Other LanguagesREQUEST FOR EXCLUSION FROM PCH SETTLEMENT
Use this form if you do NOT want to be included in the class action settlement involving Publishers Clearing House
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I want to be excluded from the class action settlement referred to in the notice I received from Publishers Clearing House dated August 3, 1999.
Signature: ____________________________ Date:_____________________
(Please print clearly below)
Full Name: ____________________________
Full Address: ___________________________
__________________________
_________________________
YOUR CONTROL NUMBER: __________________________
[You MUST indicate your control number (see space above). The control number appears under your address on the outside of the notice of class action that you were sent, and is labeled "Control No."]
IMPORTANT: TO BE EFFECTIVE, THIS FORM MUST BE COMPLETELY FILLED OUT AND MAILED TO THE FOLLOWING ADDRESS AND MUST BE POSTMARKED NO LATER THAN OCTOBER 18, 1999:
Class Counsel
P.O. Box 4310
Fairview Heights, IL 62208
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CHECKLIST:
1. Did you sign your name in the top space above?
2. Did you fill out the form completely, with your full name and address, and your Control Number?
3. Is your envelope properly addressed to: "Class Counsel," at P.O. Box 4310, Fairview Heights, IL 62208?
4. Are you mailing this so that it will be postmarked on or before the deadline of October 18, 1999?
Please note that by supplying this form, the Attorney General's Office is neither recommending that you accept or that you opt out of the private class action settlement. The Attorney General's Office cannot provide private legal advice. You must make this decision on your own, or consult your own legal counsel for assistance.