Opt-Out Request | Apple Bag Checks Settlement

TO FILE AN OPT-OUT, THIS FORM MUST BE SUBMITTED BY APRIL 26, 2022

There are two types of Class Members, New Class Members and Existing Class Members. Only New Class Members are eligible to file an Exclusion (“Opt-Out”) Request Form.

Existing Class Members are all current and former non-exempt employees of Apple who worked at an Apple retail store in California between July 25, 2009 and August 10, 2015 who were previously provided notice of the action in 2015 and who did not opt out of the class.

New Class Members are all individuals who began working as a non-exempt employee at an Apple retail store in California between August 3, 2015 and December 26, 2015 and to whom a notice of class certification was not mailed in 2015.

If you received a Notice of Settlement through mail or email, your classification as either a New or Existing Class Member is indicated at the bottom of that Notice.

I. Claimant Information:

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Telephone Number *

Email Address *

Date of Birth *

II. Affirmation:

I do not wish to participate in the class action aspects of the settlement in the Amanda Frlekin, et al. v. Apple Inc. litigation, Case No. 13-cv-03451-WHA, and I request exclusion. I understand that by submitting this form I am giving up my right to receive money from the class action settlement.

Signature *

Date

*Required Fields

Amanda Frlekin, et al. v. Apple Inc.

Case No. 13-cv-03451-WHA

United States District Court for the Northern District of California

TO FILE AN OPT-OUT, THIS FORM MUST BE SUBMITTED BY APRIL 26, 2022

Your Opt Out Request has been submitted successfully.

First Name
Last Name
Street Address
City
State
Zip Code
Telephone Number
Email Address
Signature
Date