Information Collection Request

Forms Relating to FDIC Outside Counsel, Legal Support and Expert Services Programs

ICR 202301-3064-004 · OMB 3064-0122 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3064-0122 can be found here:

Forms and Documents

Document Name	Status
Form 5000/26 Non-Litigation Budget Form Form	Modified
Form 5210/13 Legal Service Agreement (LSA) Form	Modified
Form 5210/15 Legal Support Services (LSS) Provider Budget Form Form	Modified
Form 5210/14 Oral Representations and Certifications for Expert Legal Support Services Form	Modified
Form 5210/12 Firm Travel Voucher Form	Modified
Form 5210/11 Legal Invoice for Fees and Expenses Form	Modified
Form 5210/10 Outside Counsel Legal Services Agreement Rate Schedule Form	Modified
Form 5210/09 Reps and Certs for Experts and Legal Support Services Providers Form	Modified
Form 5210/08 Expert budget Form	Modified
Form 5210/06 Legal Services Agreement (LSA) Amendment Form	Modified
Form 5210/04 Agreement for Services (expert or Legal Support Services Provider) Provider Rate Schedule Form	Modified
Form 5210/03 Agreement for Services (Expert Legal Support Services (LSS) Provider Amendment Form	Modified
Form 5210/02 Legal Support Services (LSS) Provider Invoice for Fees and Expenses (IF&E) Form	Modified
Form 5210/01 Expert invoice for Fees and Expenses (EIF&E) Form	Modified
Form 5200/01 Representations and Certifications for Legal Contractors Form	Modified
Form 5000/35 Litigation Budget Form	Modified
Form 5000/33 Amended Non-Litigation Budget Form	Modified
Form 5000/31 Amended Litigation Budget Form	Modified
SPST-0122 Forms Relating to FDIC Outside Counsel Program 2023 FINAL.docx Supporting Statement A	2023-01-24
FR2-0122 Forms Relating to Outside Counsel 88 FR 5338 January 27 2023.pdf Supplementary Document	2023-01-27
FR1-0122 Forms Relating to Outside Counsel 87 FR 63498 Oct 19 2022.pdf Supplementary Document	2023-01-24

IC Document Collections

IC ID	Document Title	Status
42567	Non-Litigation Budget Form Form	Modified
238949	Legal Service Agreement (LSA) Form	Modified
238907	Legal Support Services (LSS) Provider Budget Form Form	Modified
238904	Oral Representations and Certifications for Expert Legal Support Services Form	Modified
238903	Firm Travel Voucher Form	Modified
238902	Legal Invoice for Fees and Expenses Form	Modified
238900	Outside Counsel Legal Services Agreement Rate Schedule Form	Modified
238899	Reps and Certs for Experts and Legal Support Services Providers Form	Modified
238898	Expert budget Form	Modified
238897	Legal Services Agreement (LSA) Amendment Form	Modified
238896	Agreement for Services (expert or Legal Support Services Provider) Provider Rate Schedule Form	Modified
238895	Agreement for Services (Expert Legal Support Services (LSS) Provider Amendment Form	Modified
238894	Legal Support Services (LSS) Provider Invoice for Fees and Expenses (IF&E) Form	Modified
238893	Expert invoice for Fees and Expenses (EIF&E) Form	Modified
238722	Representations and Certifications for Legal Contractors Form	Modified
238721	Litigation Budget Form	Modified
238720	Amended Non-Litigation Budget Form	Modified
238719	Amended Litigation Budget Form	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	FDIC
OMB Control No	3064-0122
Type of Information Collection	Extension without change of a currently approved collection
Previous ICR Reference No	202107-3064-002
Agency Tracking No	3064-0122
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31