If you received a personalized notice in the mail or via email with a Notice ID and Confirmation Code, please enter the codes you were provided below.

Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. 12345678).

If you believe you are a Settlement Class Member, and you did not receive a personalized notice via email with a Notice ID and Confirmation Code, please contact the Settlement Administrator and we will provide one to you

Click Here

The deadline for submitting this proof of claim form is

Please add the email, Confirmation@ECU-Settlement.com, to your contact list to ensure that future correspondence is delivered to your inbox.

I. CLASS MEMBER AND CONTACT INFORMATION

* Required Fields

II. PAYMENT ELIGIBILITY INFORMATION

Please review the notice and section IV of the Settlement Agreement for more information on who is eligible for a payment and the nature of the expenses or losses that can be claimed.

Please provide as much information as you can to help us figure out if you are entitled to a settlement payment.

PLEASE PROVIDE THE INFORMATION LISTED BELOW:

Check the box for each category of benefits you would like to claim. Categories include: reimbursement of out-of-pocket expenses and lost time spent as a result of the Data Incident (up to a maximum of $300.00), reimbursement of extraordinary expenses incurred as a result of the Data Incident (up to a maximum of $4,000), and up to 36-months of credit monitoring and identity protection services to be paid for by Defendant. Please be sure to fill in the total amount you are claiming for each category and to attach documentation of the charges as described in bold type (if you are asked to provide account statements as part of proof required for any part of your claim, you may mark out any unrelated transactions, account numbers, or personal information (other than name) if you wish).

A. Ordinary Losses Resulting from the Data Breach:
LOST TIME:

You can claim up to three hours of lost time, compensable at the rate of $25 per hour.

Examples - You spent at least one full hour calling customer service lines, writing letters or emails, or on the Internet in order to get fraudulent charges reversed or in updating automatic payment programs because of the Data Breach. You spent at least one full hour rescheduling medical appointments and/or finding alternative medical care and treatment, retaking or submitting to medical tests, locating medical records, retracing medical history as a result of the Data Incident.

OUT-OF-POCKET EXPENSES:

You can claim up to $225 in ordinary out-of-pocket expenses.

Examples - unreimbursed losses relating to fraud or identity theft; professional fees including attorneys’ fees, accountants’ fees and fees for credit repair services; costs associated with freezing or unfreezing credit with any credit reporting agency; credit monitoring costs that were incurred on or after August 5, 2021, through May 13, 2023 and miscellaneous expenses such as notary, fax, postage, copying, mileage and long-distance telephone charges, that were incurred on or after August 5, 2021, through May 13, 2023.

$ .00
B. Extraordinary Expenses Resulting from the Data Breach:

You can claim up to $4,000 in extraordinary expenses. To be valid, extraordinary expenses must be (i) actual, documented, and unreimbursed monetary losses; (ii) the loss must more likely than not have been caused by the Data Breach; (iii) the loss must have occurred during a specific time period; (iv) the loss cannot already be covered by the Ordinary Loss category above; and (v) the settlement class member must have made reasonable efforts to avoid or seek reimbursement for the loss, including but not limited to exhaustion of all available credit monitoring insurance and identity theft insurance.

$ .00

Documentation of out-of-pocket expenses is REQUIRED. You may mark out any transactions, account numbers, or personal information (other than name) that are not relevant to your claim before sending in the documentation.

C. Claim up to 36-months of credit monitoring and identity protection services.

The Settlement requires Defendant to provide up to 36-months of credit monitoring and identity protection services for Settlement Class Members that submit timely and valid claims.

Payment Method

You have successfully requested a payment. Click here if you would like to choose a different payment method.

III. SIGN AND DATE YOUR CLAIM FORM

I declare under penalty of perjury under the laws of the United States, the laws of Florida, and the laws of my State of residence that the information supplied in this claim form by the undersigned is true and correct, and that this form was executed on the date set forth below.

I understand that I may be asked to provide supplemental information by the Settlement Administrator before my claim will be considered complete and valid.

Your Claim Form has been submitted successfully.

Please print this page for your records.

Your Claim Details
Submitted Claim ID:
Confirmation Code:
You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
CLAIM INFORMATION
First Name
Last Name
Street Address
Street Address 2
City
State
Zip Code
Email Address
Phone Number
Signature
Date

If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at Info@ECU-Settlement.com

Click here to edit your Claim.

Print Home