Wellens et al v. Daiichi Sankyo, Inc.

Filing 191

ORDER GRANTING PLAINTIFFS MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ANDMOTION FOR FEES, REIMBURSEMENT OF EXPENSES AND SERVICE PAYMENTS. Signed by Judge William H. Orrick on 02/11/2016. (jmdS, COURT STAFF) (Filed on 2/11/2016)

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David Sanford (Pro Hac Vice)
SANFORD HEISLER KIMPEL, LLP
1666 Connecticut Ave. NW, Suite 300
Washington, DC 20009
Telephone: [phone]

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Felicia Medina (SBN 255804)
[e-mail]
Yonina Alexander (SBN 284908)
[e-mail]
Danielle Fuschetti (SBN 294064)
[e-mail]
SANFORD HEISLER KIMPEL, LLP
111 Sutter Street, Suite 975
San Francisco, CA 94104
Telephone: [phone]

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Attorneys for Plaintiffs and the Class

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UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF CALIFORNIA

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SARA WELLENS, KELLY JENSEN,
JACQUELINE PENA, BERNICE
GIOVANNI, LARA HOLLINGER, and
JENNIFER BENNIE
on behalf of themselves and all others
similarly situated,

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Plaintiffs,
v.
DAIICHI SANKYO,

No. C 13-00581 WHO (DMR)
ORDER GRANTING PLAINTIFFS’
MOTION FOR FINAL APPROVAL
OF CLASS SETTLEMENT, AND
MOTION FOR FEES,
REIMBURSEMENT OF EXPENSES
AND SERVICE PAYMENTS
Hearing Date: February 10, 2016
Hearing Time: 2:00pm

Defendant.

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The Court heard argument on preliminary approval of the proposed Class Settlement in
this matter on September 30, 2015. On October 15, 2015, the Court granted the Parties’
requests to modify the class definition by extending the starting-date of the class period for both
the California and non-California Classes to April 16, 2011. Docket No. 180. On October 16,
2015, the Court conditionally certified a Rule 23 class, certified the Equal Pay Act collective

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ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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action, granted preliminary approval to the proposed Class Settlement, and set a schedule for

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Class Notice and Final Approval.

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Parties’ request to amend the Class Notice and schedule for final approval. Docket No. 183.

Docket No. 181. On January 6, the Court granted the

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The Court conducted a final fairness hearing on February 10, 2016 on Plaintiffs’ Motion

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for Final Approval of Class Action Settlement and Motion for Attorneys’ Fees, Reimbursement

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of Expenses, and Service Awards. (“Plaintiffs’ Motions”). The Court has reviewed Plaintiffs’

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briefs and supporting declarations, and heard arguments presented by Counsel. For the reasons

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cited below, the Court grants final certification to the conditionally certified classes and final

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approval of the Class Settlement as amended by the Joint Stipulation and Order Regarding Class

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Period of Settlement (the “Settlement”). The Court finds the Class Settlement to be fair,

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reasonable and adequate.

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Reimbursement of Expenses, and Service Awards. Finally, the Court retains jurisdiction as

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described in paragraph 30 below.

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It is hereby ORDERED:

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I.

JURSIDICTION
1.

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The Court also grants Plaintiffs’ Motion for Attorneys’ Fees,

This Court has jurisdiction over the subject matter of the litigation and over all

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parties to this litigation, including all members of the Settlement Class, as defined below.

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II.

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FINAL CERTIFICATION OF SETTLEMENT CLASSES
2.

The proposed Settlement Classes are as follows:
California Settlement Class: All female sales force employees who are or were
employed in a sales representative and/or first level district manager role,
including, without limitation, Sales Representative; Sales Representative I-V;
Sales Specialist; Senior Sales Specialist; Senior Sales Professional;
Cardiovascular (“CV”) Specialty Sales Representative; CV Specialty Sales
Representative I-III; Senior CV Specialty Sales Representative; Senior CV
Specialty Sales Professional; Hospital Representative; Hospital Representative I3; Senior Hospital Sales Representative; Hospital Sales Specialist; and Primary
Care, CV, and Hospital District Manager in DSI’s sales organization in
California for at least one day between April 16, 2011 and October 16, 2015.

