SBA Form 1624, Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions

SBA Form 1624, Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions
SBA Form 1624, Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions

What Is SBA Form 1624?

SBA Form 1624, Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion - Lower Tier Covered Transactions - also known as the SBA Debarment Form - is a form used by the prospective lower tier participant to certify that neither they nor their principals were debarred, suspended, proposed for disbarment, declared ineligible, or voluntarily excluded from participation in the transaction by any Federal agency at the time of filing the form.

The form was last updated by the Small Business Administration (SBA) in December 1992. The form is no longer hosted on the SBA website. A fillable SBA Form 1624 is available for download below:

SBA Debarment Form

The SBA Form 1623 (Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions) is the form currently required to be completed by the prospective primary participant to provide the necessary certification instead of the SBA 1624. The form requires the authorized representative of the prospective lower tier participant to sign the form in order to certify the following:

  1. The prospective lower tier participant certifies that it isn’t currently debarred, suspended or declared ineligible by any Federal department or agency.
  2. The prospective lower tier participant must attach an explanation to this proposal If it is unable to certify the statements in the form.

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.
  • Have not within a three-year period prior to this application been convicted of a criminal offense in connection with obtaining or performing a public transaction or contract under a public transaction, a violation of antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.
  • Are not presently indicted for or otherwise criminally charged by a governmental entity.
  • Have not within a three-year period prior to this application had a public transaction terminated for cause or default.

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