Sackin et al. v. TransPerfect Global, Inc.

Case No. 1:17-cv-1469-LGS

Reimbursement Form

Submission Deadline: February 10, 2021


Eligible Settlement Class Members may submit one or more claims for reimbursement (“Claims”) for documented economic costs related to the Data Breach which have not been reimbursed by Experian or other third party, up to an aggregate of $4,000.00 in reimbursement per Settlement Class Member, provided, however, that no Settlement Class member for whom an Experian plan has been provided by TransPerfect may submit a Claim unless said Settlement Class Member has first submitted a Claim to Experian, Experian has denied the claim, and said Settlement Class Member has exhausted Experian’s claims process.

Additional information is contained in the Notice and the Settlement Agreement, both of which are available on the Important Documents page or by calling 1-844-824-5797.

Settlement Class Members who wish to make a Claim for reimbursement of economic costs related to the Data Breach must provide to the Settlement Administrator information required to evaluate the Claim, including: (a) the Claimant’s name and current address; (b) if applicable, a signed copy of IRS Form 14039 along with a statement under penalty of perjury that the form was submitted to the Internal Revenue Service; (c) the bills or invoices documenting the amount of the Claim and proof that the bills or invoices were paid; (d) documentation showing that the Claim was submitted and denied by Experian; and (e) a statement signed under penalty of perjury indicating that: (i) the economic costs claimed is related to the Data Breach; and (ii) the total amount claimed has not been reimbursed by any other third party. Third-party documentation of the economic costs is required to establish a Claim.

If a Settlement Class Member was provided notice of his or her entitlement to enroll in an Experian plan, but was not enrolled in such service at the time of the loss for which she or he seeks reimbursement arose, and the loss would have been covered under the identity theft insurance coverage provided through an Experian plan had the Settlement Class Member been enrolled, then the loss may not be claimed for reimbursement hereunder. In addition, any Settlement Class Member whose Reimbursement Claim to Experian is rejected for failure to submit a claim within Experian’s required time period may not submit a Claim for reimbursement for documented economic costs related to the Data Breach.

Settlement Class Members must submit this form through the Settlement Website, or by mailing it to the following address:

TRANSPERFECT SETTLEMENT
1650 ARCH STREET, SUITE 2210
PHILADELPHIA, PA 19103

Deadline: All Claims must be submitted to the Settlement Administrator on or before February 10, 2021.


CLAIMANT INFORMATION

* Required







USA
Foreign




You may submit one or more reimbursement requests, but all of your requests cannot exceed an aggregate $4,000. Only one (1) form is needed for multiple costs incurred from the Data Breach.


$




The economic costs I have claimed on this form is related to the Data Breach; and
The total amount claimed has not been reimbursed by any other third party.


Your claim will be submitted to the Settlement Administrator for review. If your Reimbursement Form is incomplete, untimely, or contains false information, it may be rejected by the Settlement Administrator. If your claim is approved, you will be mailed a check at the street address you provide. This process takes time; please be patient.



Once you click "Submit," you will be given the option to upload documentation to support your claim.

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