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Non-California Settlement Class: All female sales force employees who are or
were employed in a sales representative and/or first level district manager role,
including, without limitation, Sales Representative; Sales Representative I-V;
Sales Specialist; Senior Sales Specialist; Senior Sales Professional;
ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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Cardiovascular (“CV”) Specialty Sales Representative; CV Specialty Sales
Representative I-III; Senior CV Specialty Sales Representative; Senior CV
Specialty Sales Professional; Hospital Representative; Hospital Representative I3; Senior Hospital Sales Representative; Hospital Sales Specialist; and Primary
Care, CV, and Hospital District Manager in DSI’s sales organization in the
United States for at least one day between April 16, 2011 and October 16, 2015.

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3.

brought under Title VII of the Civil Rights Act of 1964, 42 U.S.C. §§ 2000e, et seq. (“Title
VII”), the Equal Pay Act, 29 U.S.C. §§ 206 et seq. (“The Equal Pay Act”) and, with respect to
the California Settlement Class, the California Fair Employment and Housing Act, Cal. Gov’t
Code §§ 12940 et seq.

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4.

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The Court FINDS and CONCLUDES that the Settlement Classes described

above satisfy all of the requirements for certification under Rule 23(a) and Rule 23(b)(3) of the
Federal Rules of Civil Procedure. Accordingly, the Court CERTIFIES these Settlement Classes
under Rule 23(a) and (b)(3) of the Federal Rules of Civil Procedure.

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Members of the Settlement Classes allege claims for gender discrimination

5.

The Court FINDS and CONCLUDES that the Settlement Class Members who

have returned Consent-to-join forms are similarly situated. The Court designates those
Settlement Class Members who have returned Consent-to-join forms as a final certified
collective action under the Equal Pay Act, 29 U.S. Code § 206, pursuant to 29 U.S. Code §
216(b).
III.

FINAL APPROVAL OF CLASS SETTLEMENT
6.

Except as otherwise stated, the Court incorporates by reference the defined terms

in the Settlement. Docket Nos. 175 & 180.
7.

The Court finds that this action satisfies the requirements for the settlement of a

class action under Federal Rule of Civil Procedure 23 and under the Equal Pay Act, 29 U.S.
Code § 206, pursuant to 29 U.S. Code § 216(b), and finds that the Classes have at all times been
adequately represented by the Named Plaintiffs and Class Counsel.
8.

The Class Notice approved by the Court was provided by First Class mail to the

last-known address of each of the individuals identified as Class Members. In addition, followup efforts were made to send the Notice to those individuals whose original Notices were

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ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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returned as undeliverable. The Notice adequately described all of the relevant and necessary

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parts of the proposed Settlement Agreement, the request for service awards to the Class

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Representatives, and Class Counsel’s request for an award of attorneys’ fees and costs. On

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January 6, the Court approved an Amended Notice of a Proposed Class Action Settlement and a

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Notice of Amended Deadline to Object, which informed Class Members of this amendment to

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the objection deadline.

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Settlement was posted to the Class website and the Notice of Amended Deadline to Object was

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mailed to Class Members’ last known addresses. The Court finds that the Notice described

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herein fully complied with Rule 23 and §216(b), was the best notice practicable, satisfied due

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On January 7, the Amended Notice of a Proposed Class Action

process, and provides the Court with jurisdiction over Class Members.
9.

The Court has assessed the proposed Settlement in light of: (1) the strength of

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Plaintiffs’ case; (2) the risk, expense, complexity, and likely duration of further litigation; (3)

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the risk of maintaining class action status throughout the trial; (4) the amount offered in the

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settlement; (5) the extent of discovery completed and the stage of the proceedings; (6) the

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experience and views of counsel; (7) the presence of a governmental participant; and (8) the

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reaction of the class members to the proposed settlement.

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10.

