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Refresh Save Import OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
LEGAL SERVICES AGREEMENT (LSA) AMENDMENT (Continuation Sheet)
POSITION Partner (P) Associate (A) Paraprofessional (PP) Specify Other Position (O) MINORITY STATUS Asian American (A) Black American (B) Hispanic American (H) Native ... more>>
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Federal Deposit Insurance Corporation
Import Refresh OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010 LSA EFFECTIVE DATE (MM/DD/YYYY)
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LEGAL SERVICES AGREEMENT (LSA) AMENDMENT
SECTION I – LEGAL SERVICES PROVIDER INFORMATION
NAME OF LAW FIRM BRANCH/OFFICE LOCATION (Each office of a multiple office firm/business must complete a sep ... more>>
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OMB NUMBRER: 3064-0122 EXPIRATION DATE: 05/31/2007
Federal Deposit Insurance Corporation
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AGREEMENT FOR SERVICES (EXPERT/LEGAL SUPPORT SERVICES (LSS) PROVIDER) RATE SCHEDULE (Continuation Sheet)
MINORITY STATUS Asian American (A) BILLABLE INDIVIDUAL Alphabetical Order Black American (B) Hispanic American ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
AGREEMENT FOR SERVICES (EXPERT/LEGAL SUPPORT SERVICES (LSS) PROVIDER) RATE SCHEDULE
AGREEMENT FOR SERVICES EFFECTIVE DATE (MM/DD/YYYY)
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NOTE: If additional space is needed, complete and attach form FDIC 5210/04A, Agreem ... more>>
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Federal Deposit Insurance Corporation
AGREEMENT FOR SERVICES (EXPERT/LEGAL SUPPORT SERVICES PROVIDER) AMENDMENT (Continuation Sheet)
MINORITY STATUS Asian American (A) ADD (A) or DELETE (D) BILLABLE INDIVIDUAL (First, Middle, Last, Suffix) Alphabetical Order TITLE Bl ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
LEGAL SUPPORT SERVICES (LSS) PROVIDER INVOICE FOR FEES AND EXPENSES (IF&E)
MATTER NUMBER MATTER CAPTION
SECTION I – FIRM AND INSTITUTION INFORMATION
INSTITUTION NUMBER FINANCIAL INSTITUTION NAME CITY FEDERAL TAX ID NUMBER LSS ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
EXPERT INVOICE FOR FEES AND EXPENSES (EIF&E)
MATTER NUMBER MATTER CAPTION
SECTION I – FIRM AND INSTITUTION INFORMATION
INSTITUTION NUMBER FINANCIAL INSTITUTION NAME CITY FEDERAL TAX ID NUMBER EXPERT FIRM NAME CITY EXPERT FIRM ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
Representations and Certifications for Legal Contractors
The information and certifications required on this form will be used in determining the fitness and integrity of the law firm or sole practitioner (“Contractor”) for en ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
LITIGATION BUDGET
INSTRUCTIONS: Please complete all requested information. Matter Number Matter Caption
Institution Number
Institution Name
Institution Type Bank Thrift
Firm Name
PART I
Attorneys' Fees: Hourly Rate: $ Fi ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
AMENDED NON-LITIGATION BUDGET
INSTRUCTIONS: An amended budget amount is a cumulative total of all past amounts incurred plus future amounts necessary for completion of a matter. An amended budget worksheet must also be complet ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
AMENDED LITIGATION BUDGET
INSTRUCTIONS: An amended budget amount is a cumulative total of all past amounts incurred plus future amounts necessary for completion of a matter. An amended budget worksheet must also be completed p ... more>>
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OMB NUMBER: 3064-0122 EXPIRATION DATE: 05/31/2010
Federal Deposit Insurance Corporation
NON-LITIGATION BUDGET FORM
INSTRUCTIONS: Please provide all information requested. Matter Number Institution Number Institution Name Matter Caption Institution Type Bank Thrift Firm Name
PART I - NON-LITIGATION BUDGET INFORMA ... more>>
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Federal Deposit Insurance Corporation
Division of Finance
Substitute Form W-9 REQUEST FOR TAXPAYER IDENTIFICATION NUMBER AND CERTIFICATION
PRIVACY ACT STATEMENT Section 6109 of the Internal Revenue Code requires you to give your correct Taxpayer Identification Number (TIN) to persons who must file information ret ... more>>
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Federal Deposit Insurance Corporation
PAYEE INFORMATION FOR AUTOMATIC DEPOSIT OF PAYMENT
INSTRUCTIONS: Complete and return this form to the Federal Deposit Insurance Corporation (FDIC). For additional information regarding Direct Deposit, please call the Division of Finance at (703) 562-2565. NOTE: The information ... more>>
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