Claim Form Requirements Clause Samples

Claim Form Requirements. The Notice shall include instructions on how to submit a valid and timely Claim Form. The Notice shall notify Class Members that in order for the Claim Form to be valid, it must include the employee’s name, last four digits of their social security number and be signed, dated and submitted no later than the Claim Deadline or fifteen (15) days after the date of a second mailing to be eligible to receive any Settlement Award.
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Claim Form Requirements. The Settlement Administrator shall validate that all sections of the Claim Form are complete and that the Settlement Class Member provided and certified the truth and accuracy of the following information under the penalty of perjury, including by signing the Claim Form physically or by e-signature, or the Claim will not be considered a Valid Claim by the Settlement Administrator. The absence of any of the following information, or the provision of incorrect information, will result in the rejection of the Claim: (a) The Settlement Class Member’s name and mailing address; (b) The Settlement Class Member’s email address (unless the Settlement Class Member requests a claim form by mail, in which case an email address is optional); (c) The name of the Product(s) purchased, the store name where the Product(s) were purchased, and the number of Units purchased during the Class Period; (d) For Proof Claims, valid Proof of Purchase(s); (e) That the claimed purchases were not made for purposes of resale; (f) The payment preference of the Settlement Class Member (i.e., via check or electronic payment); and (g) A security code or control number provided by the Settlement Administrator at the time the Class Member requests a Claim Form on the Settlement Website (if the Settlement Class Member requests a Claim Form by mail).
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Claim Form Requirements. 1. Any Settlement Class Member who does not request exclusion from the Settlement may submit a Claim Form for the Individual Settlement Payment. A Claim Form may be submitted via the online portal on the Settlement Website or mailed to the Claims Administrator. If mailed, the Claim Form must be postmarked no later than the Notice Response Deadline specified in the Court’s Preliminary Approval Order. A Claim Form will be included on the Settlement Website that will be substantially similar in the form of Exhibit E attached hereto. Claim Forms must (A) state the Settlement Class Member’s full name and current address; (B) affirm that “Between September 21, 2019 and March 10, 2020 at the University of California, Santa ▇▇▇▇, I experienced at least one of the following on a day when in-person educational instruction was normally expected to occur: (i) cancellation of a class or other educational instruction; (ii) reduced class instruction time; (iii) lack of access to on-campus facilities or services; or (iv) restricted access to on-campus facilities or services.”; and (C) include the Settlement Class Member’s signature, whether signed physically or by e-signature by the Settlement Class Member personally. The Settlement Class Member may provide their student identification number, which shall be optional. Settlement Class Members shall only be entitled to a single recovery, regardless of whether they were enrolled in one or both of Fall 2019 or Spring 2020 terms.
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Related to Claim Form Requirements

  • W-9 Requirement Alongside a signed copy of this Agreement, Grantee will provide Florida Housing with a properly completed Internal Revenue Service (“IRS”) Form W-9. The purpose of the W-9 form is to document the SS# or FEIN# per the IRS. Note: W-9s submitted for any other entity name other than the Grantee’s will not be accepted.

  • Release Requirement Notwithstanding any provision herein to the contrary, except as otherwise determined by the Company, in order for the Grantee to receive Shares pursuant to the settlement of Vested RSUs under Section 6(a), (b), (c), (d) or (e) above, the Grantee (or the representative of his or her estate) must execute and deliver to the Company a general release and waiver of claims against the Company, its Subsidiaries and their directors, officers, employees, shareholders and other affiliates in a form that is satisfactory to the Company (the “Release”). The Release must become effective and irrevocable under applicable law no later than 60 days following the date of the Grantee’s death, termination of employment or transfer of position, as applicable.

  • Required Confidentiality Claim Form This is a requirement of the TIPS Contract and is non-negotiable. TIPS provides the required TIPS Confidentiality Claim Form in the "Attachments" section of this solicitation. Vendor must execute this form by either signing and waiving any confidentiality claim, or designating portions of Vendor's proposal confidential. If Vendor considers any portion of Vendor's proposal to be confidential and not subject to public disclosure pursuant to Chapter 552 Texas Gov’t Code or other law(s) and orders, Vendor must have identified the claimed confidential materials through proper execution of the Confidentiality Claim Form. If TIPS receives a public information act or similar request, any responsive documentation not deemed confidential by you in this manner will be automatically released. For Vendor documents deemed confidential by you in this manner, TIPS will follow procedures of controlling statute(s) regarding any claim of confidentiality and shall not be liable for any release of information required by law, including Attorney General determination and opinion. Notwithstanding any other Vendor designation of Vendor's proposal as confidential or proprietary, Vendor’s submission of this proposal constitutes Vendor’s agreement that proper execution of the required TIPS Confidentiality Claim Form is the only way to assert any portion of Vendor's proposal as confidential.

  • Program Requirements The parties shall comply with the Disadvantaged Business Enterprise Program requirements established in 49 CFR Part 26.

  • Basic Requirements To be eligible for PayPal’s Seller Protection program, all of the following basic requirements must be met, as well as any applicable additional requirements: • The primary address for your PayPal account must be in the United States. • The item must be a physical, tangible good that can be shipped, except for items subject to the Intangible Goods Additional Requirements. Transactions involving items that you deliver in person in connection with payment made in your physical store, may also be eligible for PayPal’s Seller Protection program so long as the buyer paid for the transaction in person by using a PayPal goods and services QR code. • You must ship the item to the shipping address on the Transaction Details page in your PayPal account for the transaction. If you originally ship the item to the recipient’s shipping address on the Transaction Details page but the item is later redirected to a different address, you will not be eligible for PayPal’s Seller Protection program. We therefore recommend not using a shipping service that is arranged by the buyer, so that you will be able to provide valid proof of shipping and delivery. • The shipping requirement does not apply to eligible transactions involving items that you deliver in person; provided, however, that you agree to provide us with alternative evidence of delivery or such additional documentation or information relating to the transaction that we may request. • You must respond to PayPal’s requests for documentation and other information in a timely manner as requested in our email correspondence with you or in our correspondence with you through the Resolution Center. If you do not respond to PayPal’s request for documentation and other information in the time requested, you may not be eligible for PayPal’s Seller Protection program. • If the sale involves pre-ordered or made-to-order goods, you must ship within the timeframe you specified in the listing. Otherwise, it is recommended that you ship all items within 7 days after receipt of payment. • You provide us with valid proof of shipment or delivery. • The payment must be marked “eligible” or “partially eligible” in the case of Unauthorized Transaction claims, or “eligible” in the case of Item Not Received claims, for PayPal’s Seller Protection program on the Transaction Details page. • In the case of an Unauthorized Transaction claim, you must provide valid proof of shipment or proof of delivery that demonstrates that the item was shipped or provided to the buyer no later than two days after PayPal notified you of the dispute or reversal. For example, if PayPal notifies you of an Unauthorized Transaction claim on September 1, the valid proof of shipment must indicate that the item was shipped to the buyer no later than September 3 to be eligible for PayPal’s Seller Protection program. PayPal determines, in its sole discretion, whether your claim is eligible for PayPal’s Seller Protection program. PayPal will make a decision, in its sole discretion, based on the eligibility requirements, any information or documentation provided during the resolution process, or any other information PayPal deems relevant and appropriate under the circumstances. To be eligible for PayPal’s Seller Protection program for a buyer’s Item Not Received claim, you must meet both the basic requirements and the additional requirements listed below: • Where a buyer files a chargeback with the issuer for a card-funded transaction, the payment must be marked “eligible” for PayPal’s Seller Protection on the Transaction Details page. • You must provide proof of delivery as described below.