The Court finds that the terms of the Agreement are fair, reasonable, and

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adequate in all respects. The Court specifically finds that the programmatic and monetary relief

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of the Settlement are reasonable in light of the types and amounts of relief offered, the strength

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of Plaintiffs’ and the Class Members’ claims, and the risk, expense, complexity, and duration of

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further litigation. The Court confirms its previous finding that the Settlement Agreement is the

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result of arms-length negotiations between experienced counsel representing the interests of

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Plaintiffs and Defendant, after thorough factual and legal investigation.

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11.

No Class Members have objected to any aspect of the Settlement, nor to any

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request in the Motion for Attorneys’ Fees, Reimbursement of Expenses, and Service Awards.

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The reaction of the Class also supports the conclusion that the Settlement is fair, reasonable, and

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adequate.

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12.

The individuals who timely opted out of the Settlement are identified in Exhibit

ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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1 to this Order. These individuals are excluded from the Settlement and are not bound by its

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terms.
13.

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The Court approves the cy pres recipient identified in the Settlement, the Legal

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Aid Society Employment Law Center and the Justice and Diversity Center of the Bar

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Association of San Francisco.
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IV.

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ATTORNEYS’ FEES AND COSTS
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The Settlement is HEREBY APPROVED in its entirety.

On January 13, 2016, Class Counsel filed a Motion for Attorneys’ Fees,

Reimbursement of Expenses and Service Awards.

Counsel is requesting an award of

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$3,000,000 in attorneys’ fees and unreimbursed litigation expenses, the maximum permitted

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under the Settlement. Of this amount, Plaintiff’s requested unreimbursed expenses comprise

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$125,662.55, and their requested fees comprise $2,874,337.45.

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Plaintiffs’ motion for attorneys’ fees and costs is granted.

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Plaintiffs are a “prevailing party” for purposes of awarding attorneys’ fees

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pursuant to 42 U.S.C. § 2000e-5(k).
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The lodestar method is an appropriate means of calculating attorneys’ fees in this

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The number of hours that Class Counsel spent on this case was reasonable in

case.

light of the length and complexity of the litigation and the excellent result obtained.
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The rates used by Class Counsel are reasonable, and are in line with attorneys of

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comparable skill, experience, and reputation who practice in the Northern District of California.

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The amount of attorneys’ fees requested is reasonable, particularly in light of the fact that Class

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Counsel’s requested fees are less than two-thirds (2/3) of their total lodestar and Class Counsel

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is not seeking any additional fees for their anticipated continued work in helping to administer

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compliance with the Settlement and the Claims Form Process.

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The attorneys’ fees awarded herein are also reasonable under the percentage-of-

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the-fund method of determining appropriate fees based on the complexity and duration of the

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litigation, the risk associated with it, Class Counsel’s skill and experience, and the important
ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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injunctive and monetary relief that Class Counsel obtained in this case.
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The costs and expenses incurred by Class Counsel are reasonable and are the

type that would normally be charged by an attorney to a fee-paying client.
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Accordingly, IT IS HEREBY ORDERED that Class Counsel are awarded

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$2,874,337.45 in attorneys’ fees and $125,662.55 in unreimbursed expenses. Defendant is

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ordered to pay these amounts as agreed in the Settlement Agreement.

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V.

SERVICE AWARDS
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On January 13, 2016, Class Counsel filed a Motion for Attorneys’ Fees,

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Reimbursement of Expenses and Service Awards. Plaintiffs request a service award of $25,000

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for each Class Representative, $6,000 for each member of the opt-in class who both was

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deposed and submitted a declaration in support of Plaintiffs’ Motion for Equal Pay Act

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Conditional Collective Action Certification (Docket No. 78) (“deposed declarants”); $5,000 for

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each

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(“deponents”); and $1,000 for each member of the opt-in class who submitted a declaration and

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was not deposed (“declarants”).

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requested is attached as Exhibit 2 hereto and is incorporated by reference into this Order.

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member of the opt-in class who was deposed but did not submit a declaration

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A list of the names and corresponding service awards

In evaluating the reasonableness of a service award, courts consider factors such

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as: (1) the actions the plaintiff has taken to protect the interests of the class; (2) the degree to

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which the class has benefitted from those actions; (3) the duration of the litigation and the

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amount of time and effort the plaintiff expended in pursing it; and (4) the risks to the plaintiff in

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commencing the litigation, including reasonable fears of workplace retaliation, personal

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difficulties, and financial risks.

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26.

The Court finds that the Named Plaintiffs’ requests for service payments are

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reasonable in light of their time and effort pursuing this litigation, the substantial benefit to the

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Class from the Settlement, and the risks that they have faced in representing the Class.

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27.

Accordingly, IT IS HEREBY ORDERED that: Sara Wellens, Kelly Jensen,

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Jacqueline Pena, Bernice Giovanni, Lara Hollinger, and Jennifer Bennie will each receive a

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service award of $25,000; Lisa Gonzalez, Sherri Harris, Jacquelynne Holmes, Lisa Propper, and
ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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Carol Vaughn will each receive a service award of $6,000; Hallie Blakey, Gwenn Ricchio, and

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Lisa Wyka will each receive a service award of $5,000; and Joyce Bagley, Kristi Bednar, Jamie

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Carter, Autumn Connot, Michelle Dempsey, Kari Dyjak, Cheri Green, Eunice Hawkins-

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Kimmel, Lewanna Heard, Parthenia Holly, Gabrielle Jones, Shannon Korando, Brenda Maher,

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Lisa Meleski, Julie McMahon, Jennifer Pickens, Marina Rademacher, Courtney Ronay, Carole

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Ward, and Deah Webster will each receive a service award of $1,000.

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VI.

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The Court hereby enters Judgment approving the terms of the Class Settlement

and granting Plaintiffs’ Motion for Attorneys’ Fees, Reimbursement of Expenses and Service
Awards, as set forth herein.
29.

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FINAL JUDGMENT

This document shall constitute a final judgment for the purposes of Rule 58 of

the Federal Rules of Civil Procedure.
30.

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The Court will retain jurisdiction over this matter for purposes of resolving

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issues relating to administration, implementation, and enforcement of the Settlement Agreement

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for (2) years following the “Effective Date,” as defined in Section 3.1(r) of the Settlement

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Agreement.

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VII.

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APPROVAL OF CLAIMS FORM AND CLAIM FORM PROCESS
31.

The Settlement creates a Claim Form Process that will allow class members to

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recover some measure of their proportional damages, in addition to the amount they receive

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through the Core Component. The question of whether to approve the Claim Form, attached as

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Exhibit 3 hereto, and the Claim Form Process is also before the Court.

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32.

The Court finds the Claim Form and the Claim Form Process to be a fair,

reasonable and adequate feature of the Settlement.

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33.

The Claim Form is hereby APPROVED.

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34.

The process for distributing the Claim Form, outlined in Sections 5.1-5.3 and

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8.1, 8.3, 8.4 of the Settlement and incorporated by reference hereby, is also APPROVED. The

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Claim Form Process will be conducted in conformance with the process set forth in Sections

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5.1-5.3 and 8.1, 8.3, 8.4 of the Settlement.
ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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Accordingly, IT IS HEREBY ORDERED as follows:

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Plaintiffs Motion for Final Approval of Class Settlement and Plaintiffs Motion for

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Attorneys’ Fees, Reimbursement of Expenses, and Service Awards are both GRANTED.

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Accordingly, (1) the Settlement Classes and collective action identified herein are finally

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certified; (2) the Settlement is granted final approval; (3) Class Counsel are awarded attorneys’

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fees and reimbursement of expenses in the amount of $3,000,000; (4) service payments are

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awarded to Class Representatives, Deposed-Declarants, Deponents, and Declarants consistent

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with Section V of this Order; and (5) the Claim Form Process as set forth in the Settlement is

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approved.

