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Forms Relating to FDIC Outside Counsel, Legal Support and Expert Services Programs
Forms Relating to FDIC Outside Counsel, Legal Support and Expert Services Programs
OMB: 3064-0122
IC ID: 42567
OMB.report
FDIC
OMB 3064-0122
ICR 201304-3064-006
IC 42567
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0122 can be found here:
2023-08-08 - No material or nonsubstantive change to a currently approved collection
2023-01-27 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 5000/26
Forms Relating to FDIC Outside Counsel, Legal Support and Expert Services Programs
Form
5000/26 Non-Litigation/Transactional Budget Form
5000-26 NON-LITIGATION BUDGET FORM.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5000/31 Amended Litigation Budget
5000-31 Amended Litigation Budget.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5000/33 Amended Non-Litigation/Transactional Budget
5000-33 Amended Non-Litigation Transactional Budget.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5000/35 Litigation Budget
5000-35 LITIGATION BUDGET.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5200/01 Reps and Certs Qualifications of Applicants: Law Firms a
5200-01 Representations and Certifications for Legal Contractors.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/01 Representations and Certifications for Legal Contractors
5210-01 EXPERT INVOICE FOR FEES AND EXPENSES (EIF&E).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/02 Legal Support Services (LSS) Provider Invoice for Fees a
5210-02 Legal Support Services (LSS) Provider Invoice for Fees and Expenses (IF&E).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/03 Agreement for Services (Expert Legal Support Services (L
5210-03 Agreement for Services Expert Legal Support Services Provider Amendment.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/03A Agreement for Services (Expert or Legal Support Services
5210-03A Agreement for Services (Expert Legal Support Services (LSS) Provider Amendent (Continuation Sheet).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/04 Agreement for Services (expert or Legal Support SErvices
5210-04 Agreement for Services (Expert - Legal Support Services (LSS) Provider Rate Schedule.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/04A Agreement for Svcs (Expert/Legas Support Svcs) Provider
5210-04A Agreement for Services (Expert - Legal Support Services (LSS) Provider Rate Schedule (Continuation Sheet).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/06 Legal Services Agreement (LSA) Amendment
5210-06 Legal Service Agreement (LSA) Amendment.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/06A Legal Servicees Agreement Amendment Continuation Sheet
5210-06A Legal Service Agreement (LSA) Amendment (Continuation Sheet).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/09 Reps and Certs for Experts and Legal Support Services Pr
5210-09 Representations and Certifications for Experts and Legal Support Services Providers.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/10 Outside Counsel Legal Services Agreement Rate Schedule
5210-10 Outside Counsel Legal Services Agreement (LSA) Rate Schedule.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/10A Outside Counsel Legal Services Agreement (Continued)
5210-10A Outside Counsel Legal Services Agreement (LSA) Rate Schedule (Continuation Sheet).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/11 Legal Invoice for Fees and Expenses
5210-11 Legal Invoices for Fees and Expenses.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/12 Firm Travel Voucher
5210-12 Firm Travel Voucher.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/12A Firm Travel Voucher (continuation sheet)
5210-12A Firm Travel Voucher (Continuation Sheet).pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/14 Oral Representations and Certifications for Expert Legal
5210-14 Oral Representations and Certifications for Expert legal Support Services Telephone Authorization for Expenditures Under
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/15 Legal Support Services (LSS) Provider Budget Form
5210-15 Legal Support Services (LSS) Provider Budget Form.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
5210/08 Expert budget
5210-08 Expert Budget.pdf
www.fdic.gov/buying/legal/supportdeskbook/
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Forms Relating to FDIC Outside Counsel, Legal Support and Expert Services Programs
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
12 CFR 361
12 CFR 366
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
5000/26
Non-Litigation/Transactional Budget Form
5000-26 NON-LITIGATION BUDGET FORM.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5000/31
Amended Litigation Budget
5000-31 Amended Litigation Budget.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5000/33
Amended Non-Litigation/Transactional Budget
5000-33 Amended Non-Litigation Transactional Budget.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5000/35
Litigation Budget
5000-35 LITIGATION BUDGET.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5200/01
Reps and Certs Qualifications of Applicants: Law Firms and Sole Practitioners
5200-01 Representations and Certifications for Legal Contractors.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/01
Representations and Certifications for Legal Contractors
5210-01 EXPERT INVOICE FOR FEES AND EXPENSES (EIF&E).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/02
Legal Support Services (LSS) Provider Invoice for Fees and Expenses
5210-02 Legal Support Services (LSS) Provider Invoice for Fees and Expenses (IF&E).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/03
Agreement for Services (Expert Legal Support Services (LSS)) Provider Amendment
5210-03 Agreement for Services Expert Legal Support Services Provider Amendment.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/03A
Agreement for Services (Expert or Legal Support Services Provider) Amendment
5210-03A Agreement for Services (Expert Legal Support Services (LSS) Provider Amendent (Continuation Sheet).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/04
Agreement for Services (expert or Legal Support SErvices Provider) Provider Rate Schedule
5210-04 Agreement for Services (Expert - Legal Support Services (LSS) Provider Rate Schedule.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/04A
Agreement for Svcs (Expert/Legas Support Svcs) Provider Rate Schedule (continued)
5210-04A Agreement for Services (Expert - Legal Support Services (LSS) Provider Rate Schedule (Continuation Sheet).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/06
Legal Services Agreement (LSA) Amendment
5210-06 Legal Service Agreement (LSA) Amendment.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/06A
Legal Servicees Agreement Amendment Continuation Sheet
5210-06A Legal Service Agreement (LSA) Amendment (Continuation Sheet).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/09
Reps and Certs for Experts and Legal Support Services Providers
5210-09 Representations and Certifications for Experts and Legal Support Services Providers.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/10
Outside Counsel Legal Services Agreement Rate Schedule
5210-10 Outside Counsel Legal Services Agreement (LSA) Rate Schedule.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/10A
Outside Counsel Legal Services Agreement (Continued)
5210-10A Outside Counsel Legal Services Agreement (LSA) Rate Schedule (Continuation Sheet).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/11
Legal Invoice for Fees and Expenses
5210-11 Legal Invoices for Fees and Expenses.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/12
Firm Travel Voucher
5210-12 Firm Travel Voucher.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/12A
Firm Travel Voucher (continuation sheet)
5210-12A Firm Travel Voucher (Continuation Sheet).pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/14
Oral Representations and Certifications for Expert Legal Support Services
5210-14 Oral Representations and Certifications for Expert legal Support Services Telephone Authorization for Expenditures Under $5,000.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/15
Legal Support Services (LSS) Provider Budget Form
5210-15 Legal Support Services (LSS) Provider Budget Form.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Form
5210/08
Expert budget
5210-08 Expert Budget.pdf
http://www.fdic.gov/buying/legal/supportdeskbook/
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Financial Sector Oversight
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,558
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,558
0
0
0
0
3,558
Annual IC Time Burden (Hours)
2,735
0
0
0
0
2,735
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.