MANEY ET AL V. BROWN ET AL

CASE No. 6:20-cv-00570-SB

IN THE U.S. DISTRICT COURT FOR THE DISTRICT OF OREGON - EUGENE DIVISION

Exclusion Request Form – Damages Class


I. CLASS MEMBER INFORMATION
II. SIGNATURE

I wish to be excluded from the Class Action in Maney v. Brown, Case No. 6:20-cv-00570-SB. I understand that by submitting this form I am requesting exclusion from the case, and that if this case results in a settlement or damages award, I will not receive any benefits from this case.

*Required Fields

Your Exclusion Request has been submitted successfully.

You will receive momentarily an email confirmation with the information below.
You may also print this page for your records.

Your Exclusion Request Details

First Name
Last Name
Notice ID
SID #
Street Address
City
State
Zip Code
Telephone Number
Email Address
Signature
Date

If you have any questions regarding your Exclusion Request, please email us at Info@ODOCCovidClassAction.com