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DATED: February 11, 2016

_______________________________________
HON. WILLIAM H. ORRICK
UNITED STATES DISTRICT JUDGE

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ORDER REGARDING MOTION FOR FINAL APPROVAL OF CLASS SETTLEMENT, ATTORNEYS’
FEES, EXPENSES, AND SERVICE PAYMENTS – No. C 13-00581 WHO (DMR)

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Exhibit 1

The following class members have opted out and are therefore not bound by the terms of
Settlement:
1. Amanda Ricci
2. Staci Balanay
3. Brandi Roy Kimble

Exhibit 2

SERVICE PAYMENT LIST
DECLARANTS
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2.
3.
4.
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6.
7.

Joyce Bagley
Kristi Bednar
Jamie Carter
Autumn Connot
Michelle Dempsey
Kari Dyjak
Cheri Green

8.
9.
10.
11.
12.
13.
14.

DEPOSED-DECLARANTS
1 Lisa Gonzalez
2 Sherri Harris
3 Jacquelynne Holmes
4 Lisa Propper
5 Carol Vaughn
DEPOSED OPT-INS
1.
2.
3.

Hallie Blakey
Gwen Ricchio
Lisa Wyka

CLASS REPRESENTATIVES
1.
2.
3.
4.
5.
6.

Jennifer Bennie
Bernice Giovanni
Lara Hollinger
Kelly Jensen
Jacqueline Pena
Sara Wellens

Eunice Hawkins-Kimmel
Lewanna Heard
Parthina Holly
Gabrielle Jones
Shannon Korando
Brenda McIntrye
Lisa Meleski

15.
16.
17.
18.
19.
20.

Julie McMahon
Jennifer Pickens
Marina Rademacher
Courtney Ronay
Carole Ward
Deah Webster

Exhibit 3

CONFIDENTIAL CLAIM FORM
WELLENS, ET AL. v. DAICHI SANKYO, INC.
Your Claim Form must be returned POSTMARKED by no later than [Insert date, which is 60 days
after Final Approval Date]. Enclosed is a self-addressed stamped envelope for returning a Claim
Form.

If you are a woman who is, or was, employed as a SALES REPRESENTATIVE or DISTRICT MANAGER for
DAIICHI SANKYO, INC. in the United States at any time from APRIL 16, 2011 through October 16, 2015,
you may be eligible for a monetary award from the claims process of this settlement.
You DO NOT have to submit this Claim Form to receive a monetary award for the CORE COMPONENT of
this settlement, described in the Class Action Settlement Notice previously sent to you. The check for the Core
Component will be mailed to you shortly.
HOWEVER, you may be eligible to receive an ADDITIONAL MONETARY AWARD for promotion
discrimination, harassment, retaliation and emotional distress from the claims process of this settlement. In
order to receive an additional monetary award, you must complete and submit timely answers to the
applicable questions in this CLAIM FORM, describing:
A.
B.
C.

D.

Gender, pregnancy, or caregiver discrimination you experienced at Daiichi Sankyo related to PROMOTIONS
TO DISTRICT MANAGER;
HARASSMENT you experienced at Daiichi Sankyo related to your gender and/or pregnancy or caregiver
status;
RETALIATION by Daiichi Sankyo against you for complaining about or opposing gender, and/or
pregnancy/caregiver discrimination or harassment, or for participating in an investigation or a legal process
concerning gender and/or pregnancy/caregiver discrimination or harassment; and/or
EMOTIONAL DISTRESS stemming from instances of discrimination or harassment based on gender and/or
pregnancy/caregiver status, or stemming from retaliation for complaining of, opposing, testifying or
participating in an investigation or legal process relating to gender and/or pregnancy/caregiver discrimination or
harassment. Discrimination is any form of different or unfair treatment to which you were subjected because of
your status as a woman, your pregnancy, or your caregiver status.

California Class Members
If you were employed with Daiichi Sankyo in California and are the intended recipient of this Claim Form,
you are a “California Class Member.” Your Claim Form answers must be based on facts occurring between
February 11, 2009 and October 16, 2015.
Non-California Class Members
If you were employed with Daiichi Sankyo in the United States, excluding California, and are the intended
recipient of this Claim Form, you are a “Non-California Class Member.” Your Claim Form answers must
be based on facts occurring between September 12, 2010 and October 16, 2015.
Note: Claims arising before or after the “relevant time period” (February 11, 2009 and October 16, 2015
for California Class Members, and September 12, 2010 and October 16, 2015 for Non-California Class
Members) are not eligible for compensation through this claim form process.

