Claim Form & Release

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Ortega, et al. v. Global Tel*Link Corporation, et al.
c/o Phoenix Settlement Administrators
PO Box 7208
Orange, CA 92863
Fax: (949) 209-2503

Claim Form & Release

Case No. BC636438

To Receive A Payment, You Must Sign And Complete This Claim Form On Or Before May 17, 2018


If the Settlement becomes effective, and my Claim Form is timely and valid I will be eligible to receive a payment calculated based on the information contained in the tear-off section on the right, and as stated in the Settlement Agreement and the Notice. As a member of the Settlement Class, I will also be releasing and discharging all of the Released Claims against Cooper Communications Group, Inc., Global Tel*Link Corporation, and other Released Parties, as described in the Settlement Agreement. By submitting this Claim Form, I consent to join in the Fair Labor Standards Act portion of the settlement and accordingly release all claims under the Fair Labor Standards Act (“FLSA”), 26 U.S.C section 216, et seq., arising out of or relating to the Released Claims. I understand I can review the Settlement Agreement at:

    First Name (required)


    Last Name (required)

    Address (required)

    Address 2

    City (required)

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    Electronic Signature - Type Your Name (required)

    Phone Number (required)

    Your Email (required)

    IF YOU MOVE, send your CHANGE OF ADDRESS to the Settlement Administrator at the above address. To submit a claim on behalf of an estate or incapacitated person, contact the Settlement Administrator. If you have any questions regarding this Claim Form, contact the Settlement Administrator.