Perry v. AT&T Mobility LLC et al

Filing 96

ORDER by Judge GONZALEZ ROGERS granting 90 Motion for Preliminary Approval of Settlement (lrc, COURT STAFF) (Filed on 1/9/2013) (Additional attachment(s) added on 1/9/2013: # 1 Exhibit, # 2 Exhibit, # 3 Exhibit) (lrc, COURT STAFF).

Exhibit 2 to Order Granting
Preliminary Approval

IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF CALIFORNIA

SANDRA PERRY, ARMAKIA
MARINER-REED and PATRYCE
COUNTS, individuals, on behalf of
themselves, and on behalf of all persons
similarly situated; and JASON HILTON,
an individual,
Plaintiffs,

Case No. C 11-01488 YGR
REQUEST FOR EXCLUSION
Compl. Filed:
Courtroom:
Judge:

March 28, 2011
Courtroom 5
Hon. Yvonne
Gonzalez Rogers

v.
ARISE VIRTUAL SOLUTIONS INC., a
Delaware Corporation,
Defendant.

IF YOU DO NOT WANT TO BE INCLUDED IN THE CLASS ACTION SETTLEMENT:
COMPLETE THIS FORM IN ITS ENTIRETY, SIGN THE FORM, AND MAIL IT VIA FIRST
CLASS MAIL TO THE ADDRESS BELOW WITH A POSTMARK OF NO LATER THAN [DATE]
(45 DAYS AFTER THE CLASS NOTICE AND THIS FORM WAS MAILED).
Gilardi & Co., LLC
P.O. Box 8060
San Rafael, California, 94912-8060
[phone]

I hereby declare as follows:
(1) I received notice of the proposed Settlement in this action and on one or more occasions from
March 28, 2007 through to August 31, 2012, I provided customer service or technical support
services on applications for [AT&T Mobility LLC / Apple Inc.] accounts, while located in the State
of California, pursuant to Statements of Work with Arise Virtual Solutions Inc. (“Arise”).
(2) I wish to be excluded from the Settlement Class described in the Class Notice and I do not
want to participate in the proposed settlement described therein. I understand that I will NOT receive
a share of the proposed Settlement and return this form.

1
EXCLUSION FORM

Exhibit 2 to Order Granting
Preliminary Approval

I declare that the foregoing and the information provided below is true and correct.

Executed on ____________(date), 2013, at ____________________________ (city and state).

(Signature)

(Typed or Printed Name)

(Address)

(City, State, Zip Code)

(Telephone Number, Including Area Code)

2
EXCLUSION FORM