Form NCUA 3249a NCUA 3249a Contractor Budget

OMB No. 3133-0189

NCUA
CONTRACTOR BUDGET

______________________________________________________________________
SUBMITTED BY

______________________________________________________________________
CONTRACTOR NAME

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NCUA 3249a (09/2014)

OMB No. 3133-0189

National Credit Union Administration
BUDGET
INSTRUCTIONS: Please complete all requested information. Enter N/A if not applicable.
Matter Number
Matter Caption

Institution Name

Firm Name

☐Initial Budget
☐1st Amended Budget
PART I –BUDGET INFORMATION
Attorneys' Fees:
☐Hourly Rate: $____________.
☐Fixed Fee: $____________.
☐Contingent Fee: _______% of $________.

☐2nd Amended Budget

☐3rd Amended Budget

Estimated Recovery Value: $______________________
Estimated Judgment Amount: $___________________
Estimated Judgment Probability: ________________%
Last Budget

Estimated Hours For Completion: _______________.
Fees

Expenses

Cumulative Amended
Budget
Fees
Expenses

Estimated Completion Date: ___________________.

Total Fees and Expenses
PART II – LAW FIRM BUDGET ACKNOWLEDGMENT
I acknowledge that the budget information contained herein is correct to the best of my knowledge and written approval of the
NCUA is required for any increase in the total budget amount.
Authorized Law Firm Delegate's Signature
Date

Name and Title of Authorized Law Firm Delegate

Telephone Number

FAX Number

PART III – BUDGET AUTHORIZATION FOR OUTSIDE COUNSEL TO PROCEED
NCUA Attorney (Recommending approval of budget)
Date Budget Approved

Signature of Delegated Authority

Date Budget Approved

PAPERWORK REDUCTION ACT STATEMENT
Public reporting burden for this collection of information is estimated to average 0.5 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to the Office of General Counsel, National Credit Union Administration, 1775 Duke Street, Alexandria, VA 22314. An
agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid
OMB control number.
PRIVACY ACT STATEMENT
Collection of this information is authorized by the Federal Credit Union Act, 12 U.S.C. §§ 1786, 1787, 1789 and Executive Order 9397. This
information will be primarily used to evaluate and determine potential contract awards. The information may be disclosed to appropriate Federal,
state, or local agencies for law enforcement purposes when a violation or possible violation of a civil or criminal law is apparent; to individuals
involved in judicial or administrative proceedings; and to a Congressional office in response to an inquiry made at the individual’s request. The
information may also be disclosed pursuant to the Freedom of Information Act, but only if it is no longer protected by a disclosure exemption
under 12 C.F.R. § 792.11. Furnishing the requested information is voluntary. However, failure to furnish all requested information may preclude
you from receiving an NCUA contract.

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NCUA 3249a (09/2014)