Fillable V5 C3a Claim 112019 Final Web

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V5 C3a Claim 112019 Final Web

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1
*C3AWONE*
Codeed Settlement Administrator
P.O. Box 43503
Providence, RI 02940-3503
C3A
CLIFFORD ARMSTRONG, INDIVIDUALLY AND ON BEHALF OF
ALL OTHERS SIMILARLY SITUATED, V. CODEFIED INC.
UNITED STATES DISTRICT COURT, EASTERN DISTRICT OF CALIFORNIA
Case No. 2:19-cv-00239(JAM)
Claim Form
FOR CLAIMS
PROCESSING
ONLY
OB CB
DOC
LC
REV
RED
A
B
Must Be Postmarked No Later Than
January 20, 2020
To submit a Claim for a payment from the Settlement Fund, please ll out the Claim Form below and submit it
by U.S. mail at the address below. You may also le a Claim Form online at www.HCPTCPAsettlement.com. The
deadline to le a Claim Form online is 11:59 p.m. EST on January 20, 2020. If you send in a Claim Form by regular
mail, it must be postmarked on or before January 20, 2020.
— —
Telephone Number that received one or more calls or text messages from/on behalf of Codeed
— —
Telephone Number where you can be reached
Email Address
First Name M.I. Last Name
Primary Address
Primary Address Continued
City State Zip Code
Foreign Province Foreign Postal Code Foreign Country Name/Abbreviation
CLAIMANT INFORMATION
2
*C3AWTWO*
*I declare under penalty of perjury that to the best of my knowledge I received one (1) or more telephone calls or
text messages concerning Codeed’s (d/b/a Housecall Pro’s) goods or services sent by or on behalf of Codeed
from March 28, 2015 to October 22, 2019.
Signature: Dated (mm/dd/yyyy):
Print Name:
*DENOTES INFORMATION YOU MUST PROVIDE TO HAVE A VALID CLAIM
Questions? Visit www.HCPTCPAsettlement.com or email info@HCPTCPAsettlement.com.
To submit by U.S. Mail send to:
Codeed Settlement Administrator
P.O. Box 43503
Providence, RI 02940-3503
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Completed 19 July 2020

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