Anwar et al v. Fairfield Greenwich Limited et al

Filing 1344

DECLARATION of Jason Rabe in Support of Entry of An Order for Distribution of the Fairfield Greenwich Net Settlement Fund in Support. Document filed by Pacific West Health Medical Center, Inc. Employee's Retirement Trust. (Attachments: #1 Exhibit A, #2 Exhibit B, #3 Exhibit C, #4 Exhibit D, #5 E)(Finkel, Robert)

EXHIBIT A

FAIRFIELD GREENWICH SECURITIES LITIGATION
C/O RUST CONSULTING, INC.
CLAIMS ADMINISTRATOR
P.O. BOX 2874
FARIBAULT, MN 55021-8674

Month Day, Year
RESPONSE DUE DATE: Month Day, Year
NAME1
NAME2
NAME3
ADDRESS1
ADDRESS2
CITY, STATE ZIP
COUNTRY
Claim No: «clm_no» - Account # «xref»

Re:
NOTICE OF REJECTION AND INSTRUCTIONS TO CURE–
FAILURE TO SUBMIT DOCUMENTATION FOR CLAIM OR DOCUMENTATION
PROVIDED INADEQUATE
Dear Claimant:
We received the Proof of Claim and Release form (“Claim”) that you filed, or that was filed on your behalf, in
connection with the Settlement with the Fairfield Defendants dated November 6, 2012 (the “Fairfield Settlement”)
in Pasha S. Anwar, et al. v. Fairfield Greenwich Limited, et al. (Civil Action No. 09‐cv‐118). This Notice is to
advise you of the REJECTION of your Claim and to ADVISE YOU OF THE ACTION YOU NEED TO TAKE to
cure the deficiency outlined in this Notice. Please note that the RESPONSE DUE DATE to submit a response to
this Notice is [Month, Day, Year].
DEFICIENCY:
The Claim you submitted is rejected because of your failure to submit any documentation to support your Claim or
because the documentation that was provided is inadequate.
ACTION REQUIRED:
You must submit acceptable documentation by the Response Due Date
Examples of ACCEPTABLE DOCUMENTATON include: copies of securities broker’s confirmation slips, month
or year-end account statement(s), a letter from your broker on company letterhead setting forth each transaction or
retention of the eligible securities. Please note the documentation must include the name of the beneficial owner,
the name of the institution that executed the trade(s) or held the securities, along with all trade details (including the
security traded, trade date, quantity/par, price and net amount of the entire transaction prior to any commissions,
taxes or fees applied to the trade).
CONSEQUENCES OF FAILURE TO CURE:
If your response is not received by the Response Due Date, or if you respond without acceptable
documentation, your claim will remain REJECTED in its entirety.
PLEASE NOTE that we have reviewed and considered all of the documents that have been submitted with the
Claim. Because this documentation has been deemed inadequate, we request that you provide additional documents,
but PLEASE DO NOT RE-SUBMIT THE SAME DOCUMENTATION PROVIDED WHEN YOU FILED YOUR
ORIGINAL CLAIM.
If you have any questions, please call us at 1-855-263-3450 or 1-612-359-7949. You may receive additional letters
if other issues are identified in this Claim.
Sincerely yours,
Claims Administrator

*adoc*

*FAIR*