Common use of Certification of Accuracy and Release of Claim Clause in Contracts

Certification of Accuracy and Release of Claim. I (we) hereby declare that all the information that I (we) supplied in this Claim Form, including any documents submitted in support of this Claim Form, is true and correct and this document is signed under penalty of perjury. Signature of Claimant: Date of Signature (mm/dd/yyyy): Signature of Claimant: Date of Signature (mm/dd/yyyy): Case 3:22-cv-00785 2 Document 90-2 Filed 11/25/24 Page 53 of 92 PageID #: 1722 • This Settlement resolves a lawsuit about the continuously variable transmission (“CVT”) in 2015-2018 model year Nissan Murano and 2016-2018 model year Nissan Maxima vehicles (“Class Vehicles”). Class Vehicles do not include hybrid electric vehicles. • The Settlement will provide (1) an extension of the New Vehicle Limited Warranty applicable to the transmission for the Class Vehicles; (2) reimbursement for Class Members who paid for qualifying CVT repairs or replacements that would have been covered by the Warranty Extension; (3) a Voucher towards the purchase or lease of a new Nissan or Infiniti vehicle at an authorized Nissan or Infiniti dealer for current and former owners of Class Vehicles who qualify; and (4) an expedited resolution program through the BBB if you have future claims related to your transmission. • Your legal rights are affected whether or not you act. Please read this Notice carefully. You may: Summary: Read more: Deadline: Do nothing You are included in the Settlement Class and, if the Settlement is approved, the warranty on the transmission of your Class Vehicle will be increased to 84 months or 84,000 miles (whichever occurs first) (the “Warranty Extension Period”) and you will be eligible for a Voucher towards the purchase or lease of a new Nissan or Infiniti vehicle for current or former owners of Class Vehicles, if you qualify. Page 6 Submit a Claim You do not have to do anything to be included in the Settlement Class, but to be eligible for reimbursement of qualifying transmission repairs, you must submit a Claim Form by the deadline. Page 6 Submit your Claim Form by: * Opt out of the Settlement Ask to get out of the Settlement. You get no Settlement benefits, but keep your right to file your own lawsuit against Nissan. Pages 6-7 Mail your Opt-Out Request Postmarked by: Object Remain a Class Member and tell the Court what you do not like about the Settlement. You will still be bound by the Settlement if the Court approves it. If you want your own attorney to represent you, you must pay for him or her yourself. Your attorney must file a Notice of Appearance. Pages 7-8 Objections and/or Notice of Appearance Filed by: *Claim Forms must be submitted to the Settlement Administrator by , or within 30 days of the qualifying repair to your vehicle, whichever is later.

Certification of Accuracy and Release of Claim. I (we) hereby declare that all the information that I (we) supplied in this Claim Form, including any documents submitted in support of this Claim Form, Form is true and correct and this document is signed under penalty of perjury. / / Signature of Claimant: Claimant Date of Signature (mm/dd/yyyy): / / Signature of Claimant: Claimant Date of Signature (mm/dd/yyyy): Case 3:22-cv-00785 2 Document 90-2 Filed 11/25/24 Page 53 of 92 PageID #: 1722 If you have questions about this Claim Form, call or visit www. .com. • This Settlement resolves a lawsuit about the continuously variable transmission (“CVT”) in 2014-2018 model year Nissan Rogue, 2015-2018 model year Nissan Murano Pathfinder and 20162015-2018 model year Nissan Maxima Infiniti QX60 vehicles (“Class Vehicles”). Class Vehicles do not include hybrid electric vehicles. • The Settlement will provide (1) an extension of the New Vehicle Limited Warranty applicable to the transmission for the Class Vehicles; (2) reimbursement for Class Members who paid for qualifying CVT repairs or replacements that would have been covered by the Warranty Extension; (3) a Voucher towards the purchase or lease of a new Nissan or Infiniti vehicle at an authorized Nissan or Infiniti dealer for current and former owners of Class Vehicles who qualify; and (4) an expedited resolution program through the BBB if you have future claims related to your transmission. • Your legal rights are affected whether or not you act. Please read this Notice carefully. You may: Summary: Read more: Deadline: Do nothing You are included in the Settlement Class and, if the Settlement is approved, you will automatically receive a 24 month or 24,000 mile extension (whichever occurs first) of the warranty on the transmission of your Class Vehicle will be increased to 84 months or 84,000 miles (whichever occurs first) (the “Warranty Extension Period”) and you will Vehicle; be eligible for a Voucher towards the purchase or lease of a new Nissan or Infiniti vehicle for current or former owners of Class Vehicles, if you qualify; and be covered by an expedited resolution program through the BBB if you have a future claim related to your transmission. Page 6 Pages 4-5 Submit a Claim You do not have to do anything to be included in the Settlement Class, but to be eligible for reimbursement of qualifying transmission repairs, you must submit a Claim Form by the deadline. Page 6 Pages 4-5 Submit your Claim Form by: * Opt out of the Settlement Ask to get out of the Settlement. You get no Settlement benefits, but keep your right to file your own lawsuit against Nissan. Pages 65-7 6 Mail your Opt-Opt Out Request Postmarked by: Object Remain a Class Member and tell the Court what you do not like about the Settlement. You will still be bound by the Settlement if the Court approves it. If you want your own attorney to represent you, you must pay for him or her yourself. Your attorney must file a Notice of Appearance. Pages 76-8 Objections and/or Notice of Appearance Filed by: *Claim Forms must be submitted to the Settlement Administrator by , or within 30 days of the qualifying repair to your vehicle, whichever is later.

