Online Claim Form (Step 1 of 5)
Valid Claim Forms submitted online, emailed, or postmarked by December 9, 2024 will be honored. Claims made after December 9, 2024 may
still be honored, as the final claims deadline depends on the Court's final approval order. The settlement website will be updated with
the claims deadline after final approval, and reminder notices will be sent accordingly.
Complete this Claim Form and return it by December 9, 2024 only if you are seeking actual damages and want to explain any harm you experienced as a result of an
NCC OFAC Screen. That deadline may be extended by the Court's final approval order, which will be posted on the settlement website.
All Settlement Class Members who fill out a Payment Election Form or who received notice of the
Settlement by mail are eligible for payment without filling out this Claim Form.
However, if you experienced particularized harm as a result of an NCC OFAC Screen, you may be eligible to receive an additional monetary payment.
Forms of harm that Class Members may have experienced that qualify for an Actual Damages Award include:
-
Experiencing significant emotional
distress as a result of the NCC OFAC Screen. This includes stress that caused or worsened physical symptoms (sleeplessness, panic attacks, etc.).
It also includes experiencing significant embarrassment or humiliation due to having the results of the NCC OFAC Screen provided to another person.
Other forms of significant emotional distress will be determined by the Settlement Administrator.
-
Having a transaction delayed,
being denied credit, or being unable to complete a transaction as a result of the NCC OFAC Screen, with no supporting documentation.
-
Having a transaction delayed, being denied credit, or being unable to complete a transaction as a result of the NCC OFAC Screen, with supporting documentation.
If you decide to fill out this Claim Form, please answer all questions honestly and accurately. You are swearing under penalty of perjury that your
statements are true and correct as if you were testifying in court.
Login below using the Notice ID and PIN Number which are located on your Mailed or Email Notice.
Your Notice ID and PIN Number must be entered exactly as they appear on your Mailed or Email Notice.
If you have not received a Mailed or Email Notice with a pre-assigned Notice ID but believe that you are a class
member of this litigation, please contact us.
Once you have logged in, you will be able to file a claim and update your contact information.
The deadline to file your claim is December 9, 2024. That deadline may be extended by the Court's final approval order,
which will be posted on the settlement website.
Instructions:
-
Enter the Notice ID and PIN Number exactly as printed on the Mailed or Email Notice you received.
-
Complete any tasks in the "I'm not a robot" box.
-
Click the "Next" button to continue to Step 2.
Click here to view a sample Notice,
highlighting the location of the Notice ID and PIN Number. If you have trouble logging in to the Online Claim Form,
please contact us.
The * symbol indicates a required field.