Sandoval et al v. AB Landscaping, Inc. et al

Filing 68

ORDER Certifying Tentative Settlement Class, Preliminarily Approving Proposed Settlement, Approving and Directing the Notice Plan, Appointing Class Counsel, and Appointing Settlement Officer 59 . (Attachments: # 1 Notice of Class Action Settlement and Settlement Hearing, # 2 Claim Form, # 3 Opt-in Form). Signed by Magistrate Judge Howard R. Lloyd on 9/14/11.(hrllc1, COURT STAFF) (Filed on 9/14/2011)

OPT-IN FORM
Sandoval, et al. v. AB Landscaping, Inc., et al.
Case No.: C09-04969 HRL
United States District Court for the Northern District of California
Date action filed: October 19, 2009
Records show that you are a member of the Class that comprises ALL EMPLOYEES OF AB
LANDSCAPING INC. OR VICTOR ARELLANO WHO WERE EMPLOYED ON AN
HOURLY BASIS BETWEEN OCTOBER 20, 2005 AND APRIL 1, 2011
(COLLECTIVELY, “CLASS MEMBERS”).
Records also show that you are owed unpaid wages you earned while working for AB
Landscaping Inc or Victor Arellano. As a result, pursuant to Fair Labor Standards Act (“FLSA”),
you may be entitled to liquidated damages.
If you want to receive money in settlement of your claims for liquidated damages under the
FLSA, you must submit this Opt-In Form. (The terms of the Settlement in the above-referenced
case will settle your liquidated damages claims under the FLSA only if you choose to opt in. You
are not required to settle your liquidated damages claims under the FLSA in order to participate
in the Settlement and receive wages or penalties under the California Labor Code).
To submit the attached Opt-In Form, you must complete and mail it to Class Counsel at the
following address no later than January 13, 2012:
Sandoval et al. v. AB Landscaping Inc., et al.
attn: Adam Wang
P.O. Box ______
San Jose, CA 95113
408-_______________
Note to claimant:
1.
You are responsible for income taxes on any recovery you receive.
2.
Return the attached form to the Claims Administrator, c/o Adam Wang, no later
than January 13, 2012. DO NOT WAIT UNTIL THE LAST MINUTE.

_______________________________________________________
OPT-IN
I, the undersigned, do hereby opt in to settle any liquidated damages due under Fair Labor
Standards Act per the Settlement in Sandoval, et al. v. AB Landscaping, Inc., et al. No. C0904969 HRL.
Name:
Address:
Home phone:
Work phone:
Social Security #:
I verify that I am the above named individual.
I declare, under penalty of perjury under the laws of the United States and the State of California,
that the information set forth above is true and correct.

(Print Name)

(Signature)

(Date)