EXCLUSION FORMGIANCRISTOARO vs. IMA PIZZA, LLCST. LOUIS COUNTY STATE OF MISSOURICase No. 23SL-CC04108 If you do not want to be a member of the Class and participate in this Lawsuit, you can ask the Court to exclude you from the Lawsuit. To be effective, your request to exclude yourself from the Settlement must be completed, signed and submitted online or postmarked by February 16, 2024. If you choose to be excluded from the Class: Your claims against Defendant, if any, will not be decided in the Lawsuit and you will not share in any recovery that the named Plaintiffs obtain for the Class. You will not be bound by any determinations or any judgment that the Court makes or enters in the Lawsuit, whether favorable or unfavorable. You will not be entitled to any further notice with regard to the Lawsuit. You may pursue any claims you have against Defendant at your own expense and risk by filing your own separate lawsuit, should you choose to do so, and assuming you have a claim and the applicable statute of limitations to file a case has not run. Be aware that any claims that you have or may have against Defendant are limited by the applicable statute of limitations and declining to participate in this case by excluding yourself, or by proceeding separately, may result in some or all of your claims expiring as a matter of law. Exclusion NumberClaimant ID* 1. CLASS MEMBER INFORMATIONName:* First Last Mailing Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code Phone:*Email* Please CertifySignature* I certify, under penalty and perjury, that I have read the above and wish to exclude myself from this Settlement. CAPTCHAUnique IDEmailThis field is for validation purposes and should be left unchanged.
