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  • Attention Former Eric C. Conn Clients: Here Is The Claim Form You Need To Fill Out

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    Lynnette Cooney
    5K visualizzazioni1 pagina
    All former Conn clients who were under scrutiny by the Social Security Administration have until April 6 to submit this form.

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    Attention former Eric C. Conn clients: Here is the claim form you need to fill out

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    All former Conn clients who were under scrutiny by the Social Security Administration have until April 6 to submit this form.

    Copyright:

    © All Rights Reserved
    Scarica in formato PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    5K visualizzazioni1 pagina

    Attention Former Eric C. Conn Clients: Here Is The Claim Form You Need To Fill Out

    Caricato da

    Lynnette Cooney
    All former Conn clients who were under scrutiny by the Social Security Administration have until April 6 to submit this form.

    Copyright:

    © All Rights Reserved
    Scarica in formato PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    di 1

    CLAIM FOR SHARE OF CLASS ACTION SETTLEMENT

    Cheryl Jeanne Martin, et al v. United States Fire Insurance Company


    Floyd Circuit Court, Div. I, 16-CI-00848

    Name: ____________________________________________________________

    Mailing Address: ______________________________


    ______________________________
    ______________________________
    ______________________________

    Date of Birth: ______________________________

    Phone Number: ______________________________

    Email: ____________________________________________________________

    State what your current status of Social Security Benefits is:


    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________

    Describe how you are adversely affected by the actions of Eric Conn and the Social
    Security Administration that entitles you to a share of the class action settlement:
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________
    ______________________________________________________________________________

    Please submit this form via mail to Hon. Ned Pillersdorf, 124 West Court Street, Prestonsburg,
    Kentucky 41653; or via hand delivery to Pillersdorf, DeRossett & Lane; or via Fax, 606-886-
    6148 or online at connclassaction.com.

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