In Re: Hanna Andersson and Salesforce.com Data Breach Litigation

Case No. 3:20-cv-00812-EMC

United States District Court, Northern District of California

If you received a personalized notice in the mail or via email with a Notice ID and Confirmation Code, please enter the codes you were provided below.

Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. 12345678).

OR

If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

SETTLEMENT CLAIM FORM

You may receive a payment if you properly and timely complete this Claim Form, the Settlement is approved, and you are found to be eligible for a payment.

The Class Notice describes your legal rights and options. You can obtain the Class Notice and further information about the Litigation, the Settlement Agreement, and your legal rights and options by visiting the Important Documents page or by calling (833) 378-3381.

Your claim must be submitted online or postmarked by April 28, 2021 to be considered for payment. You can submit your claim for a settlement award in two ways:

  1. Online by following instructions on this page.
  2. By mail to the Claims Administrator at this address: Hanna Settlement, Claims Administrator, 1650 Arch Street, Suite 2210 Philadelphia, PA 19103.

Only one Settlement Claim may be submitted per Settlement Class Member, and only one Settlement Claim may be submitted per purchase at the Hanna website.

1. CLASS MEMBER INFORMATION (REQUIRED)

Required: Attach a receipt, bank or credit card statement, or other proof of purchase showing your purchase from the Hanna website. (Please redact all unrelated transactions).

Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

File List: No Files Selected

    [OR] If such documents are not available, complete all parts of this section:

    2. PAYMENT ELIGIBILITY INFORMATION (REQUIRED)

    To prepare for this section of the Claim Form, please review the Class Notice and Sections 2.1 through 2.4 of the Settlement Agreement for more information on the types of awards available and rules for receiving an award.

    Settlement Class Members may receive only one of the following types of awards: (1) Basic Award; or (2) Reimbursement Award. Which type of award are you making a claim for (check one)?

    OR

    3. ADDITIONAL INFORMATION REQUIRED FROM SETTLEMENT CLASS MEMBERS SEEKING A REIMBURSEMENT AWARD.

    You must complete this Section 3 if you are seeking a Reimbursement Award. Please provide as much information as possible.

    Examples: Fraudulent charges that were made on your credit or debit card account and that were not reversed or repaid even though you reported them to your bank or credit card company.

    Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

    File List: No Files Selected

      OR


      I spent this much time (round to the nearest hour and check only one box):

      Examples: You spent at least one full hour calling customer service lines, writing letters or emails, or on the internet trying to get unauthorized charges reversed or reimbursed. Please note that the time it takes to fill out this Claim Form is not reimbursable and should not be included in the total number of hours claimed.


      If you are also seeking reimbursement for Out-of-Pocket Expenses as part of your claim for a Reimbursement Award, complete Section 4. Otherwise, go to Section 6.

      4. ADDITIONAL INFORMATION REQUIRED FROM SETTLEMENT CLASS MEMBERS SEEKING REIMBURSEMENT FOR OUT-OF-POCKET EXPENSES IN CONNECTION WITH A REIMBURSEMENT AWARD.

      Are you seeking Reimbursement of Out-of-Pocket Expenses?

      Check all that apply, stating the total amount you are claiming for each category and attaching documentation of the charges as described below. Round total amounts to the nearest dollar.

      Examples: Overdraft fees, over-limit fees, late fees, charges due to insufficient funds or interest, card reissuance fees.

      Required: A copy of a bank or credit card statement or other proof of claimed fees or charges (you may redact unrelated transactions).

      Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

      File List: No Files Selected

        Examples: Long distance or cell phone charges (if charged by the minute), or data charges (if charged based on the amount of data used).

        Required: A copy of the bill from your telephone company, cell phone company, or internet service provider showing the claimed charges.

        Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

        File List: No Files Selected

          Examples: The cost of purchasing a credit report or placing a credit freeze.

          Required: A copy of a receipt of other proof of purchase for each credit report or credit freeze purchased or placed.

          Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

          File List: No Files Selected

            Examples: Postage for correspondence with your bank or credit card company about unauthorized charges. The cost of submitting this form is not included.

            Required: A copy of any receipt or proof of purchase for all postage costs claimed showing date, amount and vendor.

            Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

            File List: No Files Selected

              5. PAYMENT METHOD

              Please select the manner in which payment will be issued for your valid Claims.

              6. CERTIFICATION

              I declare under penalty of perjury under the laws of the United States and the state where this Claim Form is signed that the information I have supplied in this Claim Form is true and correct to the best of my recollection, and that this form was executed on the date set forth below.

              I understand that all information provided on this Claim Form is subject to verification and that I may be asked to provide supplemental information by the Claims Administrator or Claims Referee before my claim will be considered complete and valid.

              Your Claim Form has been submitted successfully.

              HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: info@HannaSettlement.com.

              Please print this page for your records.

              Your Claim Details

              Submitted Claim ID:
              Confirmation Code:
              You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
              CLAIM INFORMATION
              First Name
              MI
              Last Name
              Street Address
              City
              State
              Zip Code
              Phone
              Email
              Signature
              Date

              If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at info@HannaSettlement.com

              Click here to edit your Claim.