This Claim Form should be filled out and submitted online or by mail if you received notice that your Private Information may have been compromised in a Data Incident that occurred on or about January 30, 2023 (the “Data Incident”), and you would like to receive a Cash Payment and/or Credit Monitoring.
Cash Payment A – Documented Losses: You may submit a Claim Form and provide reasonable documentation for losses related to the Data Incident for up to $5,000 per Settlement Class Member; OR
Cash Payment B – Flat Cash: Instead of Cash Payment A, without having to provide documentation, you may submit a Claim Form to receive a flat cash payment in the estimated amount of $75.00; AND/OR
Credit Monitoring: In addition to Cash Payment A or Cash Payment B, you may also submit a Claim Form to receive three years of free Credit Monitoring.
Your Cash Payment may be subject to a pro rata (a legal term meaning equal share) increase or decrease depending upon the total value of all Valid Claims submitted.
The Settlement Notice describes your legal rights and options. Please review the Notice here or call 1-888-836-1042 for more information.
If you wish to submit a claim for a Settlement Payment, you need to provide the information requested on the following pages. The deadline to submit this Claim Form online (or have it postmarked for mailing) is July 31, 2025.
Complete information about the Settlement and Settlement Benefits are available in the Notice and on the Frequently Asked Questions (FAQs) page of this website.
Remember, all Claim Forms must be submitted online or received by the Settlement Administrator no later than July 31, 2025.