Common use of FORMER PARTICIPANT CLAIM FORM Clause in Contracts

FORMER PARTICIPANT CLAIM FORM. XXXX X CLASSMEMBER 000 XXXX XX APT 1 ANYTOWN, ST 12345 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension Plan, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5, 2020. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 2 contracts

Samples: Class Action Settlement Agreement, Class Action Settlement Agreement

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FORMER PARTICIPANT CLAIM FORM. XXXX X CLASSMEMBER 000 XXXX XX APT 1 ANYTOWN, ST 12345 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Co. Inc. Profit-Sharing Retirement Plan or Money Purchase Pension Plan, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5, 2020. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 2 contracts

Samples: Class Action Settlement Agreement, Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in of the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase NRECA 401(k) Pension Plan, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans Plan as of August 5July 31, 2020. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 2 contracts

Samples: Class Action Settlement Agreement, Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension PlanParticipants, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5September 30, 20202019. This form must be completed, signed signed, and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Co. Inc. Profit-Sharing Retirement Plan or Money Purchase Pension Plan, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5, 2020. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension PlanParticipants, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5June 14, 20202019. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension Plan, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5, 2020. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

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FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWN, ST 12345 Claim Number: 1111111 000 XXXX XX XXX 0 XXXXXXX, XX 00000 This Former Participant Claim Form is ONLY for Settlement Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension PlanParticipants, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Settlement Class Member who no longer had an Active Account in the Plans does not have a Plan account with a balance greater than $0.00 as of August 5the date of [the Preliminary Approval Order]. Former Participants that would like to elect to receive their settlement payment must complete, 2020. This sign, and mail this form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds10 days before Fairness Hearing, 2021]. Former Participants participants who do not complete and timely return this form will not receive any Settlement paymenttheir settlement payment by check. Please review the instructions below carefully. If you have questions regarding this Claim Formform, you may contact the Settlement Administrator as indicated below. : XXX.XXXXXXXXXXXXXXXXX.XXX OR CALL [PHONE NUMBER] ************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. ABC1234567890 *ABC1234567890* XXXX X CLASSMEMBER Q CLASS MEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension PlanParticipants, or the beneficiaries or beneficiaries, alternate payees or attorneys-in-fact of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans did not have a plan account with a balance greater than $0 as of August 5March 31, 20202021. This form must be completed, signed and filed electronically through the claims portal at xxx.xxxxxxxx000xxxxxxxxxxxxxxx.xxx by XXXXXXX or mailed with a postmark on or before [DATE] date no later than XXXXXXXXX to the Settlement Administrator in order for you to receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ****************************************************************************************************************************** P ART 1: INSTRUCTIONS FOR COMPLETING FORMER PARTICIPANT CLAIM FORM

Appears in 1 contract

Samples: Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. XXXX X Q CLASSMEMBER 000 XXXX XX APT 1 ANYTOWNXXX 0 XXXXXXX, ST 12345 XX 00000 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension PlanParticipants, or the beneficiaries or alternate payees of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans as of August 5June 30, 20202019. This form must be completed, signed and mailed with a postmark on or before [DATE] to the Settlement Administrator in order for you receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

FORMER PARTICIPANT CLAIM FORM. ABC1234567890 *ABC1234567890* XXXX X CLASSMEMBER CLASS MEMBER 000 XXXX XX APT 1 ANYTOWN, ST 12345 Claim Number: 1111111 This Former Participant Claim Form is ONLY for Class Members who are Former Participants in the McKinsey & Company, Inc. Profit-Sharing Retirement Plan or Money Purchase Pension PlanParticipants, or the beneficiaries or beneficiaries, alternate payees or attorneys-in-fact of Former Participants (all of whom will be treated as Former Participants). A Former Participant is a Class Member who no longer had an Active Account in the Plans did not have a plan account with a balance greater than $0 as of August 5March 31, 20202021. This form must be completed, signed and filed electronically through the claims portal at xxx.xxxxxxxx000xxxxxxxxxxxxxxx.xxx by XXXXXXX or mailed with a postmark on or before [DATE] date no later than XXXXXXXXX to the Settlement Administrator in order for you to receive your share of the Settlement proceeds. Former Participants who do not complete and timely return this form will not receive any Settlement payment. Please review the instructions below carefully. If you have questions regarding this Claim Form, you may contact the Settlement Administrator as indicated below. ******************************************************************************************************************************

Appears in 1 contract

Samples: Class Action Settlement Agreement

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