OMB Control No:  3064-0122 
ICR Reference No: 
201003-3064-004 
 
Status:  Historical Active 
Previous ICR Reference No:  200703-3064-007  
 
Agency/Subagency:  FDIC 
Agency Tracking No:  3064-0122 
 
Title:  Forms Relating to FDIC
Outside Counsel, Legal Support and Expert Services Programs 
 
Type of Information Collection: 
Extension without change of a currently approved collection 
Common Form ICR:   No 
 
Type of Review Request:  Regular 
 
 
OIRA Conclusion Action:  Approved
without change 
Conclusion Date:  07/28/2010 
 
Retrieve
Notice of Action (NOA)  
Date Received in OIRA: 
06/17/2010 
 
Terms of Clearance:  
 
  
Inventory as of this Action 
Requested 
Previously Approved 
 
Expiration Date  
07/31/2013 
36 Months From Approved 
07/31/2010 
 
Responses  
3,558 
0 
3,558 
 
Time Burden (Hours)  
2,735 
0 
2,735 
 
Cost Burden (Dollars)  
0 
0 
0 
 
 
 
Abstract:  The collection involves the submission
of information on various forms by contractors who wish to do
business with, or are currently under contract with the FDIC's
Legal Division. 
 
 
 
Authorizing Statute(s):   US Code:
12 USC 1822(f)(3-4)  Name of Law: FDI Act 
    US Code: 12
USC 1819(a)  Name of Law: FDI Act 
   
 
Citations for New Statutory
Requirements:  None 
 
 
 
Associated Rulemaking
Information  
 
RIN:  
Stage of Rulemaking:  
Federal Register Citation:  
Date:  
 
 
Not associated with rulemaking 
 
 
 
 
 
Federal Register Notices &
Comments  
 
60-day Notice:  
Federal Register Citation:  
Citation Date:  
 
  
75 FR
12541  
03/16/2010 
 
30-day Notice:  
Federal Register Citation:  
Citation Date:  
 
 
75 FR
30403  
06/01/2010 
 
Did the Agency receive public comments on
this ICR?  No 
 
 
 
Number of Information Collection (IC) in this
ICR:  1  
 
IC Title 
Form No. 
Form Name 
 
Forms Relating to FDIC
Outside Counsel, Legal Support and Expert Services
Programs  
5000/26, 5000/31, 5000/33, 5210/04, 5210/04A, 5210/06, 5210/14,
5210/15, 5210/12A, 5210/02, 5210/03, 5210/03A, 5210/09, 5210/10,
5210/10A, 5210/11, 5210/12, 5210/08, 5000/35, 5200/01, 5210/01,
5210/06A 
Legal Servicees
Agreement Amendment Continuation Sheet  ,   Reps and Certs for Experts and
Legal Support Services Providers  ,   Outside Counsel Legal Services
Agreement Rate Schedule  ,   Outside Counsel Legal Services
Agreement (Continued)  ,   Legal Invoice for Fees and
Expenses  ,   Firm Travel Voucher  ,
  Firm Travel
Voucher (continuation sheet)  ,   Oral Representations and
Certifications for Expert Legal Support Services  ,  
Legal Support Services
(LSS) Provider Budget Form  ,   Expert budget  ,  
Non-Litigation/Transactional
Budget Form  ,   Amended Litigation Budget  ,
  Amended
Non-Litigation/Transactional Budget  ,   Litigation Budget  ,  
Reps and Certs
Qualifications of Applicants: Law Firms and Sole Practitioners 
,   Representations and
Certifications for Legal Contractors  ,   Legal Support Services (LSS)
Provider Invoice for Fees and Expenses  ,   Agreement for Services (Expert
Legal Support Services (LSS)) Provider Amendment  ,  
Agreement for Services
(Expert or Legal Support Services Provider) Amendment  ,  
Agreement for Services
(expert or Legal Support SErvices Provider) Provider Rate
Schedule  ,   Agreement for Svcs
(Expert/Legas Support Svcs) Provider Rate Schedule (continued) 
,   Legal Services
Agreement (LSA) Amendment  
 
 
 
 
 
ICR Summary of Burden 
  
Total Approved 
Previously Approved 
Change Due to New Statute 
Change Due to Agency Discretion 
Change Due to Adjustment in
Estimate 
Change Due to Potential Violation of
the PRA 
 
Annual Number of Responses 
3,558 
3,558 
0 
0 
0 
0 
 
Annual Time Burden (Hours) 
2,735 
2,735 
0 
0 
0 
0 
 
Annual Cost Burden (Dollars) 
0 
0 
0 
0 
0 
0 
 
Burden increases because of Program Change due to Agency
Discretion:  No 
 
Burden Increase Due to:  
 
Burden decreases because of Program Change due to Agency
Discretion:  No 
 
Burden Reduction Due to:  
 
Short Statement:  
 
 
 
Annual Cost to Federal Government:  $0 
 
Does this IC contain surveys, censuses, or employ
statistical methods?  No 
 
Is the Supporting Statement intended to be a Privacy
Impact Assessment required by the E-Government Act of 2002? 
No 
 
Is this ICR related to the Affordable Care Act [Pub. L.
111-148 & 111-152]?  No 
 
Is this ICR related to the Dodd-Frank Wall Street Reform
and Consumer Protection Act, [Pub. L. 111-203]? 
Uncollected 
 
Is this ICR related to the American Recovery and
Reinvestment Act of 2009 (ARRA)?  No 
 
Is this ICR related to the Pandemic Response? 
Uncollected 
 
Agency Contact:  Gary Kuiper 202 898-3877
gkuiper@fdic.gov