OMB NUMBER: 3064-0122EXPIRATION DATE: 09/30/2016

Federal Deposit Insurance Corporation
NON-LITIGATION BUDGET FORM
INSTRUCTIONS: Please provide all information requested.
1. REQUISITION NUMBER
Example: (ABxx-xxx-xxxx) / FEDERAL DEPOSIT INSURANCE CORPORATION
REQUISITION FOR STOCKED ITEMS / 3. DELIVER TO (Name and Room Number)
2. DATE
INSTRUCTIONS: Refer to the FDIC Supply Catalog at for items that are stocked by the FDIC Supply Stores to complete the stock number, description, unit of issue, and quantity requested for each item. Use the current Boise Cascade Catalog to complete the stock number, catalog page number, description, unit of issue, and quantity requested for each applicable item that is not listed in the FDIC Supply Catalog. Submit the completed form to the nearest FDIC Supply Store. Use the Boise Cascade Electronic Order System (I-97) at for future orders.
4. STOCK NUMBER / 5. BOISE
CASCADE
CATALOG
PAGE NUMBER / 6. DESCRIPTION / 7. UNIT OF
ISSUE / 8. QUANTITY REQUESTED / TO BE COMPLETED BY FDICSUPPLYSTORECENTER
9. QUANTITY
PROVIDED / 10. QUANTITY ON BACK ORDER / 11. BACK ORDER
TO BE FILLED BY (Date)
11. REQUESTED BY (Please print and sign name) / 12. REQUESTOR'S TELEPHONE NUMBER / 13. APPROVED BY (Signature)
() -
14. RECEIVED BY (Signature) / 15. DATE RECEIVED
FOR FDIC SUPPLY STORE USE ONLY
16. INITIAL ORDER FILLED BY / 17. DATE FILLED
FDIC 3630/02A (7-01 information.
Matter Number / Matter Caption
Institution Number / Institution Name / Institution Type / Firm Name
Bank Thrift
PART I - NON-LITIGATION BUDGET INFORMATION
Attorneys' Fees: / Estimated Recovery Value:
Hourly Rate: $
Fixed Fee: $ __\
TOA Fee: $ .
Contingent Fee: % of $ / $.
Specify Nature of Non-Litigation work to be Performed (Attach additional sheet(s) as necessary.)
Estimated Hours for Completion:.
Estimated Completion Date (MM/DD/YYYY): . / Fees / Expenses / Total
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 Legal Division is required for any increase in the total budget amount.
Authorized Law Firm Delegate’s Signature / Date (MM/DD/YYYY)
Name and Title of Authorized Law Firm Delegate (Please type or print)
Telephone Number (Include area code) / FAX (Include area code)

PART III - BUDGET AUTHORIZATION FOR OUTSIDE COUNSEL TO PROCEED

FDIC Attorney (Recommending approval of budget) / Date Budget Approved (MM/DD/YYYY)
Signature of Delegated Authority / Date Budget Approved (MM/DD/YYYY)
PAPERWORK REDUCTION ACT NOTICE
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 Paper Reduction Act Clearance Officer, Legal Division, Federal Deposit Insurance Corporation, 550 17th Street, N.W., Washington, D.C. 20429; and to the Office of Management and Budget, Paperwork Reduction Project (3064-0122), Washington, D.C. 20503. 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.

FDIC 5000/26 (10-05)