Submit a Claim Form Sample Clauses
The 'Submit a Claim Form' clause requires a party to formally notify the other party of a claim by completing and submitting a designated claim form. This process typically involves providing specific information about the nature of the claim, relevant dates, and supporting documentation, often within a set timeframe. By standardizing the way claims are reported, this clause ensures that all necessary details are captured efficiently, reducing misunderstandings and facilitating a smoother resolution process.
Submit a Claim Form. If you submit a claim form and otherwise qualify, you will also be reimbursed for certain transmission replacements or repairs made to your Class Vehicle.
Submit a Claim Form. To qualify for a cash payment, you must timely mail a Claim Form that is attached to this notice or complete and submit a Claim Form online at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Your Claim Form must be postmarked or submitted online no later than , 2024.
Submit a Claim Form. If you wish to participate in the Settlement and be eligible to receive benefits under the Settlement, you must fill out and submit a Claim Form by [INSERT DEADLINE DATE]. You can obtain a Claim Form by (1) Visiting the Settlement Website, [INSERT URL], where you can file your claim online or print a Claim Form to submit by mail; (2) Mailing a written request for a Claim Form to the Settlement Administrator: [INSERT ADDRESS]; or (3) E- mailing the Settlement Administrator at [INSERT EMAIL ADDRESS]. If you do not timely submit a valid Claim Form and do not exclude yourself from the Settlement, you will be bound by the Settlement but will not receive any benefits of the Settlement.
Submit a Claim Form. To qualify for a Settlement Payment, you must submit a timely Claim Form either in hard copy that is attached to this notice or by completing a Claim Form online at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ (“Settlement Website”). Your Claim Form must be postmarked or submitted online no later than [60 days from Notice Date].
Submit a Claim Form. If you submit a Claim Form and otherwise qualify, you will be reimbursed for qualifying transmission/ATCU replacements or repairs made to your Class Vehicle within the Warranty Extension Period or based on a Nissan dealer diagnosis within the Warranty Extension Period.
Submit a Claim Form. To qualify for a cash payment, you must timely mail a Claim Pocket losses on the attached Claim Form, you will need to submit your claim Form that is attached to this notice or timely complete and submit a Claim Form online online so you may attach all information necessary to support your request for at [Settlement Website URL] (“Settlement Website”). Your Claim Form must be payment for such out-of-pocket losses. If you wish to receive just the Pro Rata submitted no later than Cash Payment, the attached tear off claim form should suffice. A longer version ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ by mailing a written request for exclusion to the Settlement This Notice is a summary of the proposed settlement. Postage Required : 2:23-cv-03932-SDM-EPD Doc #: 49-2 Filed: 12/19/24 Page: 27 of 63 PAGEID # ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ International, Inc. c/o Settlement Administrator PO Box XXXX (city, state, zip code) : 2:23-<cv<-0B39a3r2-cSDo Md -Ee P>D>DCloascs #: 49-2 Filed: 12/19/24 Page: 28 of 63 PAGEID # Member ID: <<Refnum>> Claims must be postmarked no later than , 2025. You may also submit a Claim Form online no later than , 2025. NAME: EMAIL: ADDRESS: Monetary Compensation (You may claim one or both settlement benefits)
Submit a Claim Form. To qualify for a cash payment you must timely mail a Claim Form that is attached to this Notice or timely complete and submit a Claim Form online at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ (“Settlement Website”). Your Claim Form must be postmarked or submitted online no later than , 2023. Atticus Administration is the Settlement Administrator.
Submit a Claim Form. You must submit a Claim Form to get a monetary payment. Claim Forms may be printed or filed online at the Settlement Website, ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Claim Forms are simple and easy to complete, requiring (a) personal/contact information, (b) a statement of the quantity of products purchased during the Class Period, and (c) your affirmation that the information provided is true and correct. In exchange for receiving a monetary payment, under the Settlement Agreement, you will give up your rights to ▇▇▇ ▇▇▇▇▇▇▇’▇ about the same claims in this lawsuit. Claim forms must be postmarked, faxed, or submitted online no later than [DATE (within 56 days of commencement of full class notice)].
Submit a Claim Form. To qualify for a cash payment, you must timely mail a Claim Who is the Judge overseeing this settlement? Judge ▇▇▇▇▇ ▇. ▇▇▇▇, United States District Form that is attached to this notice or timely complete and submit a Claim Form online Judge, Western District of Texas. at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ (“Settlement Website”). Your Claim Form must Where may I locate a copy of the settlement agreement, learn more about the case, be postmarked or submitted online no later than Services, LLC is the Settlement Administrator. , 2024. KCC Class Action or learn more about submitting a Claim? ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. Settlement Administrator that is post marked no later than , 2024. If you do for payment for such out-of-pocket losses. If you wish to receive just the Pro Rata not exclude yourself, you will be bound by the settlement and give up your right to Cash Payment, the attached tear off claim form should suffice. A longer version ▇▇▇ regarding the released claims.
Submit a Claim Form. You may timely submit a valid, completed, signed Claim Form. If you submit a claim form, you will remain a member of the Settlement Class, you will be bound by the Settlement Agreement, you will give up the claims that are released by the Settlement Agreement, and you will receive a cash payment.