Common use of Required Affirmations Clause in Contracts

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS (where to send the completed form if submitting by mail): AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. This Claim Form may be submitted in one of three ways: 1. Electronically through www.[xxx].com. 2. Via email to [xxx]@[xxx].com. Please fill out the enclosed pages, scan the document in its entirety, and include the form as an attachment. 3. Mail to: AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under the proposed settlement, this form must be completed, signed, and sent, as outlined above, no later than [Month] [Day] [Year]. If this Form is not postmarked or received by this date, you will remain a member of the Settlement Class but will not receive any payment from the Settlement.

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  🞎 I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] ], [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] ], [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS Settlement Administrator Address (where to send the completed form if submitting by mail): AAG Cardinal Financial TCPA Settlement, c/o , [Address], [City] ], [State], ] [Zip Code]. A court authorized this notice. You are not being sued. This Claim Form is not a solicitation from a lawyer. • Call records indicate that you may be submitted in one affected by a Settlement1 of three ways: 1a class action lawsuit claiming that Defendant Cardinal Financial (“Cardinal Financial”) violated a federal law called the Telephone Consumer Protection Act (“TCPA”) and the Florida Telephone Solicitations Act (“FTA”). Electronically through www.[xxx].com. 2Cardinal Financial denies that it violated the law. Via email to [xxx]@[xxx].com• The lawsuit is called Xxxxx Xxxxxx x. Xxxxxxxx Financial Company, Limited Partnership, Case. Please fill out the enclosed pagesNo 21-cv-2744. Judge Xxxx Xxxxxxx decided that this settlement should be a class action on behalf of a Class, scan the document in its entiretyor group of people that could include you, and include the form as an attachment. 3a Settlement has been reached affecting this Class. Mail to• The Settlement offers payments to Class Members who file valid Claims. • Your legal rights are affected whether you act or do not act. Read this notice carefully. YOUR LEGAL RIGHTS AND OPTIONS IN THIS SETTLEMENT: AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under the proposed settlement, this form must be completed, signed, and sent, as outlined above, no later than [Month] [Day] [Year]. SUBMIT A CLAIM FORM If this Form is not postmarked or received by this date, you will remain are a member of the Class, you must submit a completed Claim Form to receive a payment of up to $51 per claimant, less any approved fees and costs. If the Court approves the Settlement Class but and it becomes final and effective, and you remain in the Class, you will receive payment by check. EXCLUDE YOURSELF You may request to be excluded from the Settlement and if you do, you will receive no benefits from the Settlement. OBJECT Write to the Court and appear at a hearing if you do not like the Settlement. DO NOTHING You will not receive any a payment from if you fail to timely submit a completed Claim Form, and you will give up your right to bring your own lawsuit against Cardinal Financial about the claims in this case. • These rights and options—and the deadlines to exercise them—are explained in this notice. • The Court in charge of this case still has to decide whether to approve the Settlement. If it does, and after any appeals are resolved, benefits will be distributed to those who submit qualifying Claim Forms. Please be patient. 1 Capitalized terms herein have the same meanings as those defined in the Settlement Agreement. BASIC INFORMATION PAGE 3 1. Why is there a notice? 2. What is this litigation about? 3. What is the Telephone Consumer Protection Act? 4. Why is this a class action? 5. Why is there a settlement? WHO IS PART OF THE SETTLEMENT. PAGE 4 6. Who is included in the Settlement? 7. What if I am not sure whether I am included in the Settlement? THE SETTLEMENT BENEFITS. PAGE 4 8. What does the Settlement provide? 9. How do I file a Claim? 10. When will I receive my payment? 11. How do I get out of the Settlement? 12. If I do not exclude myself, can I sue Defendant for the same thing later? 13. What am I giving up to stay in the Class? 14. If I exclude myself, can I still get a payment? THE LAWYERS AND THE PLAINTIFF REPRESENTING YOU. PAGE 6 15. Do I have a lawyer in the case? 16. Should I get my own lawyer? 17. How will the lawyers be paid? OBJECTING TO THE SETTLEMENT PAGE 6 18. How do I tell the Court I do not like the Settlement? 19. What is the difference between objecting and asking to be excluded? THE FINAL APPROVAL HEARING. PAGE 7 20. When and where will the Court decide whether to approve the Settlement? 21. Do I have to attend the hearing? 22. May I speak at the hearing? IF YOU DO NOTHING. PAGE 7 23. What happens if I do nothing at all? GETTING MORE INFORMATION. PAGE 7 24. How do I get more information? 1. Why was this notice issued? 2. What is this lawsuit about? 3. What is a class action and who is involved? 4. Why is this lawsuit a class action? 5. Why is this there a settlement?