If your address is different from that printed on the label or if you did not receive this Claim Form in the mail,
please write your accurate and complete address information below.
Full Name:

_________________________________________________
First/Middle Initial/Last Name

Address:

_________________________________________________
Street Address, including any apartment or box number

_________________________________________________
City State Zip Code

CLAIM FORM INSTRUCTIONS
Fill out Sections A through D to the extent that they apply to you. For example, you do not need to fill out
Section A unless you were denied a promotion to District Manager during the relevant time period. Your
completion of Section E is required for you to participate in the claims process. The monetary award that
you receive will be determined based on a combination of your answers to these questions, your supporting
documentation, and your work history at Daiichi Sankyo.
Make sure to sign and date your Claim Form in Section E. You may use additional sheets of paper to answer
any question on the Claim Form. If you do so, please be sure to put your name, social security number, and the
question number on each additional sheet of paper you include with your Claim Form.
All information contained in this Claim Form will be kept strictly CONFIDENTIAL. Answers will only be
reviewed by the Independent Claim Expert (and Class Counsel if desired), to make determinations
regarding your monetary award from the claims process of this settlement. Your answers and
documentation will NOT be disclosed to Daiichi Sankyo. You will not be subject to any retaliation for
your completion of these questions.
The Independent Claim Expert will allocate points to each eligible Class Member who submits a Claim Form.
You will receive points based upon the information you provide in your answers about gender, pregnancy, or
caregiver discrimination or harassment at Daiichi Sankyo. You will also receive points for information
pertaining to retaliation you experienced at Daiichi Sankyo for complaining of or opposing gender and/or
pregnancy/caregiver status discrimination or harassment or for participating in an investigation or a legal
process concerning gender and/or pregnancy/caregiver status discrimination or harassment. If you provide
detailed information and supporting documentation for your answers you may receive additional points.
Claimants will also be eligible to receive additional points for information provided about emotional harm
suffered as a result such discrimination, harassment or retaliation.
DEADLINE TO SUBMIT: In order to be eligible to receive a settlement award from the Claim Form
Component of the Settlement through this claims process, you must return this Claim Form postmarked
on or before [Insert date, which is 60 days after Final Approval Date], to:
WELLENS v. DAIICHI SANKYO, INC.
SETTLEMENT ADMINISTRATOR
C/O RUST CONSULTING INC - 4918
PO BOX 2396
FARIBAULT MN 55021-9096
NEED ASSISTANCE? If you need assistance in completing your Claim Form, you can get free help by
contacting Class Counsel: Sanford Heisler Kimpel, LLP, 111 Sutter Street, Suite 975, San Francisco, CA
94104, Tel: [phone], Fax: [phone], www.sanfordheisler.com.
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SECTION A
PROMOTIONS TO DISTRICT MANAGER
INSTRUCTIONS: Class Members who were or are SALES REPRESENTATIVES who believe they
experienced discrimination in PROMOTION TO DISTRICT MANAGER based on their gender and/or
pregnancy/caregiver status, please answer Question 1.
Please only fill out this section if it applies to you. You must submit your Claim Form by [Insert date, which is
60 days after Final Approval Date] to be eligible for a monetary award.
1. At any time from February 11, 2009 (for California Class Members) or September 12, 2010 (for
Non-California Class Members) through October 16, 2015, were you discriminatorily denied or
dissuaded from applying for a promotion(s) to District Manager at Daiichi Sankyo that you
believe you were qualified for?

If “Yes,” please explain. Relevant information can include: the position title, approximate date,
whether or not you were interviewed, the name, gender, and qualifications of the person who
received the position, if known, any reasons that you feel suggest that this was the result of
discrimination on the basis of your gender and/or pregnancy/caregiver status, how you applied
for the position, why you believe you were deserving of the position, and whether you were
prevented from applying for the position because you were not aware of it or did not receive
support from your direct manager.
You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form.

