REMINDER CHECKLIST. 1. Please sign the above release and certification. If this Claim Form is being made on behalf of joint claimants, then both must sign.
REMINDER CHECKLIST. 1. Please sign this Claim Form. 2. DO NOT HIGHLIGHT THE CLAIM FORM OR YOUR SUPPORTING DOCUMENTATION.
REMINDER CHECKLIST. 6. If you desire an acknowledgment of receipt of your Claim Form, please send it Certified
REMINDER CHECKLIST. 1. Keep copies of the completed Claim Form and documentation for your own records.
REMINDER CHECKLIST. Before finalizing your claim form, please consult the below checklist: Review the claim form in detail to ensure all required information has been entered. Review the claim form and Mandatory Evidence requirements (located on pages 1-2) and Injury-specific evidence (located on pages 12-16) to ensure you have provided all complete and necessary records with your claim form. Make a copy of the claim form and all evidence, for your records. If you move or your contact information changes, it is your responsibility to notify the Claims Administrator of your updated contact information. Finally, please sign and date the claim form. The Claims Administrator will acknowledge receipt of your OxyContin®/OxyNEO® User Claim Form by mail within 60 days. If you do not receive an acknowledgement postcard within 60 days, please call the Claims Administrator toll free at 0 (000) 000-0000. PLEASE ENSURE THAT YOU SIGN AND DATE THIS FORM Please sign only the appropriate lines. Signatures on all lines may not be required. Date: OxyContin®/OxyNEO® User Claimant’s (or Executor/Guardian) Signature Printed Name of OxyContin®/OxyNEO® User Claimant (or Executor/Guardian) Date: Signature of OxyContin®/OxyNEO® User Claimant’s Lawyer (if any) Printed Name of OxyContin®/OxyNEO® User Claimant’s Lawyer (if any) SUBMIT YOUR CLAIM BY MAIL: All Forms and documents must be postmarked no later than February 27, 2024 and mailed to: Claims Administrator P.O. Box 3355 London, Ontario N6A 4K3 OR SUBMIT YOUR CLAIM ONLINE: All Forms must be submitted online and all documents must be sent via email attachment to xxxxxxxxx@xxxxxxxxx.xxx by no later than 5:00 p.m. Pacific Time on February 27, 2024. OR SUBMIT YOUR CLAIM BY FAX: All Forms and documents must be faxed to the Claims Administrator to 000-000-0000 by no later than 5:00 p.m. Pacific Time on February 27, 2024.
REMINDER CHECKLIST. 1. Please check and make sure you answered all the questions on the claim form as requested.
REMINDER CHECKLIST. 1. Please sign the above release and declaration.
REMINDER CHECKLIST. 1. Please sign the Certification section of the Proof of Claim and Release on Page 7.
REMINDER CHECKLIST. Remember to sign the Certification on page 3. Keep copies of the completed Proof of Claim and documentation for your own records. If you desire an acknowledgment of receipt of your Proof of Claim, please send it Certified Mail, Return Receipt Requested, or its equivalent. You will bear all risks of delay or non-delivery of your Proof of Claim. If your address changes in the future, or if these documents were sent to an old or incorrect address, please send us written notification of your new address. If you have any questions or concerns regarding your claim, please contact the Claims Administrator at: Countrywide Employee Incentive Plans Settlement Claims Administrator c/o The Garden City Group, Inc. P.O. Box XXXX Dublin, OH 43017-XXXX Toll-Free: 0 (000) XXX-XXXX Website: xxx.xxxxxxxXxxxxxxxxx.xxx This form and your supporting documentation must be postmarked no later than , XXXX. EXHIBIT B XXXXX+XXXXX LLP 1 XXXXXX X. XXXXXXXX III (181719) XXX X. XXXXXXXXXX (243048) 2 0000 Xxxxx Xxxxxx Xxxx. Los Angeles, CA 90038 3 Telephone: 000.000.0000 000.000.0000 (fax) XXXXX+XXXXX LLP 5 Xxxxxxxx X. Xxxxxxx (pro hac vice) 00000 Xxxxx Xxxx, Xxxxx 00 0 Xxxxxxxxx Xxxxxxx, XX 00000 Telephone: 000.000.0000 0 000.000.0000 (fax) 8 Attorneys for Plaintiffs 9 [Additional Counsel on Signature Page] 00 XXXXXXXX XXXXX XX XXX XXXXX XX XXXXXXXXXX COUNTY OF LOS ANGELES 12 XXXXXXX XXXXX, on Behalf of Himself and 13 All Others Similarly Situated, 14 Plaintiff, 15 vs. 16 COUNTRYWIDE FINANCIAL CORP., et al.,
REMINDER CHECKLIST. 1. Complete all sections of this Claim Form. 2. Sign and date the Claim Form in Section 3.
