Bracamontes & Vlasak, P.C.
220 Montgomery Street
Suite 870
San Francisco, CA 94104
Phone: 415.835.6777
San Francisco Personal Injury
Subject to certain exclusions, you may submit a claim for a Settlement Payment if:
To register/submit a claim for a Settlement Payment, you must either:
Michael R. Bracamontes
Bracamontes & Vlasak, P.C.
220 Montgomery Street, Suite 870
San Francisco, California 94104
Phone: (415) 835-6777
Fax: (415) 835-6780
Website: www.bvlawsf.com
Email: info@bvlawsf.com
DEADLINE FOR MAKING A CLAIM: In order for your claim to be considered, it must be received by Class Counsel and postmarked no later than October 30, 2019. Any claims received or postmarked later than October 30, 2019 will be untimely and invalid and will not be considered. Important: If your Claim is rejected for any reason, you will be notified and given an opportunity to address any deficiencies.
ALL information must be completed and DOCUMENTATION concerning your stay must be provided.
Please also provide some documentation that you stayed at the Modesto Inn during the above dates. Acceptable documentation includes, but is not limited to, receipts, bank statements, credit card statements, money order receipts, notarized declarations from two witnesses that are not also members of the Class or Sub-class that you stayed at the Modesto Inn during said time period.
If you cannot provide any documentation, your claim will be denied.
You may contact Class Counsel at Bracamontes & Vlasak, P.C. with any additional questions concerning your claim.
Affirmation: By filling out the claim form, I hereby affirm, under penalty of perjury, that I stayed at the Modesto Inn for 30 consecutive days or more between May 23, 2008 through September 14, 2012 (the “Class “) or stayed at the Modesto Inn from June 23, 2012 through September 14, 2012 (the “Sub-class “).
The information I have provided in this Claim Form is true and correct to the best of my knowledge and this is the only Modesto Inn Claim Form that I have submitted. I further understand, acknowledge, and agree that I am eligible to receive only ONE payment from this Settlement based on my stay. I further understand, acknowledge, and agree that the amount I will receive shall be calculated according to the terms of the Settlement Agreement and subject to the terms of the Settlement Agreement, including the release of all known and unknown claims.
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