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PART I: GENERAL INSTRUCTIONS

  • This Proof of Claim and Release form (“Claim Form”) incorporates by reference the definitions in the Notice of Pendency and Proposed Settlement of Class Action (the “Notice”) and, unless defined herein, capitalized words and terms shall have the same meanings as they have in the Notice.
  • To recover as a member of the Class, you must complete this Claim Form. If you fail to file a properly completed Claim Form, your claim may be rejected and you may be precluded from any recovery from the Settlement Fund created in connection with the proposed Settlement of the Action.
  • Submission of this Claim Form, however, does not assure that you will share in the proceeds of the Settlement.
  • You must submit your completed and signed Claim Form so that it is received (if submitted online) no later than June 22, 2026. Mailed submissions should be addressed as follows:
116e049cd01362713ede9a188bfc33f4f44e802d
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