DATE OF LATE-FILING REQUEST. (TO BE COMPLETED BY THE CLAIMS ADMINISTRATOR) The Class Member submitted a Late-Filing Request in Xxxxxxx on or before September 15, 2000. The Class Member submitted a Late-Filing Request in Xxxxxxx after September 15, 2000. EXHIBIT C EXHIBIT D Case 1:08-mc-00511-PLF Document 170-2 Filed 05/13/11 Page 93 of 110 SETTLEMENT AGREEMENT in In re Black Farmers Discrimination Litigation, Civil Action No. 1:08-mc-0511 (PLF) AUTHORIZATION TO DISCLOSE DEBT INFORMATION FORM
DATE OF LATE-FILING REQUEST. (TO BE COMPLETED BY THE CLAIMS ADMINISTRATOR) The Class Member submitted a late-filing request on or before September 15, 2000. The Class Member submitted a late-filing request after September 15, 2000. EXHIBIT C DO NOT WRITE IN THIS AREA SETTLEMENT AGREEMENT in In re Black Farmers Discrimination Litigation, Civil Action No. 1:08-mc-0511 (PLF) If you have question about completing this Form, please call the Claims Administrator at [Phone], Class Counsel at [Phone], or contact a lawyer. If you need another form, please call [Phone]. CLAIM FORM Please type or print clearly. To be Eligible for Relief, You Must Submit This Form By [Claim Deadline] To The Claims Administrator: [Address]. The submission date is the date of postmark if sent via first-class mail, the date of deposit if sent by courier or overnight delivery, and the date of transmission if sent electronically.
