The FDIC is authorized to request this information from you by 12 U.S.C §§ 1819, 1820, 1822(f); Executive Order 9397 as amended;
and 12 C.F.R. Part 366. The information collected will be primarily used to determine whether you meet the required fitness and
integrity standards to provide expert or other legal support services to the FDIC. Furnishing the requested information is voluntary, but
failure to provide the requested information in whole or in part may delay or prohibit any further consideration of you to provide expert
or other legal support services to the FDIC. The information you provide may be provided to appropriate Federal, state, local or foreign
agencies and law enforcement authorities; to a court, administrative tribunal,
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