PROOF OF CLASS MEMBERSHIP. Check this box to certify that you were a person to whom ACTS mailed notice of the Settlement. Enter the Notice ID Number provided on your Postcard Notice:
PROOF OF CLASS MEMBERSHIP. As proof of class membership, any Settlement Class and California Subclass Members filing a claim must certify that he or she was a customer of Defendant before November 1, 2021, and submit the unique identifier provided by the Claims Administrator or an attestation under the penalty of perjury that they are a Settlement Class and/or California Subclass Member, that they received either the Notice of Data Breach letter or notice of this settlement, and provide the name and address to which either notice was sent.
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you were an employee, a family member of an employee, or had applied to become an employee of Alacrity Solutions Group, LLC (“Alacrity”) before March 3, 2021. Enter the Notice ID Number provided on your Notice or the last four digits of your Social Security Number: Check this box if you wish to receive two (2) years of free identity protection and credit monitoring service.
PROOF OF CLASS MEMBERSHIP. □ Check this box to certify that you received a notification that your personal data was impacted in the Data Incident on Guardian’s servers that occurred between November 27, 2022 and January 22, 2023. Enter the Notice ID Number provided on your Notice or the last four digits of your Social Security Number:
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you were a customer of Creative Ventures before November 1, 2021, AND Enter the Notice ID Number provided on your Notice: Check this box to attest under the penalty of perjury that you are a Settlement Class Member, that you received either the Notice of Data Breach letter in December 2021 or Notice of this settlement, and provide the name and address to which either notice was sent in the space below: CLAIM FORM FOR CREATIVE VENTURES, INC. CYBERATTACK SETTLEMENT
PROOF OF CLASS MEMBERSHIP. As proof of class membership, any Settlement Class Members must submit a completed Claim Form by the Claims Deadline.
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you are a Person residing in the United States to whom <<DEFENDANT>> sent its notice of a Data Security Incident that <<DEFENDANT>> discovered on or about <<DATE>>. Enter the Class Member ID Number provided on your postcard Notice or the last four digits of your Social Security Number: Class Member ID : xxxx
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you reside in the United States and received a notice of the Data Incident that MRIA discovered on or about November 9, 2021. Enter the Notice ID Number provided on your Notice or the last four digits of your Social Security Number:
PROOF OF CLASS MEMBERSHIP. As proof of class membership, any Claimant filing a claim must certify that he or she received treatment at Beaumont before May 2019 and also submit one of the following: (1) a unique identifier to be provided by the Claims Administrator to those individuals for whom direct notice can be given; or (2) his or her name, the year or years in which he or she received treatment at Beaumont, and location of the Beaumont facility at which he or she received the treatment.
PROOF OF CLASS MEMBERSHIP. As proof of class membership, any Settlement Class Members filing an electronic claim must submit the unique identifier provided by the Claims Administrator. Any potential Claimant who loses or does not receive a unique identifier may call the Claims Administrator, and upon validation of their status as a Settlement Class Member by the Claims Administrator, have their unique identifier issued or re-issued (as the case may be). Alternatively, a potential Claimant who lacks a unique identifier may submit a Claim Form for consideration to the Claims Administrator in paper format. The Claims Administrator is authorized to use standard fraud-prevention techniques in reviewing claims for legitimacy and validity.
