Social Security (check one)
Personal Identification Number We will issue you a Personal Identification Number (PIN) for use with your Card at VISA NET automatic teller machines (ATM’s). These numbers are issued to you for your security purposes. These numbers are confidential and should not e disclosed to third parties. You are responsible for safekeeping your PIN. You agree not to disclose or otherwise make available your PIN to anyone not authorized to sign on your Accounts. To keep your Account secure, please do not write your PIN on your Card or keep it in the same place as your Card.
Date of Birth (format yyyy-mm-dd) - Employee's date of birth (e.g. if employee's birth date is March 25, 1951, it would appear as (1951-03-25).
Website, Email Address and Toll-Free Number The Administrator will establish and maintain and use an internet website to post information of interest to Class Members including the date, time and location for the Final Approval Hearing and copies of the Settlement Agreement, Motion for Preliminary Approval, the Preliminary Approval, the Class Notice, the Motion for Final Approval, the Motion for Class Counsel Fees Payment, Class Counsel Litigation Expenses Payment and Class Representative Service Payment, the Final Approval and the Judgment. The Administrator will also maintain and monitor an email address and a toll-free telephone number to receive Class Member calls, faxes and emails.
Contact Numbers The Parties agree to provide one another with toll-free nation- wide (50 states) contact numbers for the purpose of ordering, provisioning and maintenance of services.