Information Collection

Representations and Certifications for Legal Contractors

IC 238722 under ICR 202308-3064-002 · OMB 3064-0122.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5200/01 Representations and Certifications for Legal Contractors	Form
5200/01 Representations and Certifications for Legal Contractors f5200-01.pdf	Form
5200/01 Representations and Certifications for Legal Contractors f5200-01.pdf	Form
3064-0122 Justification for Non-Substantive Forms Revision Legal Services 2023 Certifications.docx Justification for Non-Substantive Change	IC Document
3064-0122 Justification for Non-Substantive Forms Revision Legal Services 2023 Certifications.docx Justification for Non-Substantive Change	IC Document

IC Title:

Representations and Certifications for Legal Contractors

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5200/01	Representations and Certifications for Legal Contractors	f5200-01.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for Non-Substantive Change	3064-0122 Justification for Non-Substantive Forms Revision Legal Services 2023 Certifications.docx	08/08/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.