Information Collection

Reps and Certs for Experts and Legal Support Services Providers

IC 238899 under ICR 202603-3064-003 · OMB 3064-0122.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5210/09 Reps and Certs for Experts and Legal Support Services Providers Reps and Certs for Experts and Legal Support Services Providers	Form
5210/09 Reps and Certs for Experts and Legal Support Services Pr f5210-09.pdf	Form
3064-0122 Justification for Non-Substantive Forms Revision Legal Services 2023 Certifications.docx Justification for Non-Substantive Change	IC Document

IC Title:

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	5210/09				Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11

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
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	11	6	5
Annual IC Time Burden (Hours)	8	3	5
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for Non-Substantive Change		08/08/2023

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

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