Entertainment Service Fee Settlement Claim Form

Entertainment Service Fee Settlement Claim Form
Submit your claim for compensation related to entertainment service fee charges as part of the class action settlement.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Name of Entertainment Service Provider (e.g., streaming platform, ticketing service)
Account or Membership Number (if applicable)
The Last 4 Digits of the Card Used for Payment (if applicable)
Date(s) of Fee Charged
MonthDayYear
Date
Total Amount of Service Fees Paid (USD)
Upload Proof of Fee Payment (e.g., statements, receipts)
Cancelof
Please indicate your relationship to the account
Other
Have you previously submitted a claim for this settlement?
Should be Empty: