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 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 Social Security Number (last four digits only):
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 a claim must submit the unique identifier provided by the Claims Administrator, attest that they received either the Notice of Cyberattack 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 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: Notice ID Number Social Security Number (last four digits only)
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: Notice ID Number Social Security Number (last four digits only) III. IDENTITY THEFT PROTECTION 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 were a customer of Creative Ventures before November 1, 2021, AND Enter the Notice ID Number provided on your Notice: OR 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: CREATIVE- A Your claim must be submitted online or postmarked by: MONTH DD, 2023 CLAIM FORM FOR CREATIVE VENTURES, INC. CYBERATTACK SETTLEMENT Xxxxxx Xxxxx v. Creative Ventures, Inc., d/b/a Pro Wrestling Tees Case No. 2023LA000177 First Name Last Name Street Address City State Zip Code III. IDENTITY THEFT PROTECTION Check this box if you wish to receive two (2) years of free credit monitoring service.
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you received notification from Afni that your PII might have been compromised in the Data Security Incident that occurred on or about June 7, 2021. Enter the Notice ID Number provided on your Notice or the last four digits of your Social Security Number: Notice ID Number Social Security Number (last four digits only)
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you were a person to whom Lower mailed notice of the Data Incident and/or Settlement. Enter the Notice ID Number provided on your Postcard Notice: Notice ID Number
PROOF OF CLASS MEMBERSHIP. Check this box to certify that you were a person to whom Xxxx-Xxxxxx mailed notice of the Data Security Incident and/or Settlement. Enter the Notice ID Number provided on your Postcard Notice or the last four digits of your Social Security Number: Notice ID Number Social Security Number (last four digits only) Xxxx Xxxxxx - C Your claim must be submitted online or postmarked by: MONTH DD, 2023 CLAIM FORM XXXX-XXXXXX ENGINEERS, INC. DATA SECURITY INCIDENT SETTLEMENT Xxxxxxx Xxxxxxxx x. Xxxx-Xxxxxx Engineers, Inc.. Case No. 2022CI21570 438th Judicial District for Bexar County, Texas III. IDENTITY THEFT PROTECTION Check this box if you wish to receive one (1) year of free identity protection and credit monitoring service.
