T-Mobile Consent Form CA

CONSENT TO JOIN SETTLEMENT AS A PLAINTIFF, RELEASE, AND CLAIM FORM
[MEMBERS OF (I) TRAINING AND CALIFORNIA COVID COLLECTIVES OR (II) CALIFORNIA COVID COLLECTIVE ONLY]

TO RECEIVE MONEY FROM THIS SETTLEMENT IN EXCHANGE FOR YOUR RELEASE OF CLAIMS, YOU MUST COMPLETE AND SUBMIT THIS FORM BY DECEMBER 30, 2024

Walker et al. v. T-Mobile USA, Inc.,
Case No. 50-2024-CA-007377-XXXA-MB, Circuit Court in the Fifteenth Judicial Circuit
Palm Beach County, Florida

To receive your settlement payment, become a party to the case, and release your right to sue for the settled claims, you must complete, sign, and return this Claim Form by mail, fax, online or by email to:

SMB Account Settlement
c/o Atticus Administration
PO Box 64053
St. Paul, MN 55164

Email: SMBAccountSettlement@atticusadmin.com
Fax No:1-888-326-6411

Your Claim Form must be submitted by December 30, 2024.

If you participate in the Settlement, you will receive an estimated settlement payment (listed below), which is based on an allocation for your initial Account Executive training period and/or the number of weeks you worked as an SMB Account Executive during certain periods of the Covid-19 pandemic as set forth below. In exchange, you will be releasing T-Mobile from all wage and hour and related claims for those time frame(s).

RELEASE OF YOUR CLAIMS

By signing and timely submitting this Claim Form, you agree to be bound by the terms of the Settlement and release T-Mobile USA, Inc. and Released Parties as defined in the Notice of Settlement for any time during the period between March 1, 2021 through February 27, 2024, while you worked and/or trained as an SMB Account Executive for T-Mobile USA, Inc., of and from: any and all state, local, and federal Wage and Hour Claims, which shall include, without limitation, all federal, state, and local claims, demands, liabilities, primary rights, and causes of action relating to any alleged failure to pay any type of straight time, minimum wages, and/or overtime wages, payment for all hours worked, spread of hours, meal and/or rest breaks, keeping records of hours worked or compensation due, timing and method of payments, or any other wages under any federal, state, or local law or regulation or common law, whether known or unknown, all claims for penalties, and liquidated damages, punitive damages, interest, attorneys’ fees, paralegals’ fees, experts’ fees, litigation expenses, restitution, equitable relief, and any other available relief based on the wage and hour claims listed above. If you were based in California during the settlement period, you further acknowledge that you understand and waive the provisions of California Civil Code Section 1542 with regards to these released claims that “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.”

CONSENT TO JOIN AGREEMENT TO BE BOUND BY RELEASE:

I hereby consent, agree, and opt-in to be a party Plaintiff in the above-captioned collective action. I further agree to be bound by the collective action settlement and release approved by the Court as contained in the Settlement Agreement. I hereby designate the Shavitz Law Group, P.A. to represent me in this action. I understand that by filing this consent, I will be bound by the judgment of the Court on all issues in this case.

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Note: Your address and other identifying information will be kept confidential and will not be filed with the Court.

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CHANGE OF ADDRESS: If you change your address, please inform the Settlement Administrator of your new address to ensure processing of your claim. It is your responsibility to keep a current address on file with the Settlement Administrator. Please contact the Settlement Administrator at the address, phone number or e-mail address listed above.

CLAIMS FORMS SUBMITTED AFTER DECEMBER 30, 2024 WILL BE REJECTED.

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