Claim Form and Release definition

Claim Form and Release is the written form to be completed by any Potential Class Member, to begin the claim process and release his or her Claim pursuant to the Claims Process and Distribution Plan set forth in this Settlement Agreement. A sample Claim Form and Release is attached hereto as Exhibit B.
Sample 1
Claim Form and Release means the form, a copy of which is attached hereto as Appendix A, that an Eligible Employee must sign and return during the Acceptance Period to become an Authorized Claimant.
Sample 1
Claim Form and Release means the form to be completed by members of the Settlement Class seeking to become eligible to receive an Award, the content of which shall be substantially similar to that contained in Exhibit A to this Agreement.
Sample 1

Examples of Claim Form and Release in a sentence

  • Submit a Claim Form and Release The only way to receive a payment.

  • If you wish to receive compensation as part of the Settlement, you must also submit a Claim Form and Release to the Claims Administrator by August 16, 2022.

  • If you do not opt-out or submit a Claim Form and Release, you will not receive an Individual Monetary Award, but you will still be bound by the terms of this settlement, including the release of claims set forth in the Settlement Agreement.

  • To preserve your right to participate in the Settlement, you must also submit the enclosed Claim Form and Release to the Claims Administrator, which the Claims Administrator must receive by August 16, 2022, unless the Claims Administrator agrees in advance and in writing that it may be submitted up until September 15, 2022.

  • However, as long as any New York or California Class Member does not properly submit an Opt-Out Statement, New York and California Class Members shall be subject to the Judgment of Dismissal and release of Released State Law Claims even if they do not submit the Claim Form and Release in accordance with the above sentences.

  • Class Members who wish to exercise this option and certify their entitlement to payment under the Settlement must (1) fully and timely complete and sign the Claim Form and Release, and (2) timely mail, email, or fax, (i) the executed Claim Form and Release, (ii) an IRS 2015 W-9 Form, and (iii) a copy of a government- issued identification such as a passport or driver’s license (“Authorization Documents”).

  • To confirm you want to participate in the Settlement, you must fill out and submit the enclosed Claim Form and Release to the Claims Administrator as soon as possible, but in any event so that it is received by the Claims Administrator no later than August 16, 2022.

  • In order to be paid more than the minimum amount described above, you must also fill out and return to the Claims Administrator the attached Questionnaire, in addition to your Claim Form and Release.

  • If you intend to object to the Settlement but still wish to receive your share of the Settlement if it is approved, you must submit a timely and valid Claim Form and Release under Section VII above.

  • You will need to complete and timely submit a Claim Form and Release in order to receive an Individual Monetary Award.


More Definitions of Claim Form and Release

Claim Form and Release means the document substantially in the form attached hereto as Exhibit A, as approved by the Arbitrator. The Claim Form, which shall be completed by Settlement Class Members, who wish to file a claim for a Settlement Payment, shall be available in paper format and electronic format. The Claim Form will require claiming Settlement Class Members to provide the following information: (i) full name; (ii) current U.S. Mail address; (iii) current contact telephone number and e-mail address; and (iv) a statement that they worked for RRH-Florida, LLC d/b/a Denny’s in the Margate (“9590”), Plantation (“9592”), and/or Boca Raton (“9594”) locations from July, 18, 2019, through December 31, 2023. The Claim Form will not require notarization but will require affirmation under oath that the information supplied is true and correct.
Sample 1

Related to Claim Form and Release

  • Proof of Claim and Release means the Proof of Claim and Release form for submitting a Claim, which, subject to approval of the Court, shall be substantially in the form attached hereto as Exhibit A-2, that a Class Member must complete and submit should that Class Member seek to share in a distribution of the Net Settlement Fund.

  • Claim Form or “Proof of Claim Form” means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant or Settlement Class Member must complete and submit should that Claimant or Settlement Class Member seek to share in a distribution of the Net Settlement Fund.

  • Disability benefits means any cash payments which are payable to a covered individual for all or part of a period of disability pursuant to P.L.1948, c.110 (C.43:21-25 et al.).

  • Minor Release means an incremental release of Software that provides maintenance fixes and additional Software functions. Cisco designates Minor releases as a change in the tenths digit of the Software version number [x.(x).x].