WP E-Signature by Approve Me - Sign Documents Using WordPress -

Good-To-GoFood Claim and Release_6215

IN THE CIRCUIT COURT OF COOK COUNTYILLINOIS
COUNTY DEPARTMENT, CHANCERY DIVISION
Navarrete v. Josam Acquisitions d/b/a Good To Go Food, Case No.: 2019 CH 14368

IMPORTANT NOTICE

You are receiving this Claim Form because you may be eligible for a monetary recovery due to violation of the Illinois Biometric Information Privacy Act (“BIPA”) as a part of a class action settlement. If you were employed by Good To Go Food in Illinois and Good To Go Food has obtained hand-scan data for use with its timekeeping system from December 13, 2014, and November 18, 2024, you may be eligible to participate in the Settlement.

CLAIM AND RELEASE FORM

Claimant ID:

Name:

PART I: INSTRUCTIONS:

You must complete, sign and return this Claim Form in order to be eligible for a monetary recovery. Your Claim Form must be postmarked on or before April 15, 2025. If you move, it is your responsibility to update your contact information with the Claims Administrator HERE.

Returning this Claim Form does not ensure that you will share in the Settlement Proceeds. You will share in the proceeds only if (1) the Settlement receives final approval from the Court and (2) you meet requirements for recovery set forth in the Settlement Agreement, which is summarized in the Notice.

PART II: WAIVER AND RELEASE

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

January 27, 2025 8:00 am PDT

Good-To-GoFood Claim and Release_6215 Uploaded by Atticus Administration - esigndocs@atticusadmin.com IP 52.252.236.64