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 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
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

Examples of Claim Form and Release in a sentence

  • For the purpose of having Natural Gas transported in the Transmission System, the Shipper must make Nominations.

  • I/We hereby warrant and represent that I am/we are authorized to execute and deliver this Proof of Claim Form and Release.

  • For more information, you can contact the Claims Administrator, Strategic Claims Services, by toll-free phone at (866) 274-4004 or by facsimile at (610) 565-7985, visit the website www.strategicclaims.net, or fill out and return the Lifetrade Litigation Claim Form and Release described in Question 11, to see if you qualify.

  • You may still submit the Claim Form and Release in the name of a deceased veteran even if you have not yet had someone appointed as Personal Representative.

  • By submitting this Proof of Claim Form and Release, I/we, and every Settlement Class Member I/we represent, submit to the jurisdiction of the United States District Court for the Northern District of California for purposes of this Action and the Settlement of the Action, as reflected in the Stipulation.

  • 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.

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

  • 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.

  • The Treaty of the EU also plans the possibility of a retreat of a member from the EU.

  • The attached Lifetrade Litigation Claim Form and Release must be filled out, signed in the location indicated, and mailed postmarked no later than April 4, 2022; faxed; or emailed to the Claims Administrator:Lifetrade Litigationc/o Strategic Claims Services 600 N.


More Definitions of Claim Form and Release

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

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.

  • Release of Claims means the Release of Claims in substantially the same form attached hereto as Exhibit A (as the same may be revised from time to time by the Company upon the advice of counsel).

  • Waiver and Release means the Waiver and Release attached hereto as Exhibit A.

  • General Release has the meaning stated in Section 6.03.

  • Release Agreement means an agreement, substantially in a form approved by the Company, pursuant to which Executive releases all current or future claims, known or unknown, arising on or before the date of the release against the Company, its subsidiaries and its officers.

  • Earned release means earned release from confinement as

  • 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.

  • Conditional release means a revocable modification of a

  • Pre-Release shall have the meaning set forth in Section 2.09.

  • Notification of Claim means the process of intimating a claim to the insurer or TPA through any of the recognized modes of communication.

  • Work release means a program of partial confinement

  • Current Release means that version of the Product installed on the Equipment at the Commencement Date and any modifications to it or if a new Release is available, that new Release installed on the Equipment and any modifications to it;

  • Released PAGA Claims means the claims being released as described in Paragraph 6.2 below.

  • Defendants’ Releasees means Defendants and their current and former parents, affiliates, subsidiaries, officers, directors, agents, successors, predecessors, assigns, assignees, partnerships, partners, trustees, trusts, employees, Immediate Family Members, insurers, reinsurers, and attorneys.

  • Released Plaintiff Claims means any and all manner of claims, demands, rights, liabilities, losses, obligations, duties, damages, costs, debts, expenses, interest, penalties, sanctions, fees, attorneys’ fees, actions, potential actions, causes of action, suits, agreements, judgments, decrees, matters, counterclaims, offsets, issues, and controversies of any kind, nature, or description whatsoever, whether accrued or unaccrued, disclosed or undisclosed, apparent or not apparent, foreseen or unforeseen, matured or not matured, suspected or unsuspected, liquidated or not liquidated, fixed or contingent, whether based on state, local, federal, statutory, regulatory, common, or other law or rule, including known claims and Unknown Claims, that (a) were asserted in the Derivative Matters, or (b) Plaintiffs (individually or derivatively on behalf of AMC) or AMC ever had, now have, or hereafter can, shall, or may have that, in full or in part, concern, relate to, arise out of, or are in any way connected to the claims, allegations, transactions, facts, circumstances, events, acts, disclosures, statements, representations, omissions, or failures to act alleged, set forth, referred to, or involved in the Derivative Matters. For the avoidance of doubt, the Released Plaintiff Claims shall not include any claims to enforce the Stipulation or the Settlement.

  • Plaintiffs’ Releasees means Plaintiffs, and any and all of their related parties, including, without limitation, any and all members of their immediate families, agents or other persons acting on their behalf, attorneys, advisors, financial advisors, accountants, assigns, creditors, heirs, estates and legal representatives.

  • Request for Release A release signed by a Servicing Officer, in the form of Exhibit E attached hereto.

  • Threatened Release means a substantial likelihood of a Release which requires action to prevent or mitigate damage to the soil, surface waters, groundwaters, land, stream sediments, surface or subsurface strata, ambient air or any other environmental medium comprising or surrounding any Property which may result from such Release.

  • Mutual Release means the General Mutual Release substantially in the form attached hereto as Exhibit B in all material respects.

  • date of claim means the date on which the application or claim is made, or treated as made, for the purposes of this scheme

  • Covenant not to compete means an agreement:

  • Title IX Sexual Harassment means conduct on the basis of sex that satisfies one or more of the following:

  • SHIPPING RELEASE means the document issued by the inspector or the inspection agency nominated by the Purchaser authorising the Contractor to ship the Stores on satisfactory completion of inspection.

  • Separation Agreement has the meaning set forth in the recitals to this Agreement.

  • 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.

  • Notice of Claim has the meaning set forth in Section 9.3.