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SECTION B
HARASSMENT
INSTRUCTIONS: Class Members who believe they were subjected to HARASSMENT on the basis of
their gender and/or pregnancy/caregiver status, please answer Question 2.
Please only fill out this section if it applies to you. You must submit your Claim Form by [Insert date, which is
60 days after Final Approval Date] to be eligible for a monetary award.
2. At any time from February 11, 2009 (for California Class Members) or September 12, 2010 (for
Non-California Class Members) through October 16, 2015, do you believe that you were
subjected to harassment or a hostile work environment on the basis of gender and/or
pregnancy/caregiver status at Daiichi Sankyo?

If “Yes,” please explain. Relevant information can include: the approximate date(s) of each
occurrence, the manager(s) or employee(s) involved, and any specifics about the situation;
and/or whether you complained about the harassment, the approximate date(s) you made the
complaint(s), the manager(s), employee(s), Human Resources representatives or other agents
you complained to, whether the harassment continued after your complaint(s), and any reasons
you have for believing this harassment was motivated by your gender and/or
pregnancy/caregiver status.
You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form.

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SECTION C
RETALIATION
INSTRUCTIONS: Class Members who believe Daiichi Sankyo RETALIATED against them for opposing
gender, pregnancy, or caregiver discrimination or harassment, please answer Questions 3-4.
Please only fill out this section if it applies to you. You must submit your Claim Form by [Insert date, which is
60 days after Final Approval Date] to be eligible for a monetary award.
3. At any time from February 11, 2009 (for California Class Members) or September 12, 2010 (for
Non-California Class Members) through October 16, 2015, did you ever complain of, oppose or
object to gender, pregnancy, or caregiver discrimination or harassment or participate in an
investigation or a legal process concerning gender, pregnancy or caregiver discrimination or
harassment at Daiichi Sankyo?

If “Yes, please explain. Relevant information can include: any complaint, opposition, report or
refusal to participate in gender, pregnancy, or caregiver discrimination or harassment; any
testimony or participation in any investigation, proceeding, lawsuit, or hearing, whether in
connection with this lawsuit or any other complaint of gender, pregnancy, or caregiver
discrimination or harassment; or any lawsuit, complaint or charge filed by you or on your
behalf with any government agency (e.g., Equal Employment Opportunity Commission)
alleging gender, pregnancy, or caregiver discrimination or harassment, whether in connection
with this lawsuit or any other complaint of gender, pregnancy, or caregiver discrimination or
harassment.
You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form.

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4. If you replied “Yes” to Question 3 do you believe that you were retaliated against for
complaining of or opposing gender, pregnancy or caregiver discrimination or harassment or for
participating in an investigation or a legal process concerning gender, pregnancy or caregiver
discrimination or harassment?

If “Yes,” please explain. Relevant information can include a description of the retaliation,
including the approximate date(s) of each occurrence; the date(s) of your complaint, opposition,
report, testimony, participation in an investigation or legal process, or refusal to participate in
gender, pregnancy, or caregiver discrimination; the manager(s) or employee(s) involved;
whether you complained about the retaliation and if it continued after your complaints; and any
specifics about the situation.

You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form.

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SECTION D
MEDICAL AND/OR PSYCHOLOGICAL EFFECTS (COMPENSATORY DAMAGES)
INSTRUCTIONS: Class Members who believe they experienced MEDICAL AND/OR
PSYCHOLOGICAL EFFECTS of discrimination, harassment, or retaliation related to gender and/or
pregnancy/caregiver status, please answer Questions 5-9.
Please only fill out this section if it applies to you. You must submit your Claim Form by [Insert date, which is
60 days after Final Approval Date] to be eligible for a monetary award.

NOTE:

All medical information will be kept strictly CONFIDENTIAL. It will not be
disclosed to Daiichi Sankyo. It will be reviewed by a Court approved Independent
Claim Expert to make determinations regarding your monetary award.
5. a.

