Claim Form definition

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.

Claim Form means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant must complete and submit should that Claimant seek to share in a distribution of the Net Settlement Fund.

Claim Form means the standard form used to file a dental claim, request a dental Pre-Treatment Estimate, or request Prior Authorization.

Examples of Claim Form in a sentence

• If you wish to designate your required W-9 confidential, please do so according to the terms of the Confidentiality Claim Form which is an attachment to this solicitation.

• You must submit a timely and complete Claim Form no later than [claims deadline].

• Each Program Participant agrees that she will indicate on his or her Claim Form whether a bankruptcy action is currently pending in which he or she is seeking bankruptcy protection.

• If your Claim is deficient, the Settlement Notice Administrator will mail you a letter requesting that you complete and/or correct the deficiencies and resubmit the Claim Form within sixty(60) days.

• Alternatively, you can obtain a Claim Form from the Settlement website, print it out, complete it, and mail it on or before up to and including sixty (60) days after the Court’s issuance of the Final Order and Final Judgment, which will occur after the Fairness Hearing, which is currently scheduled for June 4, 2019, at 11:00 a.m. Eastern time, to the Settlement Notice Administrator in Simerlein, et al., v.

More Definitions of Claim Form

Claim Form means the form or forms to be approved by the Court, which, when completed and submitted in a timely manner to the Administrator, enables a Class Member to apply for compensation pursuant to this Agreement.

Claim Form means the prescribed form of claim for registration as a voter under Part V;

Claim Form means the paper or electronic form that a Settlement Class Member must complete and submit before the Claims Filing Deadline in order to be considered for settlement benefits under this Distribution Protocol.

Claim Form means the form attached as Exhibit 1 to this Agreement and/or as ultimately approved by the Court.

Claim Form means the document substantially in the form attached hereto as Exhibit A, as approved by the Court. The Claim Form, to be completed by Settlement Class Members who wish to file a Claim for a payment, shall be available in electronic and paper format in the manner described below.

Claim Form means the proof of claim and release form provided to or requested by members of the Settlement Class.

Claim Form means the Form contained in Appendix D that must be submitted as part of the Claim Package.