CLAIM FORM INSTRUCTIONS Sample Clauses

CLAIM FORM INSTRUCTIONS. A. Please type of print all the information that is asked for. B. By signing this form you are confirming the information you have given is correct. You also agree to give more information to Plaintiffs’ Counsel or the Settlement Administrator to support your claim. They may ask you to do this in the future.

CLAIM FORM INSTRUCTIONS. To make a cla im under the Settlement, you must complete this form and submit it online, via electronic mail, or ma il it to the address at the bottom of this form. Your Claim Form must be received by the Settlement Administrator by 11:59 p.m., Central Time, on ____ _. The information will not be disclosed to anyone other than the Court, the Settlement Administrator, and the Parties in this case, and will be used only for purposes of administering this Settlement (such as to audit and review a cla im for completeness, truth, and accuracy). You can submit a Claim for a Settlement Benefit payment under this Settlement if you purchased any Xxxx Xxx Frozen Bakery, LLC branded Products in the United States, except for purposes of resale, between April 27, 2017 and __ , which contain the term “All Butter Pound Cake” on the labeling, including those Products listed in the Complaint. Settlement Class Memberswho seek payment fromthe Settlement must complete and return this Claim Form. Completed Claim Forms must be mailed to the Settlement Administrator at Kroll Business Services, __ or can be submitted via the __ Settlement Website, www. .com. Claim Forms must be POSTMARKED or SUBMITTED ONLINE NO

CLAIM FORM INSTRUCTIONS. A. Please type or neatly print all the information that is asked for. B. If you believe you are entitled to money from the Settlement Fund you must complete Part 1 of the Claim Form and the additional parts of the Claim Form that apply to you. C. By signing below you are verifying, under penalty of perjury, that the information you have included is correct. You also agree to provide additional information to Class Counsel or the Settlement Administrator to support your claim. They may ask you to do this in the future. D. By signing below you are also verifying that you have not filed a claim or lawsuit about being strip searched at the Jail, that you did not ask anyone else to file one for you, and that you don't know of anyone who might have filed one for you. E. Please read the instructions carefully. Your claim will be checked and verified by the Settlement Administrator. You should keep copies of all documents that support your claim while this is going on. F. A Claim Form will be considered submitted to the Settlement Administrator if it is mailed in a first-class envelope postmarked by the due date. You may want to send in your Claim Form by Certified Mail, Return Receipt Requested or a form of overnight delivery that provides a record of delivery. If you send the Claim Form to the Settlement Administrator in some way other than first-class mail, the Claim Form will be considered "submitted" when it is received by the Settlement Administrator. G. The Settlement Administrator will not tell you when they get your Claim Form. If you want to make sure the Settlement Administrator gets your form, you should send it by Certified Mail, Return Receipt Requested. It will take some time to process all the forms and send the checks. This work will be done as fast as possible, but each claim must be checked for accuracy and recorded. H. Please write or call Settlement Administrator if your address changes. SETTLEMENT FUND. THE ENVELOPE MUST BE POSTMARKED NO LATER THAN [INSERT DATE] 2019, AND MUST BE MAILED TO: Claimant’s Name: Mailing Address: City: State/Country: Zip Code: Date of Birth: Social Security No. Date of Arrest if known. Please say so if the date you give is an estimate. Please note that only persons arrested between May 5, 2013 and January 1, 2018, who were admitted into the Essex County Correctional Facility are eligible. All criminal charges or reasons for arrest, if known (i.e. violation of probation, Family Court warrant): Telephones:

CLAIM FORM INSTRUCTIONS. A. Please type or neatly print all the information that is asked for.