluded from Federal programs and activities and may not receive financial and nonfinancial assistance and benefits.
The certificate is signed by prospective participants (vendors or service providers) of the government programs with the goal to attest that they, their company, and their principals have not been debarred, proposed for debarment, or are not in the process of being debarred, suspended, declared ineligible, or voluntarily excluded from conducting business with a federal department. The suspension and debarment are actions taken by the federal government against fraud.
The latest version of the form was released by the SBA on October 1, 1988 , and replaced SBA Form 1624 . An up-to-date SBA Form 1623 fillable version is available for digital filing and download below{class="scroll_to"} or can be found through the SBA website.
SBA Form 1623 Instructions
The prospective primary participant must comply with certain requirements to submit SBA 1623 Form.
- SBA Form 1623 Part A. The prospective primary participant must certify that it and its principals are not presently debarred, suspended, proposed for disbarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency.
- SBA Form 1623 Part B. The prospective primary participant must certify that it and its principals have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against them for the commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or a contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.
- SBA Form 1623 Part C. The prospective primary participant must certify that it and its principals are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with the commission of any of the offenses enumerated above.
The applicant states that it and its principals have not within a three-year period preceding this application had one or more public transactions (federal, state, or local) terminated for cause or default. If the prospective primary participant is unable to certify to any of the statements therein, an explanation to this proposal must be attached. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction.
The prospective participant must fill in the business name, write the actual date, and fill in the name, title, and signature of the authorized representative, if applicable.
Download SBA Form 1623 Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions
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