Certification of Accuracy and Release of Claim. I (we) hereby declare that all the information that I (we) supplied in this Claim Form, including any documents submitted in support of this Claim Form, Form is true and correct and this document is signed under penalty of perjury. / / Signature of Claimant: Claimant Date of Signature (mm/dd/yyyy): / / Signature of Claimant: Claimant Date of Signature (mm/dd/yyyy): Case 3:22-cv-00785 2 Document 90-2 Filed 11/25/24 Page 53 of 92 PageID #: 1722 If you have questions about this Claim Form, call or visit www. .com. • This Settlement resolves a lawsuit about the continuously variable transmission (“CVT”) in 20152017-2018 model year Nissan Murano Altima and 20162018-2018 2019 model year Nissan Maxima Sentra, Versa, and Versa Note vehicles (“Class Vehicles”). Class Vehicles do not include hybrid electric vehicles. • The Settlement will provide (1) an extension of the New Vehicle Limited Warranty applicable to the transmission for the Class Vehicles; (2) reimbursement for Class Members who paid for qualifying CVT repairs or replacements that would have been covered by the Warranty Extension; (3) a Voucher towards the purchase or lease of a new Nissan or Infiniti vehicle at an authorized Nissan or Infiniti dealer for current and former owners of Class Vehicles who qualify; and (4) an expedited resolution program through the BBB if you have future claims related to your transmission. • Your legal rights are affected whether or not you act. Please read this Notice carefully. You may: Summary: Read more: Deadline: Do nothing You are included in the Settlement Class and, if the Settlement is approved, you will automatically receive a 24 month or 24,000 mile extension (whichever occurs first) of the warranty on the transmission of your Class Vehicle will be increased to 84 months or 84,000 miles (whichever occurs first) (the “Warranty Extension Period”) and you will Vehicle; be eligible for a Voucher towards the purchase or lease of a new Nissan or Infiniti vehicle for current or former owners of Class Vehicles, if you qualify; and be covered by an expedited resolution program through the BBB if you have a future claim related to your transmission. Page 6 Pages 4-5 Submit a Claim You do not have to do anything to be included in the Settlement Class, but to be eligible for reimbursement of qualifying transmission repairs, you must submit a Claim Form by the deadline. Page 6 Pages 4-5 Submit your Claim Form by: * Opt out of the Settlement Ask to get out of the Settlement. You get no Settlement benefits, but keep your right to file your own lawsuit against Nissan. Pages 65-7 6 Mail your Opt-Opt Out Request Postmarked by: Object Remain a Class Member and tell the Court what you do not like about the Settlement. You will still be bound by the Settlement if the Court approves it. If you want your own attorney to represent you, you must pay for him or her yourself. Your attorney must file a Notice of Appearance. Pages 76-8 Objections and/or Notice of Appearance Filed by: *Claim Forms must be submitted to the Settlement Administrator by , or within 30 days of the qualifying repair to your vehicle, whichever is later.