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INTHEUNITEDSTATESDISTRICTCOURT

FORTHEDISTRICTOFMINNESOTA

JohnFrederickDryer,etal.,

)
CivilActionNo.092182(PAM/AJB)

Plaintiffs,

)
REQUESTFOREXCLUSION

)
FROMSETTLEMENTCLASS
v.

)
NationalFootballLeague,

Defendant.

REQUESTFOREXCLUSIONFROMSETTLEMENTCLASS

PleasetakenoticethatI,__________________________,herebyrequesttobeexcludedfrom
theSettlementClassintheabovecaptionedaction.[Ifyouaretheestaterepresentativeforadeceased
NationalFootballLeague(NFL)and/orAmericanFootballLeague(AFL)player,pleaseprintthename
oftheplayerhere:___________________________________________].

Name:

________________________________________________

Address:

________________________________________________

________________________________________________

Phoneno.:

________________________________________________

Email:

________________________________________________

I(orthedeceasedNFL/AFLplayernamedabove)playedintheNFL)andorAFLfrom

_________to_________forthefollowingNFLand/orAFLteams:

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________.

Dated: ________________,2013

By:____________________________________

[Signature]

______________________________________

[Printname]

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