You can receive reimbursement for up to $5,000.00 for documented unreimbursed out-of-pocket expenses fairly traceable to the Data Incident. You must attach documents to your Claim Form that show what happened and how much you lost or spent so that you can be repaid. This may include receipts or other documentation. Self-prepared documentation (e.g., handwritten logs) may be used as supplementary support but must be accompanied by third-party documents.
Selected files:
If you spent time monitoring accounts, reversing fraudulent charges, or otherwise dealing with the aftermath/cleanup of the Data Incident, you may be reimbursed for your time. The total amount you may receive for Documented Ordinary Losses and Attested Time Spent will be limited to $5,000 combined. The maximum you may receive for Attested Time Spent is 3 hours at $25.00 per hour.
If you do not want to claim reimbursement for Ordinary Losses or Time Spent, you may instead claim a pro rata (a legal term meaning equal share) payment from the Net Settlement Fund after all costs associated with the Settlement have been paid. If all costs and payments exceed the Settlement Fund amount, this option could result in no payment.
I declare under penalty of perjury under the laws of the United States and the state where this Claim Form is signed that the information I have supplied in this Claim Form is true and correct to the best of my recollection, and that this form was executed on the date set forth below.
I understand that all information provided on this Claim Form is subject to verification and that I may be asked to provide supplemental information by the Settlement Administrator before my claim will be considered complete and valid..