Surety Bond Guarantee Program- Default Report, Claim for Reimbursement, and Record of Administrative Action

  1. The Surety may use this form to file an initial or updated Default Status Report by completing sections A, B, C, and H. If a different format is used, all of the requested information must be provided.
  2. The Surety must use this form to:
  • File a Claim for Reimbursement; complete sections: A, C, E, F, G, H
  • Report Recoveries, complete sections: A, C, F, G, H
  • The surety company must print, sign, and mail to U.S. Small Business Administration, Office of Surety Guarantees, 409 3rd St., SW, Washington, DC, 20416
OMB Approved: 
OMB Approved
OMB No.: 
3245-0007
SBA Form No.: 
994H
Version #: 
2-16
Expiration Date: 
Sunday, March 31, 2019
Attachments Size
SBA Form 994 H_workingCopy.pdf 115Kb