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  □ I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS (where to send the completed form if submitting by mail): AAG TCPA IHP Telemarketing Settlement, c/o , [Address], [City] [State], [Zip Code]] UNITED STATES DISTRICT COURT FOR THE DISTRICT OF SOUTH CAROLINA CHARLESTON DIVISION XXXX XXXXXXXXX, individually and on behalf of all others similarly situated, Vs. This Claim Form may be submitted in one of three ways: 1Plaintiff, Case No. Electronically through www.[xxx].com. 2. Via email to [xxx]@[xxx].com. Please fill out the enclosed pages2:19-cv-02993-XXX INDEPENDENT HOME PRODUCTS, scan the document in its entirety, and include the form as an attachment. 3. Mail to: AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under the proposed settlement, this form must be completed, signed, and sent, as outlined above, no later than [Month] [Day] [Year]. If this Form is not postmarked or received by this date, you will remain a member of the Settlement Class but will not receive any payment from the Settlement.LLC,

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  🞎 I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS Settlement Administrator Address (where to send the completed form if submitting by mail): AAG Safe Streets TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. This Claim Form may be submitted in one of three ways: 1. Electronically through www.[xxx].com. 2. Via email to [xxx]@[xxx].com. Please fill out the enclosed pages, scan the document in its entirety, and include the form as an attachment. 3. Mail to: AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under the proposed settlement, this form must be completed, signed, and sent, as outlined above, no later than [Month] [Day] [Year]. If this Form is not postmarked or received by this date, you will remain a member of the Settlement Class but will not receive any payment from the Settlement.728 x 90 Online Display Banner

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS (where to send the completed form if submitting by mail): AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. EXHIBIT 6 OPT-OUT FORM Only use this Form if you want to request exclusion from (i.e., opt-out) of the proposed settlement class. For more information on the proposed settlement, please visit www.[xxx].com. Section I - Instructions This Claim Form may form must be submitted in one of three ways:received by the Settlement Administrator no later than [Month] [Day], [Year]. 1. Electronically through www.[xxx].comwww.[xxx]com. 2. Via email to [xxx]@[xxx].com. Please fill out the enclosed pages, scan the document in its entirety, and include the form Form as an attachment. 3. Mail to: AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under an opt-out from the proposed settlement, this form must be completed, signed, and sent, as outlined above, no later than [Month] [Day] ], [Year]. If this Form form is not postmarked or received by this date, you will remain a member of the Settlement Class. Opting out of the Settlement Class but is not the same as objecting to the Settlement Agreement. If you request exclusion from the Settlement Class prior to [Month] [Day], [Year], you will not receive any payment from be bound by the Settlementterms of the Settlement Agreement and therefore cannot argue that the Settlement Agreement should not be approved. More information about objecting to the Settlement is available at www.[xxx].com. Section II - Settlement Class Member Information

