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 / / Signature of Claimant Date of Signature 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 the 2013-2017 Nissan Juke vehicles (“Class Vehicles”). • The Settlement will provide (1) an extension of the Nissan New Vehicle Limited Warranty for current owners and lessees of Class Vehicles; (2) reimbursement for Class Members who paid for qualifying repairs 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 former owners of Class Vehicles who meet the requirements of the Settlement Agreement; and (4) an expedited resolution program through the BBB if you claim Nissan breaches the warranty extension. • Your legal rights are affected whether or not you act. Please read this Notice carefully.

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 / / Signature of Claimant Date of Signature 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 the 2013-2017 Nissan Juke Sentra, 2014-2017 Nissan Versa Note, and 2012-2017 Nissan Versa vehicles (“Class Vehicles”). • The Settlement will provide (1) an extension of the Nissan New Vehicle Limited Warranty for current owners and lessees of Class Vehicles; (2) reimbursement for Class Members who paid for qualifying repairs 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 former owners of Class Vehicles who meet the requirements of the Settlement Agreement; and (4) an expedited resolution program through the BBB if you claim Nissan breaches the warranty extension. • Your legal rights are affected whether or not you act. Please read this Notice carefully.

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 / _ / Signature of Claimant Date of Signature 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 the 2013-2017 2016 model year Nissan Juke Altima vehicles (“Class Vehicles”). •  The Settlement will provide (1) an extension of the Nissan New Vehicle Limited Warranty for current owners and lessees of Class Vehicles; (2) reimbursement for Class Members who paid for qualifying repairs 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 former owners of Class Vehicles who meet the requirements of the Settlement Agreement; and (4) an expedited resolution program through the BBB if you claim Nissan breaches the warranty extension. •  Your legal rights are affected whether or not you act. Please read this Notice carefully.