Mabry TCPA Settlement

Only use this Form if you want to request exclusion from the proposed settlement class.

Section I - Instructions

This form must be received by the Settlement Administrator no later than February 13, 2023. If this form is not submitted by this date, you will remain a member of the Settlement Class.

Opting out of the Settlement Class is not the same as objecting to the Settlement Agreement.
If you request exclusion from the Settlement Class prior to February 13, 2023, you will not be bound by the terms of the Settlement Agreement and therefore cannot argue that the Settlement Agreement should not be approved. You can get more information about objecting to the Settlement in the Notice and Settlement Agreement.

Section II - Settlement Class Member Information

Claimant Name: *

Claimant Telephone Number : *

* Your claimant telephone number was the number you were called on. If you do not have your claimant telephone number, call or email the Settlement Administrator for assistance at 1-877-307-7871 or info@MabryTCPASettlement.com.

Current Contact Information

Street Address: *

City: *

State: *

Zip Code: *

Email:

Preferred Phone Number:

Your contact information will be used by the Settlement Administrator to contact you, if necessary, about your request for exclusion. Provision of your phone number is optional.

Section III – Attestation, Opt-Out Request, Signature, and Submit

Through the submission of this form, I attest under the penalty of perjury that I have received notice of the class action Settlement in this case and I am a member of the class of persons described in the notice. I further attest that I request exclusion from the Settlement Class in Johansen v. Eric Mabry, et. al., S.D. Oh. Case No. 2:21-cv-36. By signing below, I agree to the submission of this Opt-Out Form.

IF SUBMITTED ELECTRONICALLY:

Checking this box constitutes my electronic signature and election to opt out of the Settlement on behalf of myself.

Your Signature: *