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  🞎 I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] ], [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] ], [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS Settlement Administrator Address (where to send the completed form if submitting by mail): AAG Health Insurance Associates TCPA Settlement, c/o , [Address], [City] ], [State], ] [Zip Code]. A court authorized this notice. You are not being sued. This Claim Form is not a solicitation from a lawyer. • Call records indicate that you may be submitted in one affected by a Settlement1 of three ways: 1. Electronically through www.[xxx].com. 2. Via email a class action lawsuit claiming that Defendant Health Insurance Associates LLC (“Health Insurance Associates”) violated a federal law called the Telephone Consumer Protection Act (“TCPA”) when telemarketing vendor Leads Mogul LLC (“Leads Mogul”) made telemarketing calls to [xxx]@[xxx].com. Please fill out individuals who were on the enclosed pages, scan the document in its entiretynational Do Not Call Registry, and those calls were forwarded to Health Insurance Associates. Health Insurance Associates denies that it violated the law. • The lawsuit is called Lomas and Xxxxxx v. Health Insurance Associates, LLC, Case. No 22-cv-1564. Judge Xxxx Xxxxx decided that this settlement should be a class action on behalf of a Class, or group of people that could include the form as an attachment. 3. Mail to: AAG TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under the proposed settlement, this form must be completed, signedyou, and sent, as outlined above, no later than [Month] [Day] [Year]a Settlement has been reached affecting this Class. • The Settlement offers payments to Class Members who file valid Claims. • Your legal rights are affected whether you act or do not act. Read this notice carefully. YOUR LEGAL RIGHTS AND OPTIONS IN THIS SETTLEMENT: SUBMIT A CLAIM FORM If this Form is not postmarked or received by this date, you will remain are a member of the Class, you must submit a completed Claim Form to receive a payment of approximately $100 per claimant. If the Court approves the Settlement Class but and it becomes final and effective, and you remain in the Class, you will receive your payment by check. EXCLUDE YOURSELF You may request to be excluded from the Settlement and if you do, you will receive no benefits from the Settlement. OBJECT Write to the Court and appear at a hearing if you do not like the Settlement. DO NOTHING You will not receive any a payment from if you fail to timely submit a completed Claim Form, and you will give up your right to bring your own lawsuit against Health Insurance Associates about the claims in this case. • These rights and options—and the deadlines to exercise them—are explained in this notice. 1 Capitalized terms herein have the same meanings as those defined in the Settlement Agreement. • The Court in charge of this case still has to decide whether to approve the Settlement.. If it does, and after any appeals are resolved, benefits will be distributed to those who submit qualifying Claim Forms. Please be patient. BASIC INFORMATION PAGE 3 1. Why is there a notice? 2. What is this litigation about? 3. What is the Telephone Consumer Protection Act? 4. Why is this a class action? 5. Why is there a settlement? WHO IS PART OF THE SETTLEMENT PAGE 4 6. Who is included in the Settlement? 7. What if I am not sure whether I am included in the Settlement? THE SETTLEMENT BENEFITS PAGE 4 8. What does the Settlement provide? 9. How do I file a Claim? 10. When will I receive my payment? EXCLUDING YOURSELF FROM THE SETTLEMENT PAGE 5 11. How do I get out of the Settlement? 12. If I do not exclude myself, can I sue Defendant for the same thing later? 13. What am I giving up to stay in the Class? 14. If I exclude myself, can I still get a payment? 15. Do I have a lawyer in the case? 16. Should I get my own lawyer? 17. How will the lawyers be paid? OBJECTING TO THE SETTLEMENT PAGE 6 18. How do I tell the Court I do not like the Settlement? 19. What is the difference between objecting and asking to be excluded? THE FINAL APPROVAL HEARING PAGE 7 20. When and where will the Court decide whether to approve the Settlement? 21. Do I have to attend the hearing? 22. May I speak at the hearing? IF YOU DO NOTHING PAGE 7 23. What happens if I do nothing at all? GETTING MORE INFORMATION PAGE 7 24. How do I get more information? 1. Why was this notice issued? 2. What is this lawsuit about? 3. What is a class action and who is involved? 4. Why is this lawsuit a class action? 5. Why is this there a settlement?

Required Affirmations. IF SUBMITTED ELECTRONICALLY:  I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Checking this box constitutes my electronic signature on the date of its submission. IF SUBMITTED BY U.S. MAIL: I agree that, by submitting this Claim Form, the information in this Claim Form is true and correct to the best of my knowledge. I understand that my Claim Form may be subject to audit, verification, and Court review. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.[xxxx].com or by writing the Settlement Administrator at the email address [xxxx]@[xxxx].com or the postal address [Address] [City], [State] [Zip Code]. Dated: Signature: SETTLEMENT ADMINISTRATOR ADDRESS (where to send the completed form if submitting by mail): AAG Divvydose TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. This Claim EXHIBIT 6 OPT-OUT FORM Only use this Form may be submitted in one if you want to request exclusion from (i.e., opt-out) of three ways:the proposed Settlement Class. For more information on the proposed settlement, please visit www.[xxx].com. Section I - Instructions 1. Electronically through www.[xxx].comthe www.[xxx]com. 2. Via email to [xxx]@[xxx].com. Please fill out the enclosed pages, scan the document in its entirety, and include the form Form as an attachment. 3. Mail to: AAG Divvydose TCPA Settlement, c/o , [Address], [City] [State], [Zip Code]. To be effective as a Claim under the proposed settlement, this form must be completed, signed, and sent, as outlined above, no later than [Month] [Day] [Year]. If this Form is not postmarked or received by this date, you will remain a member of the Settlement Class but will not receive any payment from the Settlement.