Common use of The Claim Form Clause in Contracts

The Claim Form. 2.5.1. The Claim Form must be verified by the Settlement Class Member with a statement that his or her claim is true and correct to the best of his or her knowledge and belief. Notarization shall not be required. The Settlement Class Member must reasonably attest that the Out-of-Pocket Losses claimed were both actually incurred and plausibly arose from the Security Incident. Failure to provide supporting attestation and documentation for Out-of-Pocket Loss claims as requested on the Claim Form and required under ¶ 2.3.1 shall result in denial of the claim. Disputes as to claims submitted under this paragraph are to be resolved pursuant to the provisions stated in ¶ 2.7. 2.5.2. Nothing in this Settlement Agreement shall be construed to provide for a double payment for the same loss or injury that was reimbursed or compensated by any other source. 2.5.3. To be valid, claims must be complete and submitted to the Claims Administrator on or before the Claims Deadline. 2.5.4. No payment shall be made for emotional distress, personal/bodily injury, or punitive damages, as all such amounts are not recoverable pursuant to the terms of this Settlement Agreement. 2.5.5. Settlement Class Members who submit a Claim Form must designate the method for payment of their claim on the Claim Form, which will include the receipt of payment via check by mail, or via PayPal, Zelle, Venmo, or such other electronic payment platform deemed efficient and appropriate by the Claims Administrator. Claim Forms failing to clearly make a single designation will receive a check by mail to the last known address on file with the Claims Administrator. In the event an electronic payment platform returns a payment to the Claims Administrator, no later than fourteen (14) days after being notified of the return of such payment, the Claims Administrator will mail a check to the Settlement Class Member’s last known address on file with the Claims Administrator.

The Claim Form. 2.5.12.7.1. The Claim Form must be verified by the Settlement Class Member with a statement that his or her he claim is true and correct to the best of his or her knowledge and beliefbelief and is being made under penalty of perjury. Notarization shall not be required. The Settlement Class Member must reasonably attest that the Outout-of-Pocket Losses pocket expenses and charges claimed were both actually incurred and plausibly arose from the Security Data Incident. Failure to provide supporting attestation and documentation for Out-of-Pocket Loss claims as requested request on the Claim Form and required under ¶ 2.3.1 ¶¶ 2.3 or 2.4 shall result in denial of the a claim. Disputes as to claims submitted under this paragraph are to be resolved pursuant to the provisions stated in ¶ 2.729. 2.5.2. Nothing in this Settlement Agreement shall be construed to provide for a double payment for the same loss or injury that was reimbursed or compensated by any other source. 2.5.32.7.2. To be valid, claims must be complete and submitted to the Claims Administrator on or before the Claims Deadline. 2.5.42.7.3. No payment Payment shall be made for emotional distress, personal/bodily injury, or punitive damages, as all such amounts are not recoverable pursuant to the terms of this Settlement Agreement.. Docusign Envelope ID: 6CC5E68E-9CE6-41E4-A210-0A69F3BB8387 2.5.52.7.4. Settlement Class Members who submit a Claim Form must designate the method for payment of their claim on the Claim Form, which will include the receipt of payment via check by mail, or via PayPal, Zelle, Venmo, or such other electronic payment platform deemed efficient and appropriate by the Claims Administrator. Claim Forms failing to clearly make a single designation will receive a check by mail to the last known address on file with the Claims Administrator. If an electronic payment platform returns a payment to the Claims Administrator. In the event an electronic payment platform returns a payment to the Claims Administrator, no later than fourteen (14) days after being notified of the return of such payment, the Claims Administrator will mail a check to the Settlement Class Membermember’s last known address on file with the Claims Administrator.