Claim Form Requirements Clause Samples
Claim Form Requirements. The Notice shall include instructions on how to submit a valid and timely Claim Form. The Notice shall notify Class Members that in order for the Claim Form to be valid, it must include the employee’s name, last four digits of their social security number and be signed, dated and submitted no later than the Claim Deadline or fifteen (15) days after the date of a second mailing to be eligible to receive any Settlement Award.
Claim Form Requirements. The Settlement Administrator shall validate that all sections of the Claim Form are complete and that the Settlement Class Member provided and certified the truth and accuracy of the following information under the penalty of perjury, including by signing the Claim Form physically or by e-signature, or the Claim will not be considered a Valid Claim by the Settlement Administrator. The absence of any of the following information, or the provision of incorrect information, will result in the rejection of the Claim:
(a) The Settlement Class Member’s name and mailing address;
(b) The Settlement Class Member’s email address (unless the Settlement Class Member requests a claim form by mail, in which case an email address is optional);
(c) The name of the Product(s) purchased, the store name where the Product(s) were purchased, and the number of Units purchased during the Class Period;
(d) For Proof Claims, valid Proof of Purchase(s);
(e) That the claimed purchases were not made for purposes of resale;
(f) The payment preference of the Settlement Class Member (i.e., via check or electronic payment); and
(g) A security code or control number provided by the Settlement Administrator at the time the Class Member requests a Claim Form on the Settlement Website (if the Settlement Class Member requests a Claim Form by mail).
Claim Form Requirements. 1. Any Settlement Class Member who does not request exclusion from the Settlement may submit a Claim Form for the Individual Settlement Payment. A Claim Form may be submitted via the online portal on the Settlement Website or mailed to the Claims Administrator. If mailed, the Claim Form must be postmarked no later than the Notice Response Deadline specified in the Court’s Preliminary Approval Order. A Claim Form will be included on the Settlement Website that will be substantially similar in the form of Exhibit E attached hereto. Claim Forms must (A) state the Settlement Class Member’s full name and current address; (B) affirm that “Between September 21, 2019 and March 10, 2020 at the University of California, Santa ▇▇▇▇, I experienced at least one of the following on a day when in-person educational instruction was normally expected to occur: (i) cancellation of a class or other educational instruction; (ii) reduced class instruction time; (iii) lack of access to on-campus facilities or services; or (iv) restricted access to on-campus facilities or services.”; and (C) include the Settlement Class Member’s signature, whether signed physically or by e-signature by the Settlement Class Member personally. The Settlement Class Member may provide their student identification number, which shall be optional. Settlement Class Members shall only be entitled to a single recovery, regardless of whether they were enrolled in one or both of Fall 2019 or Spring 2020 terms.