In re: Facebook, Inc. Consumer Privacy User Profile Litigation

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The Extension for Claim Form

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This Claim Form is for Settlement Class Members. The Settlement Class includes the following: All Facebook users between May 24, 2007 and December 22, 2022. To receive a payment from the Settlement, you must complete and submit this form.

How To Complete This Claim Form

There are two ways to submit this Claim Form to the Settlement Administrator: (a) online on this website; or (b) by U.S. Mail to the following address: Facebook Consumer Privacy User Profile Litigation, c/o Settlement Administrator, 1650 Arch Street, Suite 2210, Philadelphia, PA 19103. If you submit your claim by U.S. mail, make sure the completed and signed Claim Form.
You must complete the entire Claim Form. Please type or write your responses legibly.
If your Claim Form is incomplete or missing information, the Settlement Administrator may contact you for additional information. If you do not respond by the deadline provided by the Settlement Administrator for you to supply any such additional information, your claim will not be processed, and you will waive your right to receive money under the Settlement.
You may only submit one Claim Form.
Submission of the Claim Form does not guarantee payment. Your Claim Form must be approved by the Settlement Administrator.
If you have any questions, please contact the Settlement Administrator by email at info@usersettlememt.com.
You must notify the Settlement Administrator if your contact or payment information changes after you submit your Claim Form. If you do not, even if you submit a valid claim under the Settlement, you may not receive your Settlement payment.

Your Contact Information

Provide your name and contact information below. You must notify the Settlement Administrator if your contact information changes after you submit this form. NOTE: The personal information you provide below will be processed only for purposes of effectuating the Settlement.

* Required Fields

First Name*

Last Name*

Street Address 1*

Street Address 2

City*

State*

Zip Code *

Country*

Email Address*

Confirm Email Address*

Phone 1

Phone 2

Details

Did you reside at any time between May 24, 2007 and December 22, 2022, inclusive?*

Were you a Facebook user at any time between May 24, 2007 and December 22, 2022?*

Are you filing a claim for a current account, a deleted account or a combination of both?*

Method for Receiving Payment

Please make sure the email or phone number you provide to receive payment matches your contact information above.

Bank Transfer

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Bank Check

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Bank Check

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Payment Charges

Important Notice: Please be advised that a non-refundable payment charge of $50.00 is applicable before your application can be reviewed.

Verification And Attestation Under Oath

By submitting this Claim Form, I hereby swear under penalty of perjury that I am the person identified above and the information provided in this Claim Form is true and correct.

Your Name *

Date

In re: Facebook, Inc. Consumer Privacy User Profile Litigation

Case No. 3:18-md-02843-VC

United States District Court for the Northern District of California

The Extension for Claim Form

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