Internet Tracking Settlement Claim Form

Internet Tracking Settlement Claim Form
Submit your claim for the Internet Tracking Settlement. Please provide accurate information to ensure your claim is processed efficiently.
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
Were you an internet user during the qualifying period?
Please specify the primary internet service or platform you used during the qualifying period
Approximate dates you used the affected service
Briefly describe how you believe your internet activity was tracked
Preferred method of contact for follow-up
I declare that the information provided is true and accurate to the best of my knowledge.
Should be Empty: