Affirmation of Claim Required for Cash Awards Sample Clauses

Affirmation of Claim Required for Cash Awards. 1. Conditions for Returning an Affirmation of Claim Form for a Cash Award. To receive a Cash Award, a Settlement Class Member must submit to the Settlement Administrator a fully-executed, complete, and timely sworn Affirmation of Claim Form verifying that they received at least one Study Fax to the fax number where they received the Class Notice. The Affirmation of Claim Form may be submitted to the Settlement Administrator by mail, facsimile transmission to a designated facsimile phone number or via the Settlement Website. The Settlement Administrator will have no obligation to honor any Affirmation of Claim Form not submitted by mail, facsimile transmission to the designated facsimile phone number, or via the Settlement Website. To be considered fully-executed, the Claim Form must contain all of the information set forth in Exhibit A hereto, including: (i) the Settlement Class Member’s full name and the full name of an authorized representative if the Settlement Class Member is an entity; (ii) a statement signed by the Settlement Class Member or a duly authorized representative, under penalty of perjury, that on or between January 21, 2012 and December 31, 2016, the Settlement Class Member was sent one or more of the Study Faxes; (iii) for mailed and faxed Affirmation of Claim Forms, the Settlement Class Member’s or its authorized representative’s signature; and (iv) for Affirmation of Claim Forms submitted via the Settlement Website, the Settlement Class Member's or its authorized representative’s electronic signature. In the case of corporate submissions, the authorized representative must also represent and warrant that he or she is authorized to act on the Settlement Class Member’s behalf. Only one Affirmation of Claim Form will be honored per Settlement Class Member, regardless of the number of faxes directed to the Settlement Class Member, or the number of facsimile phone numbers through which the Settlement Class Member was sent a Study Fax.
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Related to Affirmation of Claim Required for Cash Awards

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