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Numi Release Card Settlement Claim Form
Claims must be submitted by November 19, 2024

Did You Receive a Claim Number? 

If you received a postcard regarding this settlement, there should be a "Reference Number" on the top left of the front of the card. If you did not receive a postcard with a claim number do not enter anything and go to Step One below. Entering this code will help us process your claim faster. Enter the letters and the numbers into the box below:

 

To submit a claim follow the steps below. After you provide the requested information, you will be asked to verify that the information you submit is correct and then may click on the "Submit" button to submit your claim. Items with an asterisk(*) must be filled out. If you need assistance send an email to NumiReleaseCard@sylaw.com.

 

Step One: Your Name. 

Provide your first name and last name in the boxes below. 

Did you receive a release card under a different name than the one you are currently using? If so, enter the enter the prior name under which you received release cards. If you received release cards under additional names, or you are filing a claim on behalf of an estate, do not complete this claim form and contact us at releasecard@sylaw.com. If you received release cards only under your current name, go to Step Two.

Step Two: Personal Information

Please provide your date of birth and telephone number in the boxes below. The date of birth is required. A telephone number is not required to submit a claim, but this information is helpful if we have questions regarding your claim.

Why do we want your date of birth?

This information is included in records provided to us by Defendants that link their release cards to specific persons, which helps verify your claim and the amounts that should be paid.  

Step Three: Addresses.

Enter your email address and your current mailing address in the boxes below. Email is the best method for contacting us and providing information to you. A mailing address is necessary to provide payment by check.  

Step Four: Where You Received Release Cards. 

Select the facilities where you received release cards that are eligible for compensation in this lawsuit. This form allows up to four facilities to be identified. If you received more than one release card from a facility, you only need to list that facility once. If you received release cards from more than four facilities that are eligible for compensation, send an email to NumiReleaseCard@sylaw.com with the names of the additional facilities. Click the "Site" button to select a state and then click on "Select Facility" to choose a facility from that state.

Your claim could not be submitted because you did not fill out all of the required boxes on the claim. Fill in the missing information and try submitting your claim again. If you are still having trouble, contact us at NumiReleaseCard@sylaw.com

Step Five: Verify and Submit Claim. 

Enter your name below to verify that the information you are providing in support of your claim is true and accurate. After completing the verification click the "submit" button and your claim will be submitted. You should receive an acknowledgment on the screen that your claim has been submitted. If you receive an error message, check to make sure that all the required fields have been filled in. Click NumiReleaseCard@syaw.com to contact us if you still are unable to submit your claim.

 

declares under penalty of perjury under the laws of the State of Oregon that I am the person identified in this claim and that the information provided in this claim is true and accurate.

:

Your claim has been submitted!

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