Do you contend that you have experienced physical, emotional, or psychological effects
or damages as a result of discrimination or harassment based on gender, pregnancy, or
caregiver status?

5. b.

Do you contend that you have experienced physical, emotional, or psychological effects
or damages as a result of retaliation for opposing or complaining of gender, pregnancy, or
caregiver discrimination or harassment or for providing testimony or participating in an
investigation or legal process pertaining to gender and/or pregnancy/caregiver
discrimination or harassment?

5. c.

If you answered yes to either Questions 5a or 5b, describe the discrimination or
retaliation. If you have already described the discrimination, harassment or retaliation
in Sections A through C, please do NOT describe it again.

If you answered “No” to Question 5(a) or (b), please skip the remainder of this section.

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6. If you answered yes to Question 5(a) or 5(b), please describe your emotional distress
symptoms, e.g. stress, anxiety, depression, loss of sleep, etc.

You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form. All medical information will be kept strictly confidential.

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7. At any time from February 11, 2009 (for California Class Members) or September 12, 2010 (for
Non-California Class Members) through October 16, 2015, did you see a medical doctor,
medical practitioner, psychiatrist, psychologist or any other mental health professional because
of any physical, emotional or psychological effects you believe were caused by any conduct
you allege in this Claim Form as gender, pregnancy, or caregiver discrimination or harassment,
or retaliation?

If “Yes,” please explain. Relevant information can include the name(s) and address(es) of each
medical or mental health professional you have seen, the number of times you sought treatment,
the duration (time period) of any treatment, any diagnosis, and whether medication or any other
treatment regimen was prescribed.
You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form. All medical information will be kept strictly confidential.

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8. Have you suffered any short-term or long-term disability related to the physical, emotional or
psychological effects of any conduct you allege in this Claim Form as gender, pregnancy, or
caregiver discrimination or harassment or retaliation?

If “Yes,” please explain. Relevant information can include the diagnosis, the duration (time
period) of the disability, and the economic (lost wages) or non-economic harm of the disability.
You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form. All medical information will be kept strictly confidential.

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9. Have you incurred any monetary costs for any medical or psychological treatments or
prescriptions you sought as a result of the physical, emotional or psychological effects of any
conduct you allege in this Claim Form as gender, pregnancy, or caregiver discrimination or
harassment or retaliation?

If “Yes,” please explain. Relevant information can include the amount of cost(s) and what any
cost(s) was/were incurred for.
You may, but are not required to, provide supporting documentation. If you cannot provide all
relevant information on this page, please append any additional information that you deem
relevant to your Claim Form. All medical information will be kept strictly confidential.

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SECTION E
SWORN AFFIRMATION AND SIGNATURE
I, _____________________, DECLARE UNDER PENALTY OF PERJURY THAT THE
INFORMATION AND FACTS I HAVE STATED IN THIS CLAIM FORM ARE TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.
I understand that I must keep the Claims Administrator informed of my current address and of any
change in my home address. If I do not do so, I understand that I may not receive any award that I
might otherwise be entitled to receive.

Executed this ____ day of ________, 2016.

_____________________________________
Signature of Claimant

_____________________________________
Typed or Printed Name of Claimant

_____________________________________
Social Security Number of Claimant

WHEN YOU HAVE COMPLETED THIS CLAIM FORM, PUT IT IN THE SELF-ADDRESSED
STAMPED ENVELOPE PROVIDED (PLEASE PROVIDE ADEQUATE POSTAGE AS NECESSARY
DEPENDING ON THE AMOUNT OF DOCUMENTS YOU ARE SENDING) AND ENSURE THAT IT
IS POSTMARKED BY NO LATER THAN [Insert date, which is 60 days after Final Approval Date]:
WELLENS v. DAIICHI SANKYO, INC.
SETTLEMENT ADMINISTRATOR
C/O RUST CONSULTING INC - 4918
PO BOX 2396
FARIBAULT MN 55021-9096

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