Common use of PROOF OF CLAIM AND RELEASE FORM Clause in Contracts

PROOF OF CLAIM AND RELEASE FORM. To be eligible to receive a share of the Net Settlement Fund in connection with the Settlement of this Action, you must be a Class Member and complete and sign this Proof of Claim and Release Form (“Claim Form”) and either mail it by first-class mail to the above address or submit it online at www. , no later than , 2018. Failure to submit your Claim Form by the date specified will subject your claim to rejection and may preclude you from being eligible to recover any money in connection with the Settlement. TABLE OF CONTENTS PAGE # The Claims Administrator will use this information for all communications regarding this Claim Form. If this information changes, you MUST notify the Claims Administrator in writing at the address above. Beneficial Owner’s First Name Beneficial Owner’s Last Name Co-Beneficial Owner’s First Name Co-Beneficial Owner’s Last Name Entity Name (if Beneficial Owner is not an individual) Representative or Custodian Name (if different from Beneficial Owner(s) listed above) Address1 (street name and number) Address2 (apartment, unit or box number) City State Zip Code Country Last four digits of Social Security Number or Taxpayer Identification Number Telephone Number (home) Telephone Number (work) Email address (E-mail address is not required, but if you provide it you authorize the Claims Administrator to use it in providing you with information relevant to this claim.): Account Number (where securities were traded): Claimant Account Type (check appropriate box): Individual (includes joint owner accounts) Pension Plan Trust Corporation Estate IRA/401K Other (please specify)

PROOF OF CLAIM AND RELEASE FORM. To be eligible to receive a share of the Net Settlement Fund in connection with the Settlement of this Action, you must be a Class Member and complete and sign this Proof of Claim and Release Form (“Claim Form”) and either mail it by first-class mail to the above address or submit it online at www. address, postmarked no later than , 2018. Failure to submit your Claim Form by the date specified will subject your claim to rejection and may preclude you from being eligible to recover any money in connection with the Settlement. TABLE OF CONTENTS PAGE # The Claims Administrator will use this information for all communications regarding this Claim Form. If this information changes, you MUST notify the Claims Administrator in writing at the address above. Beneficial Owner’s First Name Beneficial Owner’s Last Name Co-Beneficial Owner’s First Name Co-Beneficial Owner’s Last Name Entity Name (if Beneficial Owner is not an individual) Representative or Custodian Name (if different from Beneficial Owner(s) listed above) Address1 (street name and number) Address2 (apartment, unit or box number) City State Zip Code Country Last four digits of Social Security Number or Taxpayer Identification Number Telephone Number (home) Telephone Number (work) Email address (E-mail address is not required, but if you provide it you authorize the Claims Administrator to use it in providing you with information relevant to this claim.): Account Number (where securities were traded): traded)1: 1 If the account number is unknown, you may leave blank. If filing for more than one account for the same legal entity you may write “multiple.” Please see paragraph 8 below for more information on when to file separate Claim Forms for multiple accounts. Claimant Account Type (check appropriate box): Individual (includes joint owner accounts) Pension Plan Trust Corporation Estate IRA/401K Other (please specify)

PROOF OF CLAIM AND RELEASE FORM. To be eligible to receive a share of the Net Settlement Fund in connection with the Settlement of this Action, you must be a Class Member and complete and sign this Proof of Claim and Release Form (“Claim Form”) and either mail it by first-class mail to the above address or submit it online at www. address, postmarked no later than , 2018. Failure to submit your Claim Form by the date specified will subject your claim to rejection and may preclude you from being eligible to recover any money in connection with the Settlement. TABLE OF CONTENTS PAGE # The Claims Administrator will use this information for all communications regarding this Claim Form. If this information changes, you MUST notify the Claims Administrator in writing at the address above. Beneficial Owner’s First Name Beneficial Owner’s Last Name Co-Beneficial Owner’s First Name Co-Beneficial Owner’s Last Name Entity Name (if Beneficial Owner is not an individual) Representative or Custodian Name (if different from Beneficial Owner(s) listed above) Address1 (street name and number) Address2 (apartment, unit or box number) City State Zip Code Country Last four digits of Social Security Number or Taxpayer Identification Number Telephone Number (home) Telephone Number (work) Email address (E-mail address is not required, but if you provide it you authorize the Claims Administrator to use it in providing you with information relevant to this claim.): Account Number (where securities were traded): traded)1: 1 If the account number is unknown, you may leave blank. If filing for more than one account for the same legal entity you may write “multiple.” Please see paragraph 8 below for more information on when to file separate Claim Forms for multiple accounts. Claimant Account Type (check appropriate box): Individual (includes joint owner accounts) Pension Plan Trust Corporation Estate IRA/401XXX/401